Rabies is a deadly disease and endemic in over 100 countries. It causes around 59,000 human deaths annually, the vast majority in Asia and Africa. There are safe and effective human vaccines for pre- and post-exposure prophylaxis. With a prompt and proper post-exposure prophylaxis (PEP), exposed people have a survival rate close to 100%.
On the occasion of World Rabies Day on 28 September, Eurosurveillance has published a rabies-focused issue.
In Prevention of human rabies: a challenge for the European Union and the European Economic Area (EU/EEA),Gossner et al. highlighted that for the majority of European Union/European Economic Area (EU/EEA) countries, rabies has become a disease affecting travellers who are bitten or scratched by dogs or cats in countries with uncontrolled rabies. Between 2006 and 2019, 18 travel-related fatal cases of rabies were detected in this region. None had received pre-exposure prophylaxis (PrEP), which demonstrates a lack of awareness among EU/EEA travellers regarding the risk of rabies in enzootic countries.
In Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation, Suijkerbuijk et al. concluded that the change in rabies pre- and post-exposure prophylaxis according to updated World Health Organisation (WHO) recommendations in 2018, reduced total costs and that recommendations can positively influence uptake of pre-exposure vaccination (PrEP). However, overall PrEP remained a costly intervention. A third article by Scheuer et al., Abandon of intramuscular administration of rabies immunoglobulin for post-exposure prophylaxis in the revised guidelines in the Netherlands in 2018: cost and volume savings, assessed the impact of the simplification of vaccination schedules and the use of rabies immunoglobulin as per the 2018 WHO recommendations in the Netherlands. The authors found that since implementing the revised policy infiltrating immunoglobulin only locally saved large quantities of human immunoglobulin making full PEP where needed, more affordable and accessible. They highlight the relevance of these findings for settings where rabies virus is endemic and point out the potential contribution towards the goal of zero human rabies deaths by 2030 worldwide.