Question 1

What is rabies?

Accepted Answer

Rabies is a viral zoonotic disease caused by rabies virus — a neurotropic lyssavirus — transmitted primarily through the saliva of infected animals via bites or scratches. Once the virus reaches the brain, it causes fatal encephalitis (inflammation of the brain). The incubation period is typically 1-3 months (but can range from days to years). Once neurological symptoms appear, rabies is almost invariably fatal.

Question 2

How many people die from rabies?

Accepted Answer

Approximately 59,000 people die from rabies every year — one person every nine minutes — predominantly in rural Africa and Asia. 99% of cases are from dog bites. 40% of victims are children under 15, who are more likely to be bitten and less likely to report bites to caregivers. The true burden is significantly underestimated due to poor surveillance in affected regions.

Question 3

What should you do after a dog bite?

Accepted Answer

Immediate wound washing with soap and water for 15 minutes under running water is the single most important first step — it significantly reduces viral load and infection risk. Seek medical care immediately for assessment: category III bites (deep bites, scratches, mucous membrane exposure) require full PEP — wound washing + rabies vaccine series + rabies immunoglobulin (RIG). Do not suture the wound immediately. Even if the biting animal appears healthy, the WHO recommends PEP for high-risk bites.

Question 4

What is post-exposure prophylaxis (PEP)?

Accepted Answer

PEP involves: immediate wound washing (soap and water, 15 minutes); rabies vaccine series (4-5 doses over 14-28 days, or reduced intradermal protocols); and rabies immunoglobulin (RIG) infiltrated into the wound and given systemically (for category III bites). PEP is nearly 100% effective when started before symptom onset. Access to PEP — particularly RIG — is severely inadequate in many African and Asian countries, resulting in preventable deaths.

Question 5

What is the Zero by 30 strategy?

Accepted Answer

Zero by 30 is the WHO/FAO/WOAH/GARC commitment to eliminate human deaths from dog-mediated rabies by 2030. Its primary tool is mass dog vaccination — vaccinating 70% of dogs in an area interrupts canine rabies transmission and eliminates the source of human exposure. Supporting strategies include: improved PEP access; surveillance and reporting; responsible dog ownership; and community education. Dog vaccination is more cost-effective than providing human PEP indefinitely.

Question 6

Is rabies present in Europe?

Accepted Answer

Classical canine rabies has been eliminated from Western and most of Eastern Europe through dog vaccination programmes. However, wildlife rabies (from foxes, bats) persists in parts of Eastern Europe, including the former Soviet states. Oral fox vaccination (baiting) has progressively eliminated fox rabies westward. Bats can carry lyssaviruses throughout Europe — bat bites should always prompt PEP assessment. Georgia has made progress in dog rabies control but challenges remain.

Question 7

Why does rabies kill so many children?

Accepted Answer

Children under 15 account for approximately 40% of rabies deaths — disproportionately, because: children are shorter and more likely to be bitten on the face or head (worst prognosis); children are more likely to play with unfamiliar animals; children may not report bites due to fear of punishment; and caregivers may not recognise the severity or know to seek PEP. School-based education about animal safety and bite reporting is a critical preventive measure.

Question 8

What animals carry rabies?

Accepted Answer

Dogs cause 99% of human rabies deaths globally. Other significant vectors include foxes (Europe), raccoons and skunks (North America), jackals (Africa), mongooses and wolves (Asia/Africa). Bats are the reservoir for many lyssavirus species globally — including classical rabies virus. All mammals can theoretically be infected, but cats, cattle and horses are occasional sources. Wild carnivore bites in endemic areas should always prompt PEP assessment.

Question 9

Can rabies survive as long as the patient does?

Accepted Answer

There are extremely rare documented cases (fewer than 20 globally) of survival after symptomatic rabies — most following the "Milwaukee Protocol" (induced coma). However, the outcomes are rarely full recovery; most survivors have severe neurological sequelae. For practical purposes, once encephalitic rabies symptoms appear, the disease is fatal. This is why preventing symptom onset through PEP is the only effective strategy.

Question 10

How does dog vaccination stop human rabies?

Accepted Answer

When 70% or more of dogs in an area are vaccinated, the virus can no longer sustain transmission through the dog population — creating herd immunity in dogs. Since 99% of human rabies comes from dogs, eliminating canine rabies essentially eliminates human rabies. Mass dog vaccination campaigns — as implemented across Latin America — have successfully eliminated dog-mediated rabies from the Americas. The same approach can work globally.

Question 11

What is Georgia's rabies situation?

Accepted Answer

Georgia has endemic rabies in dogs and wildlife — dog bites are a significant public health concern, particularly in rural areas. PHIG supports rabies surveillance and PEP access programmes. The Georgian Medical Journal has covered rabies epidemiology and dog bite management. Georgia is working toward the Zero by 30 target through dog vaccination campaigns and improved PEP availability.

Question 12

How does GMJ News cover rabies?

Accepted Answer

GMJ News tracks WHO Zero by 30 progress, dog vaccination campaigns, PEP access equity and rabies elimination milestones. Rabies is a direct public health concern in Georgia, making this hub particularly relevant to PHIG's mandate and the Georgian Medical Journal's regional coverage.

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