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INTRODUCTION

Rabies is an acute progressive viral infection of the central nervous system that has affected animals and humans for millennia. The etiological agents of rabies are bullet-shaped RNA viruses in the genus Lyssavirus, family Rhabdoviridae. Currently, 16 species are recognized members of the Lyssavirus genus (Table 140-1).1 Human rabies cases have been attributed to six different species, but rabies lyssavirus remains the leading cause of rabies globally. While most warm-blooded vertebrates have been shown to be susceptible to infection under experimental conditions,2,3 mammals are the hosts responsible for maintaining the virus in nature. Specifically, species in the orders Carnivora and Chiroptera act as primary reservoirs.4 Globally, the domestic dog is the primary reservoir and the species most associated with infection in humans.5 However, multiple wildlife species have also been identified as reservoirs of specific rabies virus variants and various bat species as reservoirs of different Lyssavirus species. Human rabies cases are an incidental consequence of interaction with rabid animals.

TABLE 140-1LYSSAVIRUS SPECIES

DISTRIBUTION AND EPIDEMIOLOGY

Rabies is globally distributed, with the exception of Antarctica and some islands (mostly Pacific Islands).6 Some countries such as those in Western Europe have been successful at eliminating rabies in both domestic dogs and wildlife [e.g., Arctic foxes (Vulpes lagopus)] populations through vaccination campaigns. While domestic dogs were targeted using historical vaccination methods (i.e., parenteral vaccines), foxes were successfully vaccinated through oral rabies vaccination campaigns.7–9 While Lyssaviruses are present in European bat populations, rabies lyssavirus is not present in bats outside the Western hemisphere.10

In the United States and Canada, rabies virus was eliminated from domestic dogs through increased vaccination coverage ...

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