Rabies is one of the oldest known zoonotic diseases and remains an important public health concern in many parts of the world. The disease is almost entirely preventable if appropriate measures are taken before symptoms develop. However, once clinical symptoms appear, rabies is virtually 100% fatal. Understanding how rabies is transmitted is therefore an important step in preventing the disease.

What Is Rabies?

Rabies is a vaccine-preventable viral zoonotic disease that primarily affects the central nervous system of mammals, including humans.

Rabies virus belongs to the genus Lyssavirus within the family Rhabdoviridae. After entering the human body, the virus can invade peripheral nerves and gradually travel toward the central nervous system. Once it reaches the brain and spinal cord, it causes progressive neurological disease that is ultimately fatal.

According to the World Health Organization (WHO), rabies remains a major public health problem, particularly in Asia and Africa. Globally, dogs are responsible for up to approximately 99% of human rabies cases.

How Is Rabies Transmitted?

Rabies virus is primarily transmitted through the saliva of an infected animal.

The most common route of transmission is a bite from an infected animal that breaks the skin, allowing virus-containing saliva to enter the body.

However, bites are not the only possible route of exposure.

Transmission may also occur when the saliva of an infected animal comes into contact with:

• scratches or other breaks in the skin;
• open wounds; or
• mucous membranes, such as the eyes or mouth.

Therefore, any bite, scratch, or other contact in which saliva from a potentially rabid animal reaches broken skin or a mucous membrane should be promptly assessed by a healthcare professional for possible rabies exposure.

Which Animals Can Transmit Rabies?

Rabies can infect a wide range of mammals, including both domestic and wild animals.

Globally, dogs are the most important source of human rabies infection. WHO states that approximately 99% of human rabies cases are associated with bites or scratches from infected dogs, particularly in countries where dog-mediated rabies remains endemic.

Other mammals that may become infected with and transmit rabies include:

• bats;
• foxes;
• raccoons;
• skunks;
• jackals;
• mongooses;
• cats; and
• livestock.

The relative importance of different animal species varies by geographical region. For example, wildlife, particularly bats, represents an important source of rabies exposure in parts of the Americas, while dogs remain the leading source of human rabies deaths worldwide.

What Happens After the Virus Enters the Body?

Following exposure, rabies virus typically enters peripheral nerves near the site of exposure and then travels along the nerves toward the brain and spinal cord.

This process helps explain why rabies has an incubation period during which an infected person may have no apparent symptoms.

According to WHO, the incubation period is typically around two to three months, although it can range from approximately one week to one year, depending on factors such as the site of virus entry and the amount of virus introduced.

Once the virus reaches the central nervous system, it causes progressive inflammation of the brain and spinal cord. The virus may then spread along nerves to other tissues, including the salivary glands.

Can Rabies Be Transmitted from Person to Person?

Direct person-to-person transmission of rabies through ordinary contact has not been documented.

Very rare cases of rabies transmission have occurred through transplantation of infected organs or tissues. These exceptional events are fundamentally different from the usual pattern of rabies transmission, which occurs from infected animals to humans.

Routine social contact with a person who has rabies, such as being in the same room or casual touching, is not considered a typical route of rabies transmission.

Why Is It Important to Recognize Rabies Exposure?

One of the most important characteristics of rabies is that the disease can still be prevented after exposure to the virus, provided appropriate post-exposure prophylaxis is initiated before clinical symptoms develop.

WHO recommends immediately washing a potentially contaminated wound thoroughly with soap and water for at least 15 minutes and seeking prompt medical assessment.

Depending on the type and severity of exposure, post-exposure prophylaxis may include rabies vaccination and, when indicated, rabies immunoglobulin or rabies monoclonal antibodies.

The key message is clear:

Rabies exposure requires prompt medical attention, but rabies is preventable when appropriate measures are taken in time.

Rabies Prevention Requires a One Health Approach

Preventing human rabies involves more than providing treatment after exposure.

Because dogs are responsible for the vast majority of human rabies transmission worldwide, controlling rabies at its animal source is essential.

WHO and its global partners promote a One Health approach that integrates mass dog vaccination, dog-bite prevention, public education, disease surveillance, improved access to post-exposure prophylaxis, and collaboration between human and animal health sectors.

The global goal is to achieve zero human deaths from dog-mediated rabies by 2030.