Rabies, a One Health imperative
Rabies presents a paradox: it is one of the world’s deadliest infectious diseases once symptoms appear, yet it is also one of the most preventable. Despite decades of progress and the availability of effective vaccines, rabies continues to claim nearly 60,000 lives every year.
Recent detections of rabies in parts of Central Europe serve as an important reminder that disease elimination is not a permanent achievement. Even where significant progress has been made, maintaining freedom from rabies requires ongoing vigilance, robust surveillance and sustained investment in prevention. As animal and human populations become increasingly interconnected across borders, protecting these gains remains a shared responsibility.
Rabies is also one of the clearest examples of why a One Health approach matters. The disease sits at the intersection of animal health, human health and environmental management. Success depends on coordinated action between veterinary services, public health authorities, wildlife experts, policymakers, local communities and industry partners.
Vaccination: the cornerstone of rabies prevention
Vaccination remains the most effective tool for rabies control. Yet achieving and sustaining high levels of immunity across animal populations requires more than periodic campaigns. Long-term commitment, adequate resources and strategies tailored to local realities are essential to ensure that protection reaches the populations most at risk.
One of the greatest challenges lies in dogs which remains the primary source of human rabies transmission globally, particularly in reaching wildlife reservoirs and “last-mile” animal populations (free-roaming and stray dogs) that may be inaccessible through traditional capture-and-vaccinate approaches. Closing these immunity gaps is crucial to tackle re-emergence of the disease, even in areas where significant progress has been achieved. Innovative vaccination approaches, including oral vaccination strategies where appropriate, can help expand coverage and support broader disease-control efforts.
In Sarawak, Malaysia, more than 25 field teams have joined forces in a large-scale dog vaccination campaign using Rabitec®. Led by the Department of Veterinary Services Sarawak, Sarawak SPCA, and the Sarawak Infectious Disease Centre, in collaboration with Mission Rabies, the campaign is supporting progress toward the 70% vaccination coverage needed to interrupt dog-mediated rabies transmission.
Surveillance: the foundation for sustainable elimination
Effective rabies control is multi-layered. Vaccination alone is not enough and must be supported by strong surveillance systems capable of detecting cases quickly, monitoring disease circulation and guiding targeted interventions with resources deployed where they can have the greatest impact.
Timely laboratory confirmation, transparent reporting mechanisms and coordinated information-sharing between animal and public health authorities are all critical components of an effective surveillance framework.
One Health collaboration
For regional and global rabies elimination programmes to succeed, collaboration must extend beyond individual sectors. Governments, and where relevant, municipal organisations, civil society, research institutions and animal health companies all have a role to play in developing and implementing effective, science-based strategies.
The world already possesses the tools needed to dramatically reduce the burden of rabies and ultimately eliminate dog-mediated human rabies. The challenge is not a lack of scientific knowledge, but ensuring the sustained implementation of proven measures. Continued investment in vaccination, surveillance and cross-sector collaboration are essential.
Rabies offers a powerful reminder of what can be achieved when preventive medicine and One Health principles are translated into coordinated action.
Europe has made tremendous progress in eliminating terrestrial rabies thanks to decades of coordinated surveillance, vaccination and control efforts. However, recent developments in Central and Eastern Europe are a reminder that these achievements cannot be taken for granted.
Since 2021, several countries including Poland, Romania, Hungary and Slovakia have reported an increase in rabies cases in both wildlife and domestic animals after years of low incidence. Scientific investigations have identified the continued circulation of endemic rabies virus variants in Easter Europe, as well as the re-emergence of a viral lineage not detected in the European Union. Most reported cases remain concentrated near the borders with Ukraine and Moldova, highlighting the importance of sustained cross-border disease surveillance and control.
While the overall risk to the general public in Western Europe remains low, these developments demonstrate that rabies can quickly re-emerge when surveillance and vaccination efforts are disrupted. The disease therefore remains a genuine public and animal health concern requiring constant vigilance. Europe’s historical success against rabies was largely achieved through large-scale oral vaccination campaigns targeting wildlife reservoirs, particularly foxes, and maintaining these efforts remains essential.
Human rabies cases reported in Europe continue to be rare and are most often associated with exposures acquired during international travel to endemic countries. Nevertheless, rabies remains responsible for approximately 60,000 deaths globally every year, mostly following contact with infected dogs. As we often say, rabies anywhere remains a threat everywhere. Sustained investment in prevention, vaccination and international cooperation remains essential if we are to achieve the global goal of zero human deaths from dog-mediated rabies.
Rabies vaccination remains one of the most effective tools available to prevent this deadly disease.
For companion animals, rabies vaccination is mandatory for international travel within the European Union and is a prerequisite for obtaining the required pet travel documentation. Additional requirements may apply depending on the destination country, particularly when travelling to or returning from rabies-endemic regions. For this reason, owners should start planning their trip well in advance, as some countries impose waiting periods, specific health certifications, or serological testing requirements.
Even where vaccination is not legally required, maintaining up-to-date rabies vaccination is strongly recommended for animals that may be exposed to wildlife, stray animals or travel internationally. Before travelling, owners should consult their veterinarian to review their pet’s vaccination status, assess destination-specific risks and discuss appropriate preventive measures.
For people, pre-exposure rabies vaccination is generally recommended for individuals at increased risk of contact with the virus, including veterinarians, veterinary students, laboratory personnel, animal control professionals, wildlife workers and travellers spending extended periods in rabies-endemic areas where access to medical care may be limited.
Importantly, anyone who is bitten, scratched or exposed to the saliva of a potentially infected animal should seek medical attention immediately, regardless of their vaccination status. Thorough wound washing followed by prompt post-exposure prophylaxis is highly effective in preventing the disease when administered without delay.
Ultimately, rabies is almost entirely preventable through vaccination, responsible behaviour around animals and timely medical intervention. This is precisely why continued awareness, preparedness and collaboration between veterinary and human health professionals remain central to the One Health approach.