Rabies: a preventable but incurable disease

Rabies is a typical zoonotic disease which has been known for more than 4300 years. To date, no effective medical therapy has been established for overt rabies. The rabies post-exposure prophylaxis (PEP), which is a serial vaccination against rabies starting as soon as possible after the patient was bitten by a suspected rabid animal, is the only way to prevent death. In Japan, no rabies case has been reported for about 50 years. However, rabies is epizootic in many Asian countries, where more than 50% of the rabies deaths in the world occur. The Japanese travelers who visit these countries every year may not be aware of this fact since no rabies occurs in their own country. Therefore, the risk of being bitten by a rabid animal abroad and developing rabies after returning to Japan seems to be high. All medical staff should keep in mind that imported rabies cases can occur at any time. In addition, pre-exposure vaccination against rabies should be recommended to international travelers in order to ensure the preventative effect of PEP.