LOS ANGELES -- Rabies prevention in the United States is by and large a success story, with just one to four people dying of rabies each year in the U.S. thanks to widespread pet vaccinations and aggressive treatment for people bitten by potentially rabid animals.
Around the world, however, rabies remains a major problem with more than 55,000 human deaths annually, along with millions of animals. Half of the human victims are under 15.
In Asia and Africa, where 95 percent of human rabies deaths occur, dogs spread most of the rabies, according to the World Health Organization.
In the United States, most rabies cases before 1960 were also in domestic animals, but today more than 90 percent of all animal cases reported annually to the U.S. Centers for Disease Control occur in wildlife, most frequently in raccoons, bats, skunks and foxes.
About 7,000 animals die as a result of rabies in the U.S. each year; Hawaii is the only state where there is no rabies. Around the world, Australia and Antarctica are also rabies-free.
Rabies is a virus that targets the brain and spinal cord. It is found in the saliva of infected animals and is most often transferred through a bite. Birds, fish, insects, reptiles and other non-mammals do not get rabies, and it's rare in chipmunks, gerbils, guinea pigs, hamsters, mice, rabbits, rats and squirrels, health officials said.
Americans spend more than $300 million annually to detect, prevent and control rabies, the CDC estimates. This includes the vaccination of companion animals, animal control programs, maintenance of rabies labs and medical costs.
About 40,000 Americans a year have to get the two-week series of four shots (five if you have immune problems) after being bitten. Often the shots are administered as a preventive measure after a bite, whether or not the animal is caught and tested. These shots cost more than $1,000 a series and are injected into the hip rather than the stomach as they once were.
The American Veterinary Medical Association has no statistics on pet vaccination rates, and laws requiring vaccinations vary by state. But inoculating pets against rabies -- which costs just $15-$30 -- is a no-brainer for many owners. Rabies is always fatal in unvaccinated animals, and pets can get the disease from raccoons or other wildlife. And if your pet bites someone, proof will be required to show that your animal is rabies-free.
"Protect yourself and your pet, not just from rabies, but from legal trouble and emotional stress and strain," said veterinarian Louise Murray, vice president of the American Society for the Prevention of Cruelty to Animals' Bergh Memorial Animal Hospital in New York City.
During 2009, 81 rabid dogs were reported in the United States, an 8 percent increase over 2008, and 300 rabid cats were reported, a 2 percent increase compared to the previous year, the CDC said.
In 2009, Pennsylvania reported the largest number of rabid domestic animals -- 65 -- in any state, followed by Virginia with 55. Both states have laws requiring dog and cat vaccinations.
Nationwide, raccoons are the biggest rabies carriers, comprising 34.8 percent of all cases in 2009.
People consider them cute, Murray said. "People are never going to go to a bat on purpose. Raccoons are different. People feed raccoons," she said.
To cut down on rabies in wildlife, the U.S. Department of Agriculture's Wildlife Services Program distributes rabies vaccine cubes by air and ground. The agency started drops for gray foxes and coyotes in south Texas in 1995 and since 2002, has maintained a 30-mile wide rabies-free zone north of the Mexican border, said USDA spokeswoman Carol Bannerman.
More recently, the agency has made annual vaccine pellet drops for raccoons east of the Appalachians from Maine to Alabama. Last year, about 5.6 million baits were distributed in 16 states, she said.
Arizona's gray foxes also get annual drops.
In Southern California, bats are the primary source of rabies, said Dr. Karen Ehnert, acting director for the veterinary public health and rabies control problem for Los Angeles County, which is on track to record about 20 rabid bats this year.
Around the state, rabies has been documented in 50 bats so far this year, and 144 bats in 2010, with other cases in skunks, foxes and a couple of dogs, said Dr. Gil Chavez, state epidemiologist with the California Department of Public Health.
In Cuba, the Dominican Republic, Haiti, Puerto Rico and Grenada, the main source of rabies is the mongoose, a ferret-like creature, according to Brenda Rivera Garcia, acting state public health veterinarian for the Puerto Rico Department of Health.
She also heads the coordinating committee for the 22nd International Conference on Rabies in the Americas, which takes place in San Juan, Puerto Rico, a few weeks after World Rabies Day, Sept. 28, when individuals and organizations around the world work to create awareness about the disease.
"So many lives are lost as a result of this preventable disease," she said.