Focus Report Rabies in the ASEAN Region

Rabies is a viral zoonotic disease that affects the central nervous system, almost always resulting in death once symptoms appear (WHO, 2024). The virus is primarily transmitted through the bite or scratch of an infected animal, with domestic dogs being the main source of human rabies cases worldwide (WOAH, nd). After entering the body, the virus travels along peripheral nerves to the brain, causing progressive neurological symptoms such as fever, hydrophobia (fear of water), aerophobia (fear of air drafts), agitation, paralysis, and ultimately coma and death. Rabies is entirely preventable through prompt wound care, post-exposure prophylaxis (PEP), and pre-exposure vaccination for high-risk groups (WHO, n.d). However, individuals who do not receive PEP after exposure remain at extreme risk of developing fatal disease. Children under 15 years are disproportionately affected, as they are more likely to play with animals and may not report bites or scratches. Wildlife, including bats, foxes, and raccoons, also contribute to rabies transmission in certain regions, complicating control efforts. Globally, dog vaccination programs, combined with improved access to human vaccines and immunoglobulins, have reduced the incidence of rabies in several regions. Maintaining high vaccination coverage in dogs, ensuring timely access to PEP, and strengthening community awareness remain essential to eliminating human rabies deaths. Regional strategies, such as those supported by ASEAN member states, align with the World Health Organization (WHO) and global partners’ “Zero by 2030” goal to end human deaths from dog-mediated rabies (FAO, WOAH, WHO, and GARC, 2018). This report provides an overview of rabies, covering its transmission, symptoms, prevention, and control measures, along with data on reported cases, vaccination programs, and gaps in access to PEP. It also analyses the regional situation within ASEAN and highlights the importance of surveillance, intersectoral collaboration, and rapid public health response to achieve rabies elimination across vulnerable communities.