Between 1990 and 1944, three countries (Brazil, Mexico, and Peru) accounted for 65% of the total number of human rabies cases reported in the Americas. Belize, Costa Rica, Chile y Uruguay, have not recorded any human or canine cases since at least 1990.

Urban rabies is down significantly. Between 1989 and 1992, only four major cities reported cases of human rabies, most of the cases are reported in towns with population less than 50,000 inhabitants. In 1992, however, two cities (Lima and Guayaquil) reported cases of both human and canine rabies after having had no cases for 10 and 2 years, respectively.

Specific mortality from rabies has dropped from 1.3 cases per 1,000,000 population in 1980 to 0.3 cases per 1,000,000 in 1993.

Data obtained from 692 cases reported in Latin America between 1990 and 1992 indicate that human rabies occurs most frequently in the 6-to-20-year age group, and more commonly among males than females. In United States, 33 cases of human rabies death have been reported during 1977-1994.

The incidence of canine rabies in Latin America has fallen from an average of 20,518 cases reported per year between 1980 and 1982 to an average of 8,069 per year in the period of 1991-1993. However, between 1987 and 1990 case numbers rose in the Andean subregion and in Mexico, which together accounted for 89% Latin America’s canine rabies cases. The annual average for the period was 17,655 cases. Since 1990, Mexico has witnessed a steady decline in case numbers, and the 1993 figures were 83.9% lower than those for 1980.

In 1993 53.9% on the territory of Latin America was affected by rabies transmitted by dogs. This area had a population of 303 million inhabitants and 35.5 million dogs (64.2 and 71.5% of the total populations respectively).

In the period1990-1993, dogs were the source of infection in 84.1% of the human cases, bats were responsible for 7.2% of the cases, cats 4,0%, and other animals (monkeys, wolfs, coyotes) 4.7%. In Canada and the United States, 71.4% of the cases reported in animals in 1991 and 1992 involved wildlife mainly foxes (Vulpes fulva and Urocyon cinereoargenteus) in Canada, and raccoons (procyon lotor) and skunks (Mephitis mephitis) in the United States. Mongooses continue to be reservoirs of rabies in Cuba, the Dominican Republic, Grenada, and Puerto Rico.

Rabies transmission by vampire bats is an important public health and economic concern in Latin America, French Guinea, Guyana, Suriname, and Trinidad and Tobago. Of the three known species, the principal vector of rabies in the Americas is Desmodus rotundus, which is found from Mexico to northeastern Argentina. Areas in which vampire bats are endemic have an estimated human population of 19,960,000 and a cattle population of 49,767,000. In the last 5 years, special attention has been given to cases of human rabies transmitted by vampire bats, owing to outbreaks that have occurred in human groups that were exposed to rabies as a result of moving into natural ecosystems. Since 1989, 73 human deaths have been attributed to rabies transmitted by vampire bats.

According to estimates, Latin American industry loses more than US$ 40 million per year from vampire bat-transmitted rabies in terms of cattle mortality, losses of milk and meat, and devaluation of hides caused by bites.

From 13 to 15 February 1995, an evaluation of the national programs and an assessment of the rabies situation in each country and the region was made during the Fifth Meeting of Rabies Elimination National Program Directors, held in Santo Domingo, Dominican Republic. Some of the most important recommendations of this meeting are related to: improvement of training of public health workers; strengthening of epidemiological surveillance systems even in countries free of rabies transmitted by dogs; development of educational programs and strategies for the community and for health workers; and creation of a Regional Committee for the Elimination of Rabies in the Americas. The complete report of the Santo Domingo meeting can be requested from PAHO’s Veterinary Public Health Program, 525 23^rd St. NW Washington DC, 20037 or by Fax st(202) 861-8188.