Canine rabies is still widespread in Asia, Africa, and parts of Latin America, including Mexico, where control of dogs has proven difficult.

Source: Plotkin SA, Rupprecht CE, Koprowski H. Rabies vaccine. In: Plotkin SA, Orenstein WA, eds. Vaccines. 3rd ed. Philadelphia, PA: WB Saunders Co; 1999:743-766.

In the United States, bats are the leading transmitter of rabies to humans; 15 out of 23 cases of human rabies were attributable to bats, with nearly half of the reported patients believed to have been asleep when infected.

Source: Plotkin SA, Rupprecht CE, Koprowski H. Rabies vaccine. In: Plotkin SA, Orenstein WA, eds. Vaccines. 3rd ed. Philadelphia, PA: WB Saunders Co; 1999:743-766.

The incubation period of rabies in humans is generally 20 to 60 days.

Source: Plotkin SA. Rabies. Clin Infect Dis. 2000; 30:4-12.

The first signs of rabies in humans are nonspecific: fever, anxiety, and malaise.

Source: Plotkin SA. Rabies. Clin Infect Dis. 2000;30:4-12.

After exposure, washing of the wound is important for reducing the infection. However, antiserum and vaccination are vital to the patient's survival.

Source: Plotkin SA. Rabies. Clin Infect Dis. 2000;30:4-12.

Bats, dogs, and cats are the most likely threats to transmit rabies to Americans.

Source: Plotkin SA. Rabies. Clin Infect Dis. 2000;30:4-12.

It is believed that a bat's small teeth may leave little evidence of bites and cause no pain, thereby making exposure while a person is sleeping virtually undetectable.

Source: Plotkin SA. Rabies. Clin Infect Dis. 2000;30:4-12.