Foreword: Let’s Act Now to Make Rabies History

In 2007, international organizations, including the World Health Organization (WHO), the World Organization for Animal Health (WOAH), and the Global Alliance for Rabies Control (GARC), jointly established World Rabies Day. This global initiative mobilizes individuals, organizations, and stakeholders worldwide in the collective effort to eliminate rabies as a public health threat. September 28, 2025, marks the 19th World Rabies Day, with the theme “ACT NOW: YOU, WE, COMMUNITIES” (1). This theme reinforces the global commitment to rabies prevention and control while emphasizing the critical role of individual and community engagement in achieving rabies elimination.

Over the past decade, China has demonstrated remarkable progress in rabies prevention and control through coordinated national efforts and multi-stakeholder collaboration. From a peak of 3,300 reported cases in 2007 — the inaugural year of World Rabies Day — case numbers have declined consistently for over a decade, reaching 122 cases in 2023. This achievement reflects China’s steadfast implementation of a comprehensive prevention strategy that prioritizes dog management and vaccination, incorporates standardized post-exposure prophylaxis (PEP), and maintains robust surveillance, containment, and epidemic focus elimination measures (2). The success also demonstrates the effectiveness of prevention and control mechanisms characterized by government leadership, inter-departmental collaboration, and active public participation. However, the increase in nationally reported cases to 167 in 2024 underscores the critical need for sustained vigilance in prevention and control efforts. This epidemic resurgence correlates with inadequate implementation of prevention measures in certain areas, including suboptimal dog registration rates in specific regions, insufficient immunization coverage in rural communities, and diminished public awareness of rabies prevention strategies.

As the 2030 global target for eliminating dog-mediated human rabies approaches, China faces mounting urgency to achieve this critical milestone. Nevertheless, extensive experience both domestically and internationally has conclusively demonstrated that rabies is preventable, controllable, and ultimately eliminable. Using the core indicator of no locally transmitted dog-mediated human rabies cases reported for three consecutive years, many regions across China had already achieved regional elimination by 2024. These successes resulted from rigorous implementation of dog management regulations, enhanced canine vaccination programs, strengthened post-exposure treatment protocols, and comprehensive surveillance with rapid epidemic response measures. This progress further validates the scientific foundation of China’s prevention and control strategy, with effective “implementation” serving as the decisive factor for success: regions that fully embrace their responsibilities and systematically execute prevention measures have witnessed sustained declines in rabies cases or complete elimination, while areas failing to maintain these standards remain vulnerable to epidemic resurgence. Currently, regions that have not yet reached elimination targets or have experienced recent outbreaks require immediate, precise risk assessments of local rabies transmission dynamics. These areas must leverage government-led institutional frameworks, strengthen community-based public engagement as the frontline defense, and deploy targeted, evidence-based solutions to address specific prevention and control challenges.

To address these prevention and control challenges, promote replicable experiences, and resolve critical implementation gaps, China CDC Weekly has specially curated this rabies-themed special issue. Drawing together research findings and practical experience from experts across multiple disciplines — including disease control and prevention institutions, clinical diagnosis and treatment, and animal epidemic prevention — this issue presents the following key research reports:

Surveillance and Analysis of Animal Rabies — China, 2004–2024: Systematically analyzes epidemic trends of rabies in dogs, cats, and other animals, identifying the primary animal hosts and transmission chains of rabies across different regions (3).

Efficacy Evaluation of Virus Clearance of SYN023 in A Murine Rabies Model — China, 2025: Demonstrates the efficacy of the novel anti-rabies drug SYN023 in clearing rabies virus in a murine model, establishing an experimental foundation for clinical translation (4).

Active Surveillance on Safety and Compliance of Freeze-dried Human Rabies Vaccine (Vero Cell) — Jiangsu Province, China, 2023–2024: Documents the safety profile (adverse reaction rate <0.5%) and vaccination compliance (89%) of freeze-dried human rabies vaccine (Vero cell) in Jiangsu Province, providing evidence supporting vaccine deployment in primary medical institutions (5).

Metagenomic Next-Generation Sequencing Unmasks Atypical Rabies — Guangxi Zhuang Autonomous Region, China, 2024: Presents the diagnosis and treatment approach for atypical rabies cases (6).

The Clinical Advantages of Anti-Rabies Monoclonal Antibodies in Post-Exposure Prophylaxis — Worldwide, 2016–2025: Evaluates the efficacy, accessibility, and cost-effectiveness of anti-rabies monoclonal antibodies compared to traditional rabies immune globulin, emphasizing the application value of monoclonal antibodies in resource-limited settings (7).

Eliminating dog-mediated human rabies requires collective action — no single individual can achieve this goal alone. Success demands coordinated efforts from all stakeholders and comprehensive community-wide collaboration. As a zoonotic disease, rabies directly impacts everyone’s daily life, particularly as companion animals like dogs and cats have become integral members of human communities. Moreover, rabies functions as a natural focal infectious disease: in China, foxes now represent the primary wildlife reservoir, while recent detections in raccoon dogs and badgers suggest an expanding host range (3). As dog-mediated human rabies comes under effective control, the risk of spillover from wild animals becomes increasingly prominent, making society-wide prevention and control efforts based on a One Health approach even more essential. Let us use this special issue and World Rabies Day as catalysts to strengthen our collective responsibility, transform scientific strategies into concrete actions, ensure effective implementation of “last-mile” rabies prevention and control efforts, and achieve the elimination of dog-mediated human rabies in China while contributing meaningfully to the global elimination goal.