<unk>  is a viral disease that causes inflammation of the brain in humans and other mammals. Early symptoms can include fever and tingling at the site of exposure. These symptoms are followed by one or more of the following symptoms: nausea, vomiting, violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness. Once symptoms appear, the result is virtually always death, regardless of treatment. The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year. The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system.<unk>  is caused by lyssaviruses, including the<unk>  virus and Australian bat lyssavirus. It is spread when an infected animal bites or scratches a human or other animals. Saliva from an infected animal can also transmit<unk>  if the saliva comes into contact with the eyes, mouth, or nose. Globally, dogs are the most common animal involved. In countries where dogs commonly have the disease, more than 99% of<unk>  cases are the direct result of dog bites. In the Americas, bat bites are the most common source of<unk>  infections in humans, and less than 5% of cases are from dogs. Rodents are very rarely infected with<unk> . The disease can be diagnosed only after the start of symptoms. Animal control and vaccination programs have decreased the risk of<unk>  from dogs in a number of regions of the world. Immunizing people before they are exposed is recommended for those at high risk, including those who work with bats or who spend prolonged periods in areas of the world where<unk>  is common. In people who have been exposed to<unk> , the<unk>  vaccine and sometimes<unk>  immunoglobulin are effective in preventing the disease if the person receives the treatment before the start of<unk>  symptoms. Washing bites and scratches for 15 minutes with soap and water, povidone-iodine, or detergent may reduce the number of viral particles and may be somewhat effective at preventing transmission. , only fourteen people had survived a<unk>  infection after showing symptoms.<unk>  causes about 59,000 deaths worldwide per year, about 40% of which are in children under the age of 15. More than 95% of human deaths from<unk>  occur in Africa and Asia.<unk>  is present in more than 150 countries and on all continents but Antarctica. More than 3 billion people live in regions of the world where<unk>  occurs. A number of countries, including Australia and Japan, as well as much of Western Europe, do not have<unk>  among dogs. Many Pacific islands do not have<unk>  at all. It is classified as a neglected tropical disease.
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