Human Rabies: a fatal yet preventable zoonosis threatening Southeast Asia — A descriptive study, case series, and clinical experience in the Republic of the Philippines

Background: Rabies encephalomyelitis is a fatal yet preventable zoonosis that can be effectively controlled through coordinated public health and veterinary interventions. Despite the availability of preventive measures, approximately 59,000 deaths due to rabies occur worldwide every year. The burden of disease is concentrated in low- and middle-income countries and fragile regions, including conflict zones. Multiple factors—such as high population density, urban expansion with close human–animal contact, limited health resources, poor awareness of transmission routes, inadequate pet management, and socioeconomic disparities—contribute to the persistent circulation of the virus and the limited impact of existing control programs. Objectives: This study aims to describe the current epidemiology of human rabies in the Republic of the Philippines, a country transitioning from low- to middle-income status and characterized by significant socioeconomic inequality. The work also includes a personal clinical experience gained during an observership at San Lazaro Hospital in Manila, one of the country’s main infectious disease referral centers, which receives most rabies cases from Luzon and neighboring islands. Methods: A descriptive statistical analysis of available epidemiological data was conducted, complemented by a review of national and international rabies control guidelines, scientific literature (PubMed search), and socioeconomic reports. Clinical data from selected anonymized patient records at San Lazaro Hospital were examined to provide illustrative case descriptions. Results and Conclusions: The study highlights the ongoing public health challenge posed by rabies in the Philippines, where extensive resources are devoted to post-exposure prophylaxis while therapeutic and palliative options for symptomatic patients remain extremely limited. The presented case series reflects the broader epidemiological trends and underscores the urgent need for sustained preventive efforts, community education, and equitable resource allocation to achieve effective rabies control.