A large outbreak of rabies continues to have devastating effects in Angola, Africa. While rabies outbreaks are not uncommon in some parts of the world, the number of people affected in this outbreak is remarkable. A hospital in Luanda, the nation’s capital, has diagnosed rabies in at least 93 children in the past 3 months. All have died. The main source of the disease in this case is Angola’s large stray dog population. Stray dogs can transmit rabies to other dogs and people through bites. The poor socioeconomic status of the country increases the risk of outbreaks like this because:

• Vaccines are not readily available (for dogs or people)
• It is difficult to organize and fund vaccination programs for stray dogs
• It is difficult to educate the general population about how to avoid and manage rabies exposure
• The healthcare system is relatively limited

These problems, all related to a poor economy, create a "perfect storm" for a rabies outbreak. The shortage of human rabies vaccine and the high cost of post-exposure prophylaxis (PEP) makes it much more likely that people will actually develop signs of rabies after being exposed. The cost of PEP is more than the average Luanda family makes in a month.

Fortunately, the outbreak seems to be waning. However, without improvements in stray dog management (including vaccination) and access to adequate PEP, future outbreaks and problems are inevitable. It was reported that "adequate" supplies of canine rabies vaccine are now available. Hopefully, a concerted effort to vaccinate as many dogs as possible will reduce the rabies load in the canine population, thereby helping to decrease the risk to the people living in the area as well.