SCIENTIFIC REPORTS Article Open Access Published: 12 February 2020 Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006–2018 Ghosh, S., Rana, M.S., Islam, M.K. et al. Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006–2018.  Sci Rep 10, 2410 (2020).   “Vaccinating dogs against rabies is an effective means of reducing human rabies. We subjected 1327 clinically diagnosed human rabies death and mass dog vaccination (MDV) data during 2006–2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (422) for clinico-epidemiological analysis. A positive and increasing trend of MDV (p = 0.01 and tau = 0.71) and a negative and declining trend (p < 0.001 and tau = −0.88) of human rabies cases (Correlation coefficient: −0.82) have been observed. Among 422 deaths, the majority (78%) of the victims sought treatment from traditional healers, and 12% received post-exposure prophylaxis (PEP). The mean incubation period of rabies in cases with exposure sites on the head & neck (35 days) was shorter than the upper limb (mean = 64 days, p = 0.02) and lower limb (mean = 89 days, p < 0.01). MDV has been found to be effective for reducing human rabies cases in Bangladesh. Creating awareness among the animal bite victims to stop reliance on traditional healers rather seeking PEP, addressing the role of traditional healers through awareness education programme with respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV may help to prevent human rabies deaths.  Rabies is a zoonotic viral disease responsible for the death of approximately 59,000 people worldwide with more than 3.7 million disability-adjusted life years lost annually(1) ...”   “Conclusion  Our study showed that mass dog vaccination (MDV) is one of the most important components of controlling human rabies in Bangladesh. Also, these data clearly spelt out that most deaths had occurred as a result of consultation with the traditional healers instead of seeking post-exposure prophylaxis (PEP) from the hospitals and also due to the incomplete treatment course. Poor health-seeking behaviour of the rabies victims indicates the necessity to improve such behaviour through advocacy, communication, and social mobilization. It is necessary to address the role of traditional healers through an awareness education programme with respect to the treatment of dog bites and rabies and discouraging animal bite victims from visiting them. Ensuring the affordability and availability of rabies PEP in all areas of Bangladesh, especially in local public hospitals, is also important. Proper vaccine delivery needs sufficient personnel training to ensure correct storage, reconstitution, and injection. Sharing local epidemiological knowledge of rabies in animals may assist clinicians in making the right choice in treating rabies with PEP. We recommend conducting a humane method of dog population management programme along with the promotion of dog ownership and the continuation of scaling up MDV throughout the country to eliminate dog-mediated human rabies in Bangladesh. In addition, establishing a laboratory for rabies diagnosis and introducing an active surveillance system is necessary to monitor and evaluate emerging patterns and trends of the disease in Bangladesh. Strengthening and encouraging multi-sectoral involvement through the One Health approach is necessary for the sustainability of the rabies elimination programme in Bangladesh.”