Rabies is endemic throughout most of the world and causes approximately 60,000 human deaths per year. The virus is carried in the saliva of infected mammals (which may appear normal) and is usually spread by a bite, but licks on open wounds and scratches have been enough to transmit the virus to humans. In the event of a possible exposure the area should be washed thoroughly with soap and water, irrigated with iodine based antiseptic or a high percent alcohol, and medical attention sought as soon as possible, ideally within 24 hours. The virus affects the nervous system and once symptoms develop death is inevitable - even with good medical care.