[1] The time between contraction and the onset of symptoms is dependent on the distance the virus must travel to reach the central nervous system.

Only a small number of these rabies deaths were reported to health authorities due to the impact of the earthquake, limitations in testing capacity, and lack of awareness and education about the disease among Haitians.

Even after being reported to both the CDC and the national Department of Epidemiology and Laboratory Research (DELR), as required by Haiti's surveillance program, the woman died.

This goes to show the lack of communication and effectiveness in caring for human subjects in Haiti, and the continued focus is on eliminating dog-mediated rabies altogether.

[9] At an individual patient level, post-exposure prophylaxis (PEP) consists of local treatment of the wound, vaccination, and administration of immunoglobulin, if necessary [3].

Health officials' awareness of the need for PEP after a dog bite can only be achieved if the exposure is attended to immediately and communicated effectively.

In Haiti, the United States Centers for Disease Control (CDC) is mainly focusing on dog-mediated rabies.

The surveillance system is a bite-reporting model where the public and medical providers report bite events to rabies control officers.

[10] In 2011, the CDC along with MARNDR initiated a five-year rabies infrastructure improvement program that focused on surveillance, diagnostics, and education.

The World Bank has classified 33 other low-income countries in Africa and Asia, where dog-mediated rabies is a major problem and results in thousands of deaths annually.

This is because of the lack of laboratory facilities, making it difficult to identify evidence for the virus in humans and shed light on the disease as a whole for them, in Haiti.

Communication about finding the source of exposure and implementing control methods to prevent further cross-species transmission is also more effective.

This is why a comprehensive evaluation of Haiti's rabies program should heavily consider the costs and benefits of this separation of responsibilities between the two ministries early on.

Authorities in Haiti relied on funds donated by the World Bank for the purchase of approximately 500,000 doses of inactivated, injectable vaccine (IMRAB by Merial).

[10] Another challenge presented is vaccination failure, which usually leads to recurrent rabies in dogs and inconsistent control of the disease.

[10] The number of rabid dogs detected by the MARNDR, MSPP, and CDC is a huge risk to people and is not accurately reflected in their surveillance figures.

That being said, the 2015 elimination goal in the region was compromised and control of the disease could not yet be achieved, despite the efforts of resolute national officials.