Current Status of Rabies in the United States

In evaluating cases of human rabies in the US from 1960 – 2018, there were 62 human infections attributable to exposure to infected bats.  This represented approximately 70% of the cases of human infection.   Since 2015, bats have surpassed raccoons as the largest source of US rabies infection.   Public health laboratories and the US Department of Agriculture Wildlife Services currently test approximately 100,000 animals/year for rabies and approximately 5000 are positive for the rabies virus.  The CDC reported that in 2018 approximately 55,000 patients sought post exposure prophylaxis after contact with a potentially rabid animal, including skunks, foxes, raccoons and most importantly, bats.

Before 1960, dogs were a common reservoir of rabies in the US but with the introduction of rabies vaccine the prevalence of canine rabies virus variant (CRVV) experienced a tenfold decrease.  This represents one of the most important public health successes of the 20^th century.    

1. Our patients need to understand that bats are a major source of rabies in the US. Any contact with a bat which cannot be tested for rabies, including patients sleeping who might have had unrecognized contact with a bat identified after waking, need be evaluated for post-exposure prophylaxis. Likewise, any patient in contact with wild animals where there has been exposure and the animal cannot be rabies tested needs evaluation for post exposure prophylaxis.
2. CDC Travelers’ Health provides vaccination recommendations for international travelers (https://www.cdc.gov/travel) and should be consulted prior to visiting parts of the world where unvaccinated dogs might provide exposure or if they will be working with animals or come into contact with wild animals while traveling.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6823e1.htm?s_cid=mm6823e1_w

For more information on rabies, check out this article from Wild Life Removal.