Rabies in the U.S.
Public Health Importance of Rabies
Approximately 5,000 animal rabies cases are reported annually to CDC, and more than 90% of those cases occur in wildlife. This marks a dramatic change in the types of animals reported as rabid since 1960, when the majority of cases were in domestic animal species, primarily dogs. The principal rabies reservoir hosts in the United States today include bats, raccoons, skunks, and foxes.
The number of rabies-related human deaths in the United States declined during the twentieth century, from more than 100 annually in the early 1900’s to just one or two per year since 1960. This decline can be attributed to successful pet vaccination and animal control programs, public health surveillance and testing, and availability of post-exposure prophylaxis (PEP) for rabies.
In the United States today, human fatalities are rare but typically occur in people who do not seek prompt medical care. While the exact reason for not seeking care is often unclear, lack of awareness of the risk of rabies is thought to be an important factor. This is of particular concern for bat bites, since bats can have small teeth and leave bite marks that are the size of the tip of a pencil.
From 1960 to 2018, 127 human rabies cases were reported in the United States, with roughly a quarter resulting from dog bites received during international travel. Of the infections acquired in the United States, 70% were attributed to bat exposures.
Although human rabies deaths are rare, the estimated public health costs associated with disease detection, prevention, and control have risen. These costs include pet vaccination, animal control programs, laboratory maintenance, and medical costs.