Human Rabies

Human rabies cases in the United States are rare, with only 1 to 3 cases reported annually. Twenty-three cases of human rabies have been reported in the United States in the past decade (2008-2017). Eight of these were contracted outside of the U.S. and its territories.

The number of human rabies deaths in the United States attributed to rabies has been steadily declining since the 1970’s thanks to animal control and vaccination programs, successful outreach programs, and the availability of modern rabies biologics. Dog rabies vaccination programs have halted the natural spread of rabies among domestic dogs, which are no longer considered a rabies reservoir in the United States. Nonetheless, each year around 60 to 70 dogs and more than 250 cats are reported rabid. Nearly all these animals were unvaccinated and became infected from rabid wildlife (such as bats, raccoons, and skunks).

Despite the control of rabies in domestic dogs in the United States, each year interactions with suspect animals result in the need to observe or test hundreds of thousands of animals and to administer rabies postexposure prophylaxis to 30,000 to 60,000 persons.

Cases of Rabies in Humans in the United States and Puerto Rico from January 2008 Through September 2017 by Circumstances of Exposure and Rabies Virus Variant
Date of onset Date of death Reporting state Age (y) Sex Exposure* Rabies virus variant†
5-May-17 21-May-17 VA 65 F Bite Dog, India
25-Nov-15 1-Dec-15 PR 54 M Bite Dog-mongoose, Caribbean
17-Sep-15 3-Oct-15 WY 77 F Contact Bat, Ln
30-Jul-15 24-Aug-15 MA 65 M Bite, Philippines Dog, Philippines
12-Sep-14 26-Sep-14 MO 52 M Unknown Bat, Ps
16-May-13 11-Jun-13 TX 28 M Unknown, Guatemala Dog, Guatemala
31-Jan-13 27-Feb-13 MD 49 M Kidney transplant Raccoon, eastern United States
6-Jul-12 31-Jul-12 CA 34 M Bite Bat,Tb
22-Dec-11 23-Jan-12 MA 63 M Contact Bat, My sp
3-Dec-11 19-Dec-11 SC 46 F Unknown Bat,Tb
1-Sep-11 14-Oct-11 MA 40 M Contact, Brazil Dog, Brazil
21-Aug-11 1-Sep-11 NC 20 M Unknown (organ donor)§ Raccoon, eastern United States
14-Aug-11 31-Aug-11 NY 25 M Contact, Afghanistan Dog, Afghanistan
30-Jun-11 20-Jul-11 NJ 73 F Bite, Haiti Dog, Haiti
30-Apr-11 Survived CA 8 F Unknown Unknown
24-Dec-10 10-Jan-11 WI 70 M Unknown Bat, Ps
2-Aug-10 21-Aug-10 LA 19 M Bite, Mexico Bat, Dr
23-Oct-09 20-Nov-09 VA 42 M Contact, India Dog, India
20-Oct-09 11-Nov-09 MI 55 M Contact Bat, Ln
5-Oct-09 20-Oct-09 IN 43 M Unknown Bat, Ps
25-Feb-09 Survived TX 17 F Contact Bat, unknown
19-Nov-08 30-Nov-08 MO 55 M Bite Bat, Ln
16-Mar-08 18-Mar-08 CA 16 M Bite, Mexico Fox,Tb related

*Data for exposure history are reported when plausible information was reported directly by the patient (if lucid or credible) or when a reliable account of an incident consistent with rabies virus exposure (eg, dog bite) was reported by an independent witness (usually a family member). Exposure histories are categorized as bite, contact (eg, waking to find bat on exposed skin) but no known bite was acknowledged, or unknown (ie, no information about known contact with an animal was elicited during case investigation).

Rabies virus variants associated with terrestrial animals in the United States and Puerto Rico are identified with the names of the reservoir animal (eg, dog or raccoon), followed by the name of the most definitive geographic entity (usually the country) from which the variant has been identified. Rabies virus variants associated with bats are identified with the names of the species of bats in which they have been found to be circulating. Because information regarding the location of the exposure and the identity of the exposing animal is almost always retrospective and much information is frequently unavailable, the location of the exposure and the identity of the animal responsible for the infection are often limited to deduction. §Infection was not identified until 2013, when an organ recipient developed rabies.

Dr = Desmodus rotundus. Ln = Lasionycteris noctivagans. My sp = Myotis species. Ps = Perimyotis subflavus.Tb = Tadarida brasiliensis

Morbidity and Mortality Weekly Reports: Case Histories of Most Recent Cases

Annual Surveillance Reports in the United States