Rise in Rabies Exposure in the US

The US Centers for Disease Control and Prevention (CDC) has issued a warning indicating that rabies exposure seems to be increasing nationwide.

Between July and August, the CDC reported a 17% uptick in rabies-related inquiries compared to the same period last year. This includes various reports of large exposure incidents, as detailed in a health advisory released by the agency.

During this timeframe, the CDC noted receiving information from at least eight state health departments regarding a rise in the provision of post-exposure prophylaxis (PEP) for rabies, alongside some reported administration errors.

A notable incident this summer occurred in North Carolina, where almost 300 individuals were exposed to rabid baby goats from a mobile petting zoo. This facility made numerous visits to events including assisted living centers and a back-to-school gathering. The state’s health officials advised PEP for 213 of those exposed.

The CDC’s advisory pointed out that since July, many US jurisdictions have observed local spikes in human rabies exposures linked to known rabies carriers or animals typically not associated with rabies.

The agency emphasized that recent rabies outbreaks underscore the necessity for thorough rabies risk assessments and adherence to evidence-based guidelines when administering PEP. They highlighted that rabies is a nearly 100% fatal zoonotic viral disease but can be prevented through timely PEP before symptoms manifest.

Annually, around 100,000 individuals in the US receive rabies PEP, which usually starts with wound care if bitten or scratched by an infected animal, followed by administering human rabies immunoglobulin to combat potential infection until vaccinations take effect.

Rabies vaccinations are administered during the initial doctor visit, with additional doses typically given on days three, seven, and 14 post-initial dose, depending on the person’s immunization history. For those who were previously vaccinated against rabies, PEP involves two doses spaced three days apart.

Historically, individuals exposed to rabies faced up to 30 agonizing vaccine injections in the stomach, but current methods allow adults to receive shots in the shoulder and children in the thigh over a two-week period. Side effects tend to be mild—think sore arms, headaches, or mild stomach issues.

This year, the CDC noted a significant increase in rabies vaccine and immunoglobulin usage.

Pharmacy data as of September 2 indicated that the use of licensed rabies vaccines and immunoglobulins has shot up by approximately 33% and 76%, respectively, compared to last year.

While there is currently no shortage of human rabies vaccines or immunoglobulin in the US, the CDC urged clinicians to administer PEP correctly to avoid treatment errors, which can lead to unnecessary costs or potential side effects.

A typical course of PEP can range between $11,000 and $14,000 per individual. Following correct PEP administration guidelines ensures lifesaving vaccines remain accessible for those genuinely in need, while helping to avoid additional expenses.

PEP is crucial for preventing rabies, with an effectiveness rate close to 100% if administered promptly following exposure. However, you need to act fast—before any symptoms occur.

Rabies primarily targets the central nervous system and can cause severe brain dysfunction and death if not promptly treated. Once the clinical signs of rabies emerge, the disease is almost always fatal.

Symptoms can develop within two months and might start as headaches, nausea, and sore throats, escalating to hallucinations, delusions, disorientation, paralysis, and even coma.

If there’s a chance you’ve been exposed to rabies—whether through contact with wildlife or pets acting strangely—it’s vital to wash any wounds thoroughly with soap and water for 15 minutes, as recommended by the CDC.

Consult your doctor or a public health expert about your exposure risk, including whether you may require rabies treatment. It’s also important to provide details about the animal involved and any unusual behaviors you noticed.

If bitten by someone else’s pet, it’s smart to ask the owner for proof of current rabies vaccination.

If an animal was spotted wandering in your vicinity, and it’s safe to do so, try to contain it and get in touch with animal control or your local health department.

The CDC mentions that in some cases, with a veterinarian’s help, observing an animal might be a suitable alternative to testing for rabies.

An infected animal can transmit rabies through bites, scratches, or saliva. In the US, over 90% of rabies cases in animals occur in wildlife, with species like bats, raccoons, skunks, and foxes being common carriers.

Notably, contact with infected bats accounts for the majority of human rabies deaths in the US, with about 70% of those fatalities linked to bat bites. Around three-quarters of Americans reside in communities where rabies-carrying animals are present.

Globally, domestic dogs are responsible for more than 95% of the estimated 70,000 human rabies deaths every year. Thankfully, rabid dogs are quite rare in the US due to effective prevention and control measures.

Traveling outside the US can increase rabies risks, particularly in parts of Africa, Asia, and Latin America where dog rabies remains a significant issue. Since 1990, over 80 individuals in the US have died after contracting rabies while traveling.

Engaging in outdoor pursuits like camping or hunting may heighten the risk of rabies exposure. Moreover, professions involving regular animal interaction—like veterinary work, animal control, and wildlife research—also present higher risks.

According to the CDC, large-scale dog vaccination initiatives are the most efficient method for preventing rabies worldwide.

In the US, wildlife management professionals distribute over 5 million oral vaccines to wildlife every year to combat rabies at its source. Additionally, veterinarians vaccinate more than 90 million cats and dogs annually.

The CDC also suggests several measures to help prevent rabies:

• Ensure your pets are current on their rabies vaccinations.
• Avoid contact with wildlife.
• Contact animal control to remove stray animals from your area.
• Wash any bites or scratches with soap and water immediately following potential exposure.
• Seek medical attention urgently if you suspect rabies exposure.