CDC Warns Doctors About Spike in Rabies Activity

The CDC is warning doctors about an uptick in human exposures to rabid animals, saying it fielded 17% more rabies-related inquiries in the past 2 months than it did during the same stretch last year.

Reports have included mass exposure events, with the agency’s alert coming on the heals of officials in North Carolina warning that nearly 300 people were potentially exposed to rabid goats at a mobile petting zoo.

As a result of the activity, the use of postexposure prophylaxis (PEP) for rabies has been increasing across the U.S. this summer, the agency said in a Health Alert Network (HAN) advisory.

According to weekly pharmacy data, use of the two U.S.-licensed rabies vaccines and the two human rabies immune globulin (HRIG) products increased by an estimated 33% and 76%, respectively, from July through August compared with the same period in 2025. Health departments in at least eight states have reported increased use of rabies PEP or a rise in PEP administration errors.

“Proper administration of rabies vaccine and human rabies immune globulin is critical to ensuring patients receive effective protection while avoiding unnecessary treatment, costs, and strain on supplies,” the agency said in a statement.

In their advisory, the CDC offered clinicians a range of postexposure resources, including PEP guidance from the Advisory Committee on Immunization Practices, risk assessment tools, and state and local health department links to report potential cases.

The agency also reminded clinicians that correct PEP administration depends on a patient’s prior rabies vaccination status. People who have never been vaccinated against rabies must start PEP with both a vaccine and HRIG. Those with prior rabies vaccination don’t need HRIG when they’re revaccinated. Clinicians were advised to ask patients about immunocompromising conditions, which may require a longer vaccination course.

In general, PEP isn’t recommended when the suspect animal can be observed for 10 days, when rabies test results are negative, or when health officials decide an exposure doesn’t pose a rabies risk.

The rabies virus attacks the central nervous system and causes progressive, fatal inflammation of the brain and spinal cord. Humans are typically infected via saliva from bites or scratches by infected mammals such as dogs, bats, skunks, or raccoons.

While there are effective yet costly PEP vaccines and HRIG, there is no FDA-approved treatment to cure rabies once symptoms develop. Without timely PEP before symptom onset, infection is fatal.

Every year an estimated 1.4 million U.S. residents seek medical care after contact with a potentially rabid animal, according to the CDC, and about 100,000 people receive rabies PEP after potential exposure. Since 2000, the CDC has received one to eight reports per year of rabies-related human deaths in the U.S., primarily due to widespread canine vaccination. Two U.S. rabies deaths occurred in 2024 in Minnesota and California, both following encounters with bats.

In April, the CDC paused diagnostic testing for rabies, monkeypox, and other infectious diseases after its rabies and poxvirus labs reportedly lost about half their staff to cuts. That same month, Health Secretary Robert F. Kennedy Jr. downplayed rabies during a Senate hearing, citing the few annual fatalities from infections. Rabies diagnostic testing has since been restored, though poxvirus testing remains paused.