Vital Signs

Trends in Human Rabies Deaths and Exposures — United States, 1938–2018

Emily G. Pieracci, DVM; Christine M. Pearson; Ryan M. Wallace, DVM; Jesse D. Blanton, DrPH; Erin R. Whitehouse, PhD; Xiaoyue Ma, MPH; Kendra Stauffer, DVM; Richard B. Chipman, MS, MBA; Victoria Olson, PhD


Morbidity and Mortality Weekly Report. 2019;68(23):524-528. 

In This Article


A critical component of rabies prevention in the United States is to avoid contact with wildlife, especially bats. Contact with a bat includes bites and scratches, which are often small and can be overlooked. Contact might also occur unknowingly if a bat is present in a room with a young child or mentally impaired person, including a child or person under the influence of medication, drugs, or alcohol or a person who is asleep. In those cases where unrecognized contact might have occurred, persons should assume they have a potential exposure to rabies if the bat is not available for testing and urgently seek care from their medical provider. If the bat can be safely collected and tested, this can inform the need for PEP.

CDC Travelers' Health provides vaccination recommendations for international travelers ( Although the risk of travel-associated rabies infection is generally low, travelers should know the risk, avoid contact with animals, have a plan to get care if they are scratched or bitten, and have travel health insurance to pay for treatment should they need it. Travelers at higher risk (i.e., those who might be working with animals abroad or come into close contact with animals while traveling) should additionally consider preexposure prophylaxis vaccination and be aware that PEP is still recommended after a potential exposure, even among vaccinated persons.[2]

Human rabies is 99% fatal. However, it is 100% preventable through vaccinating pets against rabies, avoiding contact with wildlife and unknown animals, and seeking medical care as soon as possible after being bitten or scratched by an animal.