By Alicia Ault

The CDC is warning that rabies has been on the rise this summer and it is reminding clinicians about how and when to administer treatment, noting that the complex and expensive regimen should be used only when appropriate.

In a Health Alert, the agency said that from July through August, it had received 17% more rabies-related inquiries than during the same period in 2025. The CDC also received reports from at least eight state health departments of increased use of rabies postexposure prophylaxis (PEP), errors in administering PEP, or both, it said.

As of September 2, use of the two rabies vaccines licensed in the US had increased by 33% from last summer; use of the two approved rabies immunoglobulins rose by 76%.

There have been multiple notable rabies exposures in the US over the summer, including three attacks by rabid beavers at two Maryland state parks. Several hundred people in North Carolina may have been exposed through baby goats at a mobile petting zoo; the goats were probably infected by a skunk, said health authorities.

Rabies is a common virus in the US. With the advent of vaccination of pets, rabies has evolved from primarily affecting domestic animals to being largely found in wildlife. The CDC estimates that 90% of cases now occur in bats, raccoons, skunks, foxes and other wild animals.

The virus is present in every state except Hawaii. Each year, 6 million Americans report animal bites, and 1.3 million seek care for a bite. The nation’s 3000 health departments consult on two rabies cases daily, while the CDC’s rabies experts conduct seven consultations a day, according to Ryan Wallace, DVM, of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, who spoke on a clinician-focused call about rabies in late April.

Rabies is one of the deadliest zoonotic viruses. It is always fatal once symptoms start, in part because there are no effective treatments. But PEP is effective if given soon after someone has been bitten by a rabid animal.

The US rabies infrastructure — which includes surveillance, diagnosis and PEP — have potentially prevented up to 3000 deaths a year, said Wallace. The CDC estimates that 89 Americans have died of the virus since 1990.

About 100,000 Americans are judged to require PEP each year. The CDC has detailed recommendations on when and how to administer PEP and offers a variety of tools to assist clinicians, including a PEP calculator.

There are two US FDA-approved vaccines — Imovax and RabAvert — and two approved human rabies immune globulin products, KEDRAB and HyperRAB.

With only two manufacturers and perennial supply issues, the goal is to target PEP to only those who need it. The regimen is also complex, involving several administrations over a 14- to 28-day period. It also costs about $10,000-$14,000.

Earlier in 2026, the CDC had paused testing for human rabies, but it has resumed offering the specialized diagnostics, which can be ordered by state health departments.