Rabies Update: CDC Addresses Treatment Supplies as US Cases Surge - Newsweek

The U.S. Centers for Disease Control and Prevention (CDC) has issued a nationwide health advisory warning of an increase in reported rabies exposures and a rise in the use of post-exposure treatment, after several high-profile incidents involving potentially rabid animals exposed hundreds of people across multiple states.

In its September 10 Health Alert Network advisory, the CDC said it had received 17 percent more rabies-related inquiries during July and August 2026 than during the same period last year. The agency also reported that at least eight state health departments had flagged increased use of rabies post-exposure prophylaxis (PEP), administration errors or both.

"Although there is currently no shortage of human rabies vaccine or human rabies immunoglobulin in the United States, it is important for clinicians to administer PEP appropriately because errors in rabies risk assessment and PEP administration could result in unnecessary treatment, potential adverse effects, and avoidable costs," the CDC said in its update.

The warning comes as local health departments continue responding to a series of unusually large exposure events, including a North Carolina outbreak linked to rabid baby goats that traveled with a mobile petting zoo and may have exposed hundreds of people.

Newsweek reached out to the CDC by email for comment on Friday.

The CDC said recent reports from around the country point to an increase in human exposures to rabid or potentially rabid animals. Public health officials noted that traditional rabies carriers, such as bats, raccoons, skunks and foxes, and animals less commonly associated with rabies have been involved in recent incidents.

One of the largest exposure events occurred in North Carolina, where several baby goats from a mobile petting zoo tested positive for rabies. State health officials evaluated nearly 300 people who may have interacted with the animals at community events, assisted-living facilities and private gatherings. More than 200 people were advised to undergo post-exposure treatment.

The goats were reportedly too young to have received rabies vaccinations and were believed to have been infected after being bitten by a rabid skunk. The event attracted national attention because of the unusually large number of people who potentially came into contact with the animals.

While the CDC confirmed an increase in exposures and treatment demand, health officials have not identified a single cause behind the national uptick. The agency's advisory points instead to multiple local outbreaks and mass-exposure incidents involving infected animals. Experts say heightened public awareness, increased testing and reporting, and localized spikes in infected wildlife may also be contributing factors.

Rabies is a viral disease that attacks the central nervous system and is almost always fatal once symptoms begin. However, it is preventable if treatment is started before symptoms develop.

Early symptoms can resemble many other illnesses and may include fever, headache, weakness, fatigue, nausea and sore throat. Because these symptoms are nonspecific, people may not initially realize they have a potentially life-threatening infection.

As the disease progresses, symptoms can become severe and include confusion, anxiety, hallucinations, difficulty swallowing, excessive salivation, paralysis and coma. By the time neurological symptoms appear, rabies is nearly always fatal despite intensive medical care.

The CDC emphasized that timely treatment is critical. Following a potential exposure, health officials recommend an assessment of the risk based on the type of animal involved and the nature of the contact.

If treatment is warranted, patients receive rabies post-exposure prophylaxis, commonly known as PEP. The regimen begins with immediate wound cleansing when a bite or scratch has occurred. Patients then receive human rabies immune globulin (HRIG), which provides immediate antibodies against the virus, along with a series of rabies vaccine doses.

For most people, treatment consists of four vaccine doses administered over two weeks. People who are immunocompromised may require a fifth dose and additional testing to confirm a sufficient immune response.

The CDC stressed that proper administration of HRIG and vaccine is essential. Officials warned that recent increases in treatment demand have led to concerns about dosing errors and other administration mistakes.

Although rabies treatment can be lifesaving, some patients experience side effects.

Most reactions are mild and temporary. Common side effects include soreness, redness or swelling at the injection site. Some patients also report headache, fatigue, nausea, dizziness or muscle aches following vaccination.

Serious adverse reactions are uncommon. Health officials generally consider the benefits of treatment to far outweigh the risks because rabies is almost universally fatal once symptoms develop.

The CDC continues to advise clinicians not to delay treatment when a credible exposure has occurred.

Rabies treatment can be expensive, particularly because it involves immune globulin and multiple vaccine doses.

The cost varies based on location, insurance coverage and the amount of immune globulin needed, which is calculated according to a patient's body weight. A full course of PEP can cost between $11,000 and $14,000 per person, the CDC said.

The CDC's latest advisory specifically referenced concerns about unnecessary treatment because inappropriate use can increase costs for patients and health systems while also placing strain on available supplies of rabies biologics.

At the same time, officials stressed that concerns about expense should never prevent someone from seeking medical evaluation after a potential exposure.

In the United States, bats are one of the most important sources of human rabies infections. The CDC says many recent human rabies deaths have been linked to bat exposures, sometimes when individuals were unaware they had been bitten.

Other wildlife species frequently associated with rabies transmission include raccoons, skunks and foxes. These animals serve as major rabies reservoirs in different regions of the country.

Domestic animals can also become infected. Cats are reported rabid more frequently than dogs in the United States, although vaccination programs have greatly reduced the risk among pets. Livestock, including cattle, horses and goats, can contract rabies if they are bitten by infected wildlife.

The CDC advises people to avoid direct contact with wildlife and any mammal behaving unusually, regardless of species. Health officials note that animals with rabies do not always appear visibly sick, making prompt medical evaluation essential after any potential exposure.

Contact Newsweek editors on this story: Anna Skinner and Dave Siminoff.