Fewer than 10 people die from rabies in the United States each year. That number has held steady for decades, making human rabies exceptionally rare in this country. The picture changes dramatically when you look at animals: roughly 5,000 rabies cases in animals are reported annually, with more than 90% occurring in wildlife.
Human Cases Over Time
Between 1960 and 2018, a total of 125 human rabies cases were reported in the US. Of those, 89 were acquired domestically, including six cases linked to organ transplants. The remaining cases involved people who were infected abroad and developed symptoms after returning to the country. That works out to roughly one to three domestic cases per year, a figure that reflects both widespread pet vaccination and the availability of treatment after potential exposures.
The low death toll doesn’t mean exposure is uncommon. Tens of thousands of Americans receive preventive treatment each year after being bitten or scratched by an animal that could carry the virus. The average cost of that treatment runs about $3,800 for the vaccine series alone, not counting hospital or emergency room fees.
Bats Are the Primary Threat
Among the 89 domestically acquired cases from 1960 to 2018, 62 (70%) were caused by bat strains of the virus. That makes bats far and away the leading source of human rabies in the US. Many of those cases involved people who didn’t realize they’d been bitten, since bat bites can be small enough to go unnoticed during sleep or casual contact.
Raccoons, skunks, and foxes account for most of the remaining animal cases reported each year. These species circulate their own distinct strains of the virus in different regions of the country. Raccoon rabies is concentrated in the eastern US, while skunk and fox variants circulate in the central and southwestern states. Domestic dogs, once the primary source of human rabies in America, now account for a tiny fraction of animal cases thanks to mandatory vaccination laws.
Why the Numbers Stay So Low
Three layers of protection keep human rabies rare in the US. The first is pet vaccination. Laws requiring dogs and cats to be vaccinated against rabies effectively broke the main transmission route from animals to people. The second is wildlife vaccination. The USDA distributes millions of oral vaccine baits across the landscape each year, targeting raccoons, coyotes, and foxes. These programs eliminated the dog-coyote variant of rabies from the US entirely in 2008 and have cut a gray fox outbreak zone in the southwest by 50%. A raccoon-focused program along the eastern US has created a vaccine barrier that prevents the westward spread of raccoon rabies beyond the Appalachian Mountains.
The third layer is post-exposure treatment. If you’re bitten by a potentially rabid animal, a series of shots given over two weeks is nearly 100% effective at preventing the disease, as long as treatment starts before symptoms appear. Once symptoms do appear, rabies is almost universally fatal. Only six human survivors of symptomatic rabies have been well documented worldwide.
Which Animals Carry Rabies Most Often
Of the roughly 5,000 animal rabies cases reported in the US each year, the vast majority involve four species:
- Raccoons are the most frequently reported rabid animal, primarily across the eastern seaboard.
- Skunks carry rabies across the central US and parts of California.
- Bats are found in every state except Hawaii and are the species most likely to transmit rabies to humans.
- Foxes maintain rabies in parts of Texas, the Southwest, and Alaska.
Domestic animals make up less than 10% of reported cases. Cats are actually reported rabid more often than dogs in the US, partly because cats are less consistently vaccinated and more likely to encounter wildlife outdoors.
What This Means Practically
Your actual risk of contracting rabies in the US is extremely low, but the consequences of an untreated exposure are so severe that any potential contact with a rabid animal is treated as an emergency. If a bat is found in a room where someone was sleeping, if a wild animal bites or scratches you, or if a stray dog or cat breaks the skin, treatment is recommended regardless of whether the animal appeared sick. The virus can incubate for weeks to months before symptoms start, and by then it’s too late for treatment to work.
Keeping pets up to date on rabies vaccination remains the single most effective thing most people can do to reduce their risk. Avoiding contact with wildlife, especially animals that seem disoriented or unusually tame, eliminates most of the remaining exposure scenarios.