The Centers for Disease Control and Prevention reports that in the last 12 months, the United States has seen six rabies-related fatalities, marking the highest toll in years. From aggressive skunks in Kentucky to grey foxes and raccoons in Long Island, biodiversity in over a dozen states is facing a surge in lethal diseases, partly due to diminished natural habitats and improved monitoring.

“We are monitoring 15 potential outbreaks that may vary,” stated Dr. Ryan Wallace, leader of the CDC’s rabies division. Areas affected by these outbreaks include Nassau County, New York, which, last month, showed concerns about rabies beyond the notorious wildlife, with states like Cape Cod, Massachusetts, Alaska, Arizona, California, Indiana, Kentucky, Maine, North Carolina, Oregon, and certain Vermont regions also noted.

“There seems to be an increase in inquiries and reports from various parts of the US,” Wallace commented. “It remains to be seen whether these numbers will show a significant rise by the end of the year. However, for now, we are experiencing a high volume during peak rabies season.”

Rabies is found in all states except Hawaii, with bats being the primary carriers of human rabies infections. According to the CDC, they are also the species most likely to be infected with the virus.

Each year, approximately 1.4 million Americans receive a series of vaccinations to guard against potential rabies exposure, as reported by the CDC.

Samantha Lang was among those last month. The 22-year-old believed a bat had bitten her after one flew into her apartment through a ceiling gap in Greenwood, Indiana. The day after noticing a small mark on her arm, she found the bat hanging from her air conditioning vent. Upon contacting local health authorities, she was advised to receive post-exposure rabies prophylaxis, which she promptly did.

“I didn’t think it was a big deal,” Lang remarked.

Rabies viruses infiltrate the central nervous system and are nearly always deadly once symptoms manifest. Early symptoms, which can appear within a week to a year post-exposure, mimic influenza, rapidly evolving into confusion, paralysis, difficulty swallowing, and hallucinations, often resulting in death within a few weeks.

Experts express concern regarding the uptick in human rabies fatalities last year. In contrast, between 2015 and 2024, the CDC documented 17 human rabies cases.

Most rabies exposures happen through the saliva of infected wildlife and can penetrate through wounds, eyes, or mouths, making bites particularly hazardous. Prior to the 1960s, the majority of human rabies infections originated from domestic pets, especially dogs. Strict vaccination regulations have effectively eradicated rabies in dogs across the US.

A stark rise in wildlife rabies cases has been noted in Franklin County, near North Carolina’s Research Triangle, which has seen confirmed cases in wildlife double over the past year.

“This year’s rabies season has been alarming with a 100% rise in confirmed cases,” remarked county health director Scott Lavigne.

Lavigne believes that the expansion of urban areas into wildlife habitats is a significant factor accelerating the spread of rabies.

“Franklin County’s population has increased by 35% since 2010, creating new demands for housing,” he explained. “This leads to land development and the growth of residential neighborhoods.”

Animals that were previously secluded are now more densely populated, increasing the likelihood of rabies spreading among them, Lavigne noted.

Often, individuals are unaware of their exposure to rabid animals. Fatalities have been recorded from individuals who did not realize they were bitten or who encountered a bat and declined necessary vaccinations.

In December, a California teacher succumbed to rabies a month after handling bats in her classroom, unaware of her infection.

Viruses adapt and present differently based on animal species and strains. Many assume rabid animals are aggressive, yet sometimes infected creatures exhibit calm behavior.

“There’s a rabies strain that can make animals unusually friendly,” Lavigne shared. “A family observed a raccoon in their backyard that appeared ill yet was friendly and sought affection.”

The family cared for and fed the raccoon until it died, subsequently calling animal services to remove the body. “Thankfully they did because it tested positive, and the entire family required vaccinations,” Lavigne noted. “If they hadn’t contacted animal services, they would have remained oblivious.”

Concerns Regarding Dog Vaccination Rates

With the increasing spread of rabies among wildlife, veterinarians are particularly worried about vaccine hesitancy among pet owners. A 2023 survey published in a journal revealed that nearly 40% of respondents felt the dog vaccine was unsafe, while 37% believed it might cause cognitive issues in dogs, such as autism.

Gabriella Motta, a veterinarian from Glenolene, Pennsylvania, and a co-author of the study, has encountered many clients apprehensive about the vaccine’s safety for their dogs.

“This is a concern that may escalate in the future,” Motta explained. “If vaccination rates continue to dwindle due to hesitancy, could we witness an increase in rabies not only among wildlife but also in pets? We’re starting to raise alarms.”

The rabies vaccine has evolved significantly from when injections were given in patients’ abdomens after exposure. The current regimen involves administering a dose of immunoglobulin containing rabies antibodies right after exposure, followed by four additional vaccine injections into the arm.

Experts advise that rabies should be suspected whenever a wild animal displays abnormal behavior.