Over the last 100 years, rabies in the United States has changed dramatically. More than 90% of all animal cases reported annually to CDC now occur in wildlife; before 1960 the majority were in domestic animals. The principal rabies hosts today are wild carnivores and bats. The number of rabies-related human deaths in the United States has declined from more than 100 annually at the turn of the century to one or two per year in the 1990’s. Modern day prophylaxis has proven nearly 100% successful. In the United States, human fatalities associated with rabies occur in people who fail to seek medical assistance, usually because they were unaware of their exposure.
UPDATED ACIP HUMAN RABIES PREVENTION RECOMMENDATIONS –
The revised human rabies prevention recommendations of the Advisory Committee on Immunization Practices describing the use of a reduced (4 dose) vaccine schedule for postexposure prophylaxis to prevent human rabies is now available at http://www.cdc.gov/mmwr/pdf/rr/rr5902.pdf. These recommendations update the 2008 recommendations and 1) provide updated information on human and animal rabies epidemiology; 2) summarize the evidence regarding the effectiveness, immunogenicity, and safety of rabies biologics; 3) present cost-effectiveness of rabies postexposure prophylaxis and 4) present recommendations for rabies pre- and post-exposure prophylaxis.