Q&A: A rabies expert on rising exposure reports and keeping human cases rare

A greater number of rabies-related inquiries and post-exposure prophylaxis use this summer has raised questions about whether rabies activity is increasing in the United States. Rodney E. Rohde, PhD, SV/SM/MB(ASCP)CM, FACSc, Regents' professor and chair of the Medical Laboratory Science Program at Texas State University, says the distinction between a higher volume of exposures and confirmed human rabies cases is critical.

In this interview with dvm360 for World Rabies Day, Rohde discusses what may be driving the recent uptick, including seasonal wildlife activity and increased human-wildlife interactions, and explains why unusual exposures can create complex public health investigations. He also addresses misconceptions about rabies treatment and emphasizes the role veterinarians play in vaccination, early recognition, risk assessment, and communication with public health authorities.

Below is a transcript of the conversation, lightly edited for clarity.

dvm360: The CDC is reporting an increase in potential human exposures to rabies this past summer. As a public health official with experience in rabies tracking, is there anything that stands out as unusual about this activity?

Rodney E. Rohde, PhD: I’m going to back up a little bit and preface that question because I really want to preserve the distinction between increased exposures and post-exposure (PEP) utilization and increased confirmed human rabies cases.

There's not been more confirmed human rabies cases in the United States. On average, we might have one to two to three deaths from rabies in humans per year. We have hundreds and thousands of animal [cases], unfortunately, but human cases stay pretty low, thankfully. So, what's really being seen is that increase in exposure. Even on the pharmaceutical side, they're seeing an increase in post-exposure utilization like vaccine and human rabies immune globulin utilization.

What I think stands out is the breadth and the diversity of exposures. CDC reported a 17% increase in rabies related inquiries during July and August of 2026 as compared to 2025. So, they're looking across a year's difference. That really reinforces that rabies remains an active zoonotic threat, even though human rabies itself is kind of rare in the United States, and that's a really important distinction there.

Related: Amid new CDC advisory, AVMA details recent rabies exposure incidents, reiterates vaccination policy

dvm360: Is that increase in reported exposures because there may actually be more activity, or is it just that in this modern day and age we're simply better at reporting it?

Rohde: So, those numbers can reflect changes in several things. For example, seasonal changes can be cyclical in animal activity. Perhaps there was a good year of rainfall. Perhaps there's a lot of food availability, and all of a sudden, the animal population, whatever it is—coyote, fox, skunks—will explode. And when you have that explosion in the population, you can have the transmission of rabies go up. More animals, more transmission.

You could also think about human-wildlife interaction in the summer months. Historically, rabies exposures go up because people are out playing in the woods or going to the lake. They're just doing more things in the wildlife area. And then there are the unusual exposure events.

Education [also] raises awareness. [There have been] some stories about rabies with respect to CDC kind of pulling back on reporting and surveillance this past year. And then just from [news] reporting and post-exposure utilization, awareness may have risen.

I've been doing this for 30 years plus, and nothing gets people's anxiety rising like rabies. It is a paradox—death from rabies is 100% preventable if you get the vaccine and the PEP before clinical symptoms occur, which many people know. But they can’t just let it go—if you think you've been exposed to a bat or a wild animal and you're not really sure, you definitely need to follow up.

That's really why we must continue animal and laboratory surveillance before concluding that rabies itself is broadly increasing. We always need to have our radars up and our ability to understand what's happening in that human to animal interaction.

dvm360: You bring up a great point about the anxiety. As kids, a lot of us heard exaggerated stories about how terrible treatment is, like the tall tales of having to get 30 shots in your stomach or something awful like that.

Rohde: I still get that question; I had a book chapter specifically about it. It’s long gone, but [remembering those stories] can lead to fear of reporting if someone is thinking, "Oh my God, 30 shots in the stomach!” Today it’s basically 4 to 5 shots in the arm depending on your immune status. It's like getting a regular flu shot or a tetanus shot, it just has to be given over a course of about 28 days.

dvm360: There was a widely reported case this past July in North Carolina in which petting zoo patrons were exposed to rabies through baby goats. How unusual is a case like that?

Rohde: It's not totally unusual, but it's not common, right? It illustrates the fundamental rule that any warm-blooded mammal can acquire rabies. In the US, exposures are commonly from bats. We've had some really sad cases of people dying from bat rabies.

While livestock aren't our primary reservoirs, they can become infected after exposure to wildlife and subsequently expose people. In the North Carolina case, the three baby goats were laboratory confirmed with rabies after likely exposure to a skunk.

The way we know that is once you test an animal like a goat, a dog, a cat, a cow, you can type it and find out the rabies variant, and there are actually different types of skunk variants. Our pets and our livestock are usually vaccinated in most cases, but goats [are] maybe not as much as cattle, horses, pigs, and things like that. But because [the goats] weren't and they acquired rabies, there wasn’t that safety barrier between wildlife, domestic animal, and human. [At the petting zoo], the animals were held, they were fed, they were probably cuddled, so then it weaves, if you will, a large human exposure investigation.

It becomes really difficult when you have to think of all the people coming into a petting zoo or something similar. It happens in schoolyards, too, where a kid might have a bat. You know, little kids are notorious for picking up an animal or a dead animal and showing it off to people. So now, all of a sudden, you're having to interview every parent, putting out media announcements—“Did you come to this particular event? Did your child pet the goats?”—and that becomes anxiety for families because now you have to go into some type of post-exposure risk analysis and what those individuals might have to do.

It's another excellent example of why we should really think beyond just traditional bat, raccoon, skunk, fox rabies when we're assessing rabies risk. There are unfortunately still occasional cases from pets, livestock, or something you wouldn't normally associate with rabies. It can happen and veterinarians and physicians know this. They are our first line of defense in doing that patient history when that happens.

dvm360: In light of the CDC press releases and subsequent press coverage, I'm sure veterinarians are getting a lot more questions about rabies exposure. What would you want an audience of veterinarians and animal care specialists to take away from what's happening right now, and how should they counsel clients?

Rohde: First, I would say thank you to all the veterinarians out there. They are the most passionate professionals I've seen when it comes to animal health, and animal health is human health, right?

So, I would tell veterinarians, and they know this, to keep animals appropriately vaccinated, whether it's domestic or livestock. Look for those early potential exposures because we know how important recognition of those signs are, and then continue to work really closely with public health authorities on risk assessment. Your public health department is probably your best source of finding out where hotspots are around the state, the region where you're at, and even helping you determine prompt, evidence-based decisions that can protect both animals and people, while also helping them to avoid unnecessary [PEP]. PEP can be expensive and hard to get, so that risk assessment by veterinarians and physicians is critical. Always critical.

dvm360: Is there anything else you’d like to add?

Rohde: I just want to remind people that human rabies remains rare. It's not something we should be freaking out about every day, but rabies risk has not disappeared. Surveillance, vaccination, laboratory diagnostics, and rapid, accurate One Health communications are what keeps it rare. We need those things in place even when things are quiet. That really goes for all infectious diseases.