The Centers for Disease Control and Prevention has issued a health advisory warning of a nationwide increase in human rabies exposures. The agency also flagged a rise in errors when clinicians administer the treatment that prevents the disease.

What the CDC Reported

From July through August, the CDC received 17% more rabies-related inquiries than during the same period last year, including reports of mass exposure events, according to the agency’s September 10 health advisory. At least eight state health departments reported increased use of post-exposure prophylaxis, known as PEP, administration errors, or both.

Demand for treatment has climbed sharply. Pharmacy data show use of the two licensed rabies vaccines is up about 33% from last year, while use of the two rabies immunoglobulins is up about 76%. The CDC says there’s currently no shortage.

A Petting Zoo Outbreak in North Carolina

One of the summer’s largest events involved rabid baby goats from the Harmony petting zoo, a mobile operation that made at least 10 visits between July 28 and August 27. Stops included assisted living centers and a back-to-school event. Nearly 300 people were exposed, and state health officials recommended PEP for 213 of them, according to CNN’s coverage.

Health officials haven’t identified a single cause for the broader national increase in exposures.

Why Treatment Errors Matter

Rabies is nearly always fatal once symptoms begin. It is preventable, though, when PEP is given correctly before that point.

How PEP Works

PEP is not a single shot. People who have never been vaccinated against rabies receive human rabies immune globulin, called HRIG, along with four vaccine doses over two weeks. People who were previously vaccinated need only two vaccine doses and should not receive HRIG.

Common Mistakes

The CDC listed several errors it has seen. They include giving the vaccine in the buttocks, mixing HRIG and vaccine in the same syringe, and giving HRIG to someone already vaccinated. These mistakes can lead to unnecessary doses, side effects, and added costs. A typical course of PEP runs $11,000 to $14,000 per person.

Most of the advisory is directed at clinicians and health departments. For everyone else, it’s a reminder that rabies remains one of the more serious animal-related threats in health news, even though human cases in the United States are rare.

How to Lower Your Risk

The CDC recommends a few basic precautions:

• Keep your distance from wildlife, especially animals that seem sick or are active at unusual times
• Keep pets up to date on rabies vaccines
• Wash any bite or scratch with soap and water for 15 minutes
• Talk with a clinician or public health professional promptly about whether treatment is needed

North Carolina officials have asked anyone who had contact with goats from the Harmony petting zoo during that period to contact their local health department.

Aloha News Network will report on updates to the CDC’s guidance and any new exposure events as health departments continue tracking cases this fall.