Human Rabies Deaths — Minnesota and California, 2024

Rabies is an enzootic viral disease in the continental United States and is typically transmitted through the bite of an infected mammal. Infection is almost always fatal if rabies postexposure prophylaxis (PEP) is not received before the onset of symptoms. Bats are the leading source of U.S. human rabies cases. In 2024, CDC identified two U.S. human rabies deaths in September (Minnesota) and November (California) in persons who had a recognized bat encounter but might not have been aware of the potential rabies risk. Neither patient reported the bat encounter to public health officials nor sought medical attention, including PEP, before symptom onset. Health officials conducted risk assessments among 384 persons in Minnesota, North Dakota, and California who had possible contact with either the bats that were presumed to have rabies or the patients while they were infectious; 45 (12%) of these persons were recommended to receive PEP. Bat bites often result in trivialized or inapparent wounds. Anyone with a possible bat exposure, even in the absence of a recognized bite, should immediately report the encounter to a health care provider or to public health officials for risk assessment, consideration of options for bat testing, and PEP administration, if indicated. Increased awareness of the potential risk for rabies after any bat interaction, even without a visible bite wound, might help prevent deaths.