Human Rabies - Virginia, 2017

Canine rabies was eliminated from the United States in 2004, but remains endemic in 122 countries. Since 2008, nine persons have died from rabies in the United States following a rabies exposure abroad. A U.S. citizen was bitten by a puppy while in India; rabies postexposure prophylaxis was not sought. The traveler developed rabies upon return to the United States and died during hospitalization. Seventy-two health care providers were exposed to infectious materials. Treatment for exposures cost approximately $235,000. This case highlights the importance of prompt rabies diagnosis to minimize health care-associated exposures. Persons traveling internationally should seek pretravel guidance, including recommended vaccination and prophylactic measures.