vital signs trends in human rabies deaths and exposures united states 19382018 introduction each year rabies causes approximately 59000 deaths worldwide including approximately two deaths in the united states before 1960 dogs were a common reservoir of rabies in the united states however increasingly species of wildlife eg bats raccoons are the main reservoirs this report characterizes human rabies deaths summarizes trends in rabies mortality and highlights current rabies risks in the united statesmethods rabies trends in the united states during 19382018 were analyzed using national rabies surveillance data data from the healthcare cost and utilization project for 20062014 were used to estimate the number of postexposure prophylaxis pep visits per 100000 persons during 20172018 the centers for medicare medicaid services average sales price data were used to estimate pep costsresults from 1960 to 2018 a total of 125 human rabies cases were reported in the united states 36 28 were attributed to dog bites during international travel among the 89 infections acquired in the united states 62 70 were attributed to bats in 2018 approximately 55000 persons sought pep after contact with a potentially rabid animalconclusions and comments in the united states wildlife rabies especially in bats continues to pose a risk to humans travelers also might be exposed to canine rabies in countries where the disease is still present increased awareness of rabies while traveling abroad is needed vaccinating pets avoiding contact with wildlife and seeking medical care if one is bitten or scratched by an animal are the most effective ways to prevent rabies understanding the need for timely administration of pep to prevent death is critical