Rabies surveillance in the United States during 2024.

OBJECTIVE: Describe the epidemiologic landscape of rabies and rabies testing in the US during 2024. METHODS: Animal rabies testing results from approximately 130 public health, agriculture, and academic laboratories are collected by the US National Rabies Surveillance System (NRSS) each month. Data reported in 2024 were analyzed to examine temporal and geographic trends in animal rabies cases by rabies virus variant (RVV). RESULTS: In 2024, 3,834 cases of animal rabies were reported to the NRSS (4.2% of 90,343 samples submitted), representing a 2.0% increase from 2023. Of positive samples, 331 (8.6%) were domestic animals, and 3,503 (91.4%) were wildlife. The most commonly found rabid domestic animal was cats (243 positive [1.3% positivity]), and the most commonly found wildlife were bats (1,376 positive [5.7% positivity]) followed by raccoons (1,080 [10.1% positivity]). Two nonenzootic RVVs gained entry into the US in 2024. Four people died from rabies, including 2 who experienced bat exposures that were left untreated and 1 person whose case involved international travel. CONCLUSIONS: The expansion of the historical range of enzootic RVVs can lead to substantial public health and animal health burden. Domestically acquired human rabies cases in 2024 underscore the need for continual public education on the risks of rabies exposures to ensure timely and effective administration of postexposure prophylaxis. The internationally acquired human rabies case demonstrates that the US remains vulnerable to human and animal rabies importations. CLINICAL RELEVANCE: The NRSS plays a crucial role in protecting public and animal health by monitoring rabies trends in the US.