Rabies is on the rise: Experts offer advice
Infectious disease experts weigh in on what to do if you think you’ve been exposed to rabies
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Picture it: it’s the middle of the night and you’ve suddenly woken up to the sound of flapping wings.
Somehow a bat has made its way into your home.
Do you know what to do next?
The Centers for Disease Control and Prevention recently issued a health advisory for clinicians noting a nationwide increase in rabies exposure reports.
According to the report, from July through August 2026, CDC received 17% more rabies-related inquiries than during the same period in 2025.
“Rabies is an infection of the brain that is lethal in most mammals, including humans,” said Adam Lauring., M.D., Ph.D., head of the Division of Infectious Disease at Michigan Medicine, who recently had his own nighttime encounter with a bat.
“Infected animals shed virus in their saliva, and it gains entry through breaks in skin or direct contact with mucus membranes. The virus then gains access to nerves and travels along the nerves toward the brain.”
People are usually exposed via bites from infected animals, such as bats, raccoons, skunks or unvaccinated pets.
Because there's no treatment for rabies, management is focused on interrupting the virus’ ability to infiltrate the nervous system, because once that happens, it’s too late.
Rabies “is 100% fatal - or nearly so - if the exposure is not managed appropriately,” said Lauring.
Batty behavior
“If you wake up with a bat in your room, you can’t rule out a bite or scratch while you were sleeping (even if you don’t see one). So, you should contact the health department and/or animal control for trapping/testing/or recommendations,” said Lauring.
“In my case, I was so freaked out, I opened the window and ran out of the room, so we couldn’t test the bat. So, I needed to proceed with post exposure prophylaxis,” he said.
The good news is you have some time after an animal exposure, says Laraine Washer, M.D., who consulted with Lauring following his encounter.
“In most cases, rabies post-exposure prophylaxis, known as PEP, is a medical urgency, not an emergency. You can normally wait 48-72 hours to determine whether an animal is available for testing or observation.”
Unfortunately, you can’t always rely on an animal’s behavior to tell whether it’s infected with rabies.
“Specialized testing of the animal in a public health laboratory is typically required to determine if it had rabies.”
But there can be some clues, including daytime activity in a nocturnal animal or an animal attacking without provocation, says Lauring.
You've been bitten by an animal. What do you do?
If you are bitten, wash the wound with soap and water and seek medical care.
Depending on the severity and type of bite, a visit to urgent care or an emergency department may be required, says Washer, for a tetanus shot and depending on rabies reports in your area, rabies immunoglobulin and the first dose of rabies vaccine.
Rabies PEP includes four total visits for vaccine doses.
Michigan law requires that animal bites are immediately reported to the local health department.
Thankfully, rodents like squirrels, hamsters, mice, and rabbits are unlikely to have rabies in the United States and public health officials are unlikely to recommend PEP for those types of bites.
Whether rabies prophylaxis treatment is required for bites from pets, such as dogs, cats, and ferrets depends on whether they’ve been vaccinated.
“Clinicians should consult with local or state public health officials when there are questions about whether PEP is indicated,” said Washer.
Bottom line is when in doubt, say Michigan Medicine experts, seek medical attention following exposure to bats or when bitten by an animal.
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Adam Lauring, MD, PhD
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