An estimated 856 (213–2220) human rabies deaths occurred in the United States between 2000 and 2024, suggesting that only about 7% of cases were confirmed. In February 2025, rabies was diagnosed in a kidney transplant recipient and in the donor, who died in December 2024. This is the fourth case of transplant-mediated transmission since 1978. On average, 2.4 cases are confirmed annually in the U.S. and Puerto Rico. Underreporting is attributed to the long incubation period, unobserved or unrecognized exposures, and underdiagnosis in deceased donors.
