Rabies

Rabies Frequently Asked Questions

What is rabies?

Rabies is a viral disease that infects the central nervous system. If a person does not receive the appropriate medical care after a potential rabies exposure, infection with the virus is almost always fatal. All warm-blooded mammals including humans are susceptible to rabies.

Which mammals carry rabies?

In the United States, rabies virus is adapted to various animal species which have different versions of the virus. Every state, except Hawaii, has bats with rabies (bat rabies variant). Some states have other animals with rabies, such as raccoons, skunks, or foxes. In Washington, bats are the only known mammal to carry rabies. While rabid raccoons, skunks, foxes, or coyotes have not been identified recently in Washington, the virus can be transmitted from bats to these mammals.

Between 3-10% of bats submitted for testing are found to be rabid. Bats tested for rabies are more likely to test positive for rabies because they tend to be sick or to come into contact with a person or other animal. Less than 1% of bats in the wild are infected with rabies. Rabid bats have been found in almost every county in Washington. Visit our Rabies Activity webpage to learn more about rabid animals identified in the state.

How is rabies spread?

The rabies virus is found in the saliva and brain tissue of a mammal infected with rabies. It is usually spread to people by animal bites. Rabies could be spread if the virus comes into contact with mucous membranes (eye, nose, and respiratory tract), open cuts, or wounds. Other animal contact, such as petting a mammal infected with rabies or contact with its blood, urine, or feces does not result in infection. Person-to-person transmission of rabies has occurred only through tissue transplantation.

What can I do reduce the risk of rabies exposure for my family and me?

Do not touch or handle wild animals, especially bats. Teach your children never to touch or handle bats, even dead ones. Have your children tell an adult if they find a bat at home, at school, or with a pet. If you see a wild animal, leave it alone. Report wildlife observations. Do not feed wild animals or try to keep them as pets. Keep bats out of your living space by bat-proofing (PDF) your home. Pets can get rabies if bitten by a mammal infected with rabies, such as a bat. Protect your pets and yourself by getting them vaccinated against rabies on a schedule recommended by a veterinarian. Dogs, cats, and ferrets are required to be up-to-date on rabies vaccination in Washington.

What should I do if an animal bites me?

Immediately wash any animal bite with soap and water. Contact your health care provider and local health department to determine the potential for rabies exposure and the need for treatment, and for authorities to decide if the animal should be tested for rabies.

What are symptoms of rabies infection?

Symptoms normally appear two to eight weeks after exposure, but this period may vary up to months. Early symptoms include headache, fever, and sometimes pain at the site of the exposure (bite). The disease rapidly progresses into a severe nervous system (neurologic) illness. Symptoms may include agitation, confusion, paralysis, and difficulty swallowing. Most patients die within a few days or weeks of onset.

What treatment is available after exposure to rabies occurs?

Post-exposure Vaccination

Rabies in humans is 100% preventable through prompt, appropriate medical care. Safe and effective treatment following potential rabies exposure should begin as soon as possible after the exposure occurs. First, immediately wash all bite wounds and scratches with soap and water. Medical treatment is a series of shots. These shots, called post-exposure prophylaxis (PEP), include one dose of human rabies immunoglobulin (HRIG) and rabies vaccine given on the day of rabies exposure or the day of initiation of treatment, and then a dose of vaccine given on days 3, 7, and 14. People with weakened immune systems will also need a fifth dose of vaccine and a blood test to check that the vaccine worked. People who have been previously vaccinated against rabies should only receive vaccine (no HRIG), on days 0 and 3 after a rabies exposure.

Although treatment should begin as soon as possible following a potential rabies exposure, it is not too late to start treatment following potential rabies exposure if recommended by a healthcare provider or your local health jurisdiction.

Treatment can be arranged through your health care provider and your local health department. Patient assistance programs that provide medications to uninsured or underinsured patients are available for rabies vaccine and immune globulin.

If the animal involved in the exposure event is tested for rabies and tests negative, treatment can be discontinued. Animal testing can be arranged through your local health department.

Is there a way to prevent infection before an exposure to rabies?

Pre-exposure Vaccination

The majority of people in the US have a low risk of coming into contact with the rabies virus. However, people who are at higher risk of coming into contact with rabies should receive rabies pre-exposure vaccination. Pre-exposure vaccination is recommended for any person whose occupation involves frequent risk of rabies exposure. In Washington this includes anyone who handles bats (such as some animal control workers), veterinarians and veterinary staff, and laboratory workers where rabies test specimens are handled. A complete description of vaccination recommendations by risk category is available from the CDC.

Travelers going to an area of the world where dog rabies is common should consider pre-exposure rabies vaccinations. This is recommended if you are planning an extended trip to such an area (e.g., more than 30 days) or if your activities will take you into remote areas where medical care may be difficult to obtain in a timely manner. Contact your health care provider and local health department for more information.

What should I do if I find a bat in my living space?

Never handle a bat with bare hands. Call your local health department so they can help you determine if the bat needs to be tested for rabies. Only capture bats that have had direct contact with a person or pet, or if the bat was found in the room of someone who may have had contact with the bat. Instructions for safely capturing bats for rabies testing (PDF). Watch Public Health-Seattle & King County's video on how to safely capture a bat in your home.

How common is human rabies and what is the source of the rabies virus?

Human rabies is an extremely rare disease in this country. Since 1990 the number of reported cases in the United States has ranged from one to seven cases per year. Almost all human rabies cases acquired in the United States since 1980 have been due to bat rabies virus. Most of the human rabies cases that occur due to exposure outside of the United States are a result of a bite from a dog infected with rabies. In Washington, there have been two cases of human rabies identified during the last 75 years, and both residents were infected with bat rabies virus. In 1995, a four-year-old child died of rabies four weeks after a bat was found in her bedroom; and in 1997, a 64-year-old man died of rabies; exposure in this situation was unknown.

Has rabies occurred recently in domestic animals in Washington?

During the last 30 years, four domestic animals in Washington have been diagnosed with rabies. In 2015, a cat infected with bat rabies virus was identified in Jefferson County. Previous identifications of animals infected with bat rabies virus include a cat in Walla Walla County in 2002 and a llama in King County in 1994. In 1992, a horse in Benton County died of an unidentified strain of rabies. The last suspected rabid dog was identified in Pierce County in 1987.

CDC regulations govern the importation from other countries of animals capable of causing human disease, including dogs and cats.

In 2007, a rabid puppy imported from another country passed through Washington on its way to another state. It was diagnosed with rabies shortly after arriving at its destination, where it is counted as an animal case for that state. Several people in Washington were exposed. Learn why you should get your pet vaccinated for rabies.

Where can I get more information?

For more information call your local health department or Communicable Disease Epidemiology 206-418-5500 or toll-free 877-539-4344.

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