Rabies, Suspected Human Exposure

This information is intended for public health professionals. Please visit our rabies webpage for general information and number of rabid bats found in Washington State.

Rabies is most often transmitted in the virus-containing saliva of a rabid animal via a bite, or potentially a scratch or contamination of a mucous membrane. Other rare routes of transmission include aerosol exposure to the virus (e.g. in a laboratory) or organ transplantations. If a person has been exposed to a rabid (or potentially rabid) animal, or if a person is reasonably presumed to have been exposed to a rabid animal ("suspected exposure"), then rabies post-exposure prophylaxis (PEP) is warranted for the prevention of human rabies. Information about PEP is available from the Advisory Committee on Immunization Practices available on the CDC website at https://www.cdc.gov/rabies/. A reduction to four instead of five vaccine doses for PEP in immunocompetent persons became official in March 2010 (MMWR 2010; 59 No. RR-2). Also see Rabies (Human).

Recent Washington trends: Of bats tested in Washington 3-10% are identified as rabid, though this represents a skewed population of sick or injured bats. In the wild, we estimate less than 1% of bats are actually rabid. Since 1987, only five rabid domestic, terrestrial animals were identified, three with bat variant virus.

Purpose of Reporting and Surveillance

  • To assist in the prevention of human cases of rabies
  • To offer rabies post-exposure prophylaxis (PEP) and provide counseling to those who were exposed to a rabid, or potentially rabid, animal or human
  • To facilitate the capture and confinement of potentially rabid animals (involved in a human exposure) which have a defined observation period (dogs, cats, and ferrets); or facilitate histological examination of the brain of potentially rabid animals (involved in a human exposure) for animals that cannot be observed

Legal Reporting Requirements

Under the 2011 notifiable conditions rule revisions, the Washington Administrative Code (WAC) was modified such that reporting of all animal bites is no longer required; instead, only those situations in which human exposure to rabies is suspected are reportable to the local health jurisdiction (LHJ). For the purposes of reporting, “Suspected Rabies Exposure” includes two conditions listed in the 2011 rule revisions:

  1. Rabies, suspected human exposure (due to a bite from or other exposure to an animal that is suspected of being infected with rabies); and
  2. Animal bites (when human exposure to rabies is suspected)
  • Health care providers: immediately notifiable to local health jurisdiction
  • Health care facilities: immediately notifiable to local health jurisdiction
  • Laboratories: Rabies virus (human or animal specimen) immediately notifiable to local health jurisdiction; specimen submission required – clinical specimen associated with positive result (2 business days)
  • Veterinarians: suspected human case or exposure or animal case immediately notifiable to local health jurisdiction; animal cases (excluding bats) also notifiable to Washington State Department of Agriculture ( https://app.leg.wa.gov/wac/default.aspx?cite=16-70)
  • Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days
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