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 and other animals 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 was recommended in March 2010 (MMWR 2010; 59 No. RR-2). Also see Rabies (Human).

Recent Washington trends: Of bats tested for rabies in Washington, on average 3-10% are infected with rabies, though this represents a skewed population of sick or injured bats or bats that have suspected or known contact with people or animals. In the wild, it is estimated that less than 1% of bats are infected with rabies at any time. Since 1987, only five rabid domestic, terrestrial animals have been identified, three with confirmed bat variant virus and two unknown.

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 (such as bats)

Legal Reporting Requirements

Under the 2023 notifiable conditions rule revisions, only those situations in which human exposure to rabies is suspected, including confirmed rabies in animals, are reportable to the local health jurisdiction (LHJ). For the purposes of reporting, “Suspected Rabies Exposure” includes three conditions listed in the 2023 rule revisions:

  1. Rabies, suspected human exposure (suspected human rabies exposures 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); and
  3.  Rabies, suspected or laboratory confirmed human cases, or laboratory confirmed animal cases
  • Health care providers and health care facilities: immediately notifiable to local health jurisdiction
  • Laboratories: no reporting requirement; rabies virus (human or animal specimen) immediately notifiable to local health jurisdiction; specimen submission required for any clinical specimen associated with positive result, 2 business days.
  • Veterinarians: animal cases 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.

Resources

Notifiable Conditions Directory