Rabies
January 2012
What is rabies?
Rabies is a severe viral disease that affects the central nervous system. It is almost always fatal.
All warm-blooded mammals including humans are susceptible to rabies.
What mammals carry rabies?
The primary reservoir of rabies in the northwest United States is bats. Between 5-10% 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 and injured bats; less than 1% of all bats in
the wild are infected with rabies. Rabid bats have been found in almost every county in Washington.
While rabid raccoons, skunks, foxes or coyotes have not been identified in Washington, the virus
can be transmitted from bats to these mammals. In other parts of the United States, Canada, and
Mexico, rabies reservoirs include raccoons, skunks, foxes or coyotes. In developing countries
worldwide, dogs are the principal rabies reservoir.
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 1 to 7 cases annually. Almost all human rabies cases acquired in the United
States since 1980 have been due to bat rabies virus. When human rabies occurs due to exposure outside of
the United States it is usually the result of the bite of a rabid dog.
Has human rabies occurred recently in Washington?
There have been two cases of human rabies identified in Washington during the last 20 years. 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
was diagnosed with rabies. These two Washington residents were infected with bat rabies virus.
Has rabies occurred recently in domestic animals Washington?
During the last 20 years, several domestic animals in Washington have been diagnosed with rabies. In 2002,
a rabid cat was identified in Walla Walla County with bat rabies. In 1994, a llama in King County died
after becoming infected with a bat rabies virus, and in 1992, a horse in Benton County died of rabies.
The last suspected rabid dog was identified in Pierce County in 1987.
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.
How is rabies spread?
The rabies virus is found in the saliva of a rabid animal. It is usually spread to humans by animal bites.
Rabies could potentially be spread if the virus comes into contact with mucous membranes (eye, nose,
respiratory tract), open cuts, wounds, or abraded skin. Person-to-person transmission of rabies has occurred
only through tissue transplantation.
What are the symptoms?
While early symptoms include headache, fever, and sometimes pain at the site of the exposure (bite), the
disease rapidly progresses into a severe neurologic illness. Neurologic symptoms may include agitation,
confusion, paralysis, and difficulty swallowing. Most patients die within a few days or weeks of onset.
How soon do symptoms appear?
Normally two to eight weeks after exposure, but the incubation period may vary.
What should I do if an animal bites me?
Clean the site of any animal bite with soap and water. Contact your health care provider and
local health department
to determine the potential for rabies exposure, the need for treatment, and to decide whether or
not to test the animal for rabies.
What should I do if I find a bat in my living space?
Do not touch the bat. Close the doors and windows to the room. Wait until the bat lands on
the floor or a wall. Wearing leather or other thick gloves, capture the bat in a can or box
without touching it. Seal the container and call your
local health department.
The health department will help you determine if any people or pets in your home may have been
exposed and can arrange to test the bat for rabies, if needed.
“Bat proof”
your home by making sure open windows have screens and other small entry points, such as cracks,
crevices, or holes, are sealed.
What treatment is available after exposure to rabies occurs?
Safe and effective treatment following potential rabies exposure should begin as soon as
possible after the exposure occurs. Treatment, called post-exposure prophylaxis (PEP),
includes one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine
given on a specific schedule over a 14-day time period (days 0, 3, 7, and 14); persons with
weak immune systems will also need a fifth dose of vaccine given on day 28 and a blood test
to check that the vaccine worked. Treatment can be arranged through your health care provider
and your local health department.
What can I do reduce the risk of rabies exposure for my family and me?
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Do not handle wild animals, especially bats.
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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.
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If you see a wild animal leave it alone.
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Do not keep wild animals as pets.
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Keep bats out of your living space by
“bat proofing” your home.
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Pets may get rabies if bitten by a rabid animal. Protect them and yourself by getting them
vaccinated routinely. Dogs,
cats, and ferrets are now required to be vaccinated in Washington. Consult your
veterinarian for vaccine recommendations.
Pre-exposure vaccination
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 (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 for more information.
Pre-exposure vaccination is also recommended for any person whose occupation involves frequent risk
of rabies exposure. In Washington this includes anyone who handles bats, veterinarians, employees
in veterinary clinics, and laboratory workers where rabies test specimens are handled.
Where can I get more information?
Documents posted in .pdf version on the Department of Health Web site will be made available in
an alternative format on request to users who are unable to download or view .pdf files on the Web.
To request an alternative format, contact: Webmaster.
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