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- Rabies is a preventable viral disease of mammals most commonly transmitted by a rabid animal bite.
- In the U.S., rabies is mostly found in wild animals such as bats, raccoons, skunks, and foxes.
- The virus infects the central nervous system.
- If a person does not receive the appropriate medical care after a potential exposure to rabies, the virus can infect the brain and result in death.
- Rabies can be prevented by vaccinating pets, staying away from wildlife and stray animals, and seeking medical care after a bite and before symptoms begin.
Who is at risk?
Who is at risk for exposure to rabies virus?
- Any mammal can be infected with rabies virus.
- Rabies virus is contained in the saliva or brain tissue of a rabid animal.
- Rabies is spread when the virus is introduced into a bite wound, open cuts in skin, or onto mucous membranes such as the eyes, nose, or mouth.
- If contact with either of these materials has occurred, the exposure should be evaluated by a healthcare provider to determine if treatment to prevent rabies is necessary.
Most exposures fall under two categories, bite and non-bite.
- Any penetration of the skin by teeth is a bite exposure.
- Bites by some animals, such as a bat, can be minor and difficult to detect.
- The circumstances under which a bite happened are important and help to determine if rabies is a concern from the bite.
- The contamination of open wounds, abrasions, or mucous membranes are nonbite exposures.
- Nonbite exposures rarely cause rabies, but such exposures should be evaluated to determine if rabies treatment is necessary to prevent rabies infection.
- Rabies virus becomes noninfectious when it dries out or is exposed to sunlight.
- Contact such as petting or handling an animal, or contact with other body fluids such as blood, urine or feces is not a risk for rabies exposure and treatment to prevent rabies is not necessary.
What are the signs of rabies in a person?
- After an exposure to rabies, the virus must travel from the site of the bite to the brain before symptoms begin. This is called the incubation period, and it can last from a few weeks to months.
- The early symptoms of rabies in people are not specific to rabies and may include fever, headache, general weakness, and discomfort that may include prickling or an itching sensation at the site of a bite. These symptoms may last for days.
- Over time, symptoms that are more specific to brain dysfunction appear and may include difficulty sleeping, anxiety, confusion, hallucinations, agitation, partial paralysis, difficulty swallowing, and hydrophobia (fear of water).
- Once symptoms of rabies occur, the disease is nearly always fatal. Treatment at this stage is typically supportive.
- There have been fewer than 20 reports of human survival from rabies disease, and only a few of those had no previous treatment for rabies.
- Rabies disease can be prevented however, with prompt treatment following possible exposure to the virus.
What are the signs of rabies in an animal?
- Any mammal is susceptible to rabies.
- You cannot tell if an animal has rabies by looking at it, but animals with rabies may behave strangely or in ways you don't expect.
- For these reasons, you should leave wild animals alone, including baby animals.
- Rabies disease in animals is similar to the disease in people.
- The first symptoms of rabies in animals are not specific to rabies and may include fever, lethargy, vomiting and lack of appetite.
- Within days, symptoms that are more specific to brain dysfunction appear and may include weakness, difficulty walking, paralysis, seizures, difficulty swallowing/excessive salivation, abnormal behavior and aggression.
- Rabies can be prevented in pets and livestock through vaccination.
Diagnosis and Testing
How is rabies diagnosed in an animal?
- It is important to quickly and accurately identify rabies in animals that may have exposed a person or an unvaccinated pet.
- Rapid diagnosis is needed to provide for the timely administration of post-exposure treatment.
- If testing can be performed within a day or two of exposure, it may save a patient from unnecessary medical treatment and the associated financial burden, if the animal is not rabid.
- In animals, rabies is diagnosed by looking for the virus in brain tissue using the direct fluorescent antibody (DFA) test.
- Brain tissue is required for this test so it can only be performed on animals that have died or been humanely killed.
- The Michigan Department of Health and Human Services Bureau of Laboratories is the only laboratory in Michigan that can test animals for rabies.
- Testing of animals in Michigan that have potentially exposed people is performed daily and must be arranged through your local health department.
How is rabies diagnosed in a person?
- In humans, a number of tests are required to diagnose rabies before death has occurred. No single test is sufficient. Samples of serum, cerebral spinal fluid, saliva, and skin are necessary.
- Tests to detect virus and antibodies produced by the body against rabies virus are used to make a diagnosis of rabies in a person.
- Testing of human samples must be coordinated through the Michigan Department of Health and Human Services, and must be approved by the Centers for Disease Control and Prevention, where the specialized rabies testing is performed.
How is rabies prevented once a person has been potentially exposed?
- Bites from animals can be a risk for more than rabies.
- Animal bites can cause serious injury, such as nerve or tendon damage, and the can lead to local and even systemic infections.
- Wound cleansing is an important infection prevention measure and can markedly reduce the risk for rabies.
- Seek medical attention for any bite wound so that proper treatment can be initiated.
- You may also need to receive a tetanus booster if you have not been immunized in more than 10 years.
Rabies Postexposure Treatment:
- To prevent rabies in a person that has potentially been exposed to rabies, a series of injections must be initiated and completed. This is called Rabies Postexposure Prophylaxis.
- For people who have never received rabies vaccinations in the past, treatment must include the administration of both rabies antibody (rabies immune globulin, or HRIG) and vaccine.
- For people who have been previously vaccinated against rabies should receive only rabies vaccine.
- This combination treatment is recommended for both bite and non-bite exposures, regardless of the time that has passed between the exposure and the start of treatment.
How Can I Prevent Being Exposed to Rabies?
Animals: Be a responsible pet owner
- Keep vaccinations up-to-date for all dogs, cats, ferrets, horses, cattle, and sheep. Michigan law requires that dogs and ferrets must be vaccinated for rabies and it is recommended that all cats and any domestic livestock in contact with the public be vaccinated if a licensed vaccine exists.
- Vaccination is important for keeping your pet from getting rabies, but it also provides a barrier of protection for you if a wild animal bites your pet.
- There is no post-exposure treatment available for animals. As a result, unvaccinated pets and domestic animals that are exposed to a potential rabies carrier may be required to be euthanized.
- Do not keep wild animals or exotic animals as pets. Many wild and exotic species make poor pets. No rabies vaccine is licensed for use in these species. It is illegal to keep wild animals as pets, and wild animals may not be kept except by persons who possess Wildlife Rehabilitation permits.
- Keep your pets under direct supervision so they do not come in contact with wild animals that may be carrying rabies. If your pet is bitten by a wild animal, seek veterinary assistance immediately.
- Call your local animal control agency to remove any stray animals from your neighborhood. Strays may be unvaccinated and could be infected with rabies.
- Spay or neuter you pets to help reduce the number of unwanted animals that may not be properly cared for or regularly vaccinated.
People: Avoid contact with unfamiliar animals
- In Michigan, rabies most commonly occurs in bats, therefore, prevent bats from entering living quarters or occupied spaces in homes, churches, schools, or other similar settings where they might come in contact with people and pets.
- In situations where a bat has been in close contact with people, if possible, safely confine the bat and contact your local health department to determine if it should be tested for rabies or can be let go.
- Do not approach, handle, feed, or unintentionally attract wild animals with food, open garbage cans or litter. Tightly cap garbage cans. Feed pets indoors.
- Do not attempt to capture or feed feral cats. Unlike stray domesticated cats, feral cats are born in the wild and should be treated as wild animals.
- NEVER adopt wild animals or bring them into your house. Do not try to nurse unfamiliar sick animals to health. Call animal control for assistance in these situations.
- Teach children NEVER to handle unfamiliar animals, wild or domestic, even if they appear friendly. "Love your own, leave other animals alone" is a good principle for children to learn.
- Seek medical attention if bitten or scratched by a stray or wild animal.
- Animal bites should be reported to the local health department.
- Rabies Post-exposure Prophylaxis (PEP) is highly effective in preventing rabies in people possibly exposed to a rabid animal, if administered before symptoms develop.
Data and Statistics
Current Year Rabies Maps for Michigan
Previous Year Rabies Maps for Michigan
National Data and StatisticsHuman Rabies Case information
International Data and Statistics
CDC - Travelers' Health Page
WHO - Rabies Bulletin
Guidance Documents and Educational Materials
- Poster: Rabies PEP Guidance for Healthcare Providers and Facilities
- Michigan Rabies Assessment Flowchart: When a Person has been Exposed
- Michigan Rabies Assessment Flowchart: When Animals have Bitten People or been Exposed
- Michigan Rabies Assessment Flowchart: Zoo or Exotic Animal Bites
- Compendium of Animal Rabies Prevention and Control, 2016
- ACIP Human Rabies Prevention—United States, 2008
- ACIP Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies
- Guidelines for Humane Euthanasia of Bats
Where can I find more information about rabies?
- Centers for Disease Control and Prevention Rabies Website
- Beware of Rabies. Be Aware of Rabies. Learn about rabies in bats and other animals, how to prevent rabies, and what to do if bitten or scratched by an animal.
- Video: How to safely catch a bat
- Video: Are you at risk for rabies?
- Communicable Disease Division Publication Order Form - (Order rabies flowcharts, refrigerator magnets, brochures, or stickers free of charge for use by Michigan local health departments, healthcare providers, social service agencies, and others)