In California, bats, skunks and foxes are the wild animals most likely to test positive for rabies. Coyotes, raccoons and opossums can also transmit rabies. Occasionally, domestic animals such as cats, dogs, rabbits and horses, cattle, goats and sheep can be infected with the rabies virus. Small rodents, such as squirrels, rats, mice, hamsters, guinea pigs, gerbils and chipmunks are seldom infected with rabies. The safest rule of thumb is to never approach or handle wildlife, especially if it appears ill or injured, and to make sure that pets are appropriately vaccinated against rabies.
Because San Mateo County is a rabies-endemic county (California Code of Regulations, 2606), all bites that involve animals capable of transmitting rabies must be reported. Download Animal Bite Report Form. The form must be faxed to (650) 685-0102. For more information, you may call the Peninsula Humane Society and SPCA at (650) 340-8200, or San Mateo County Health System Communicable Disease Program at (650) 573-2346.
Health care providers who have questions regarding the need for rabies post-exposure prophylaxis (rabies PEP), may call San Mateo County Health System Communicable Disease Program at (650) 573-2346 during business hours. After hours, and for emergencies only, providers may call (650)363-4981 and ask for the on-call Health Officer.
Q: What is rabies?
A: Rabies is a preventable viral disease of mammals that affects the central nervous system. The virus is usually passed to humans through the bite of a rabid animal. Occasionally, rabies can be transmitted if the saliva of an infected animal gets into a fresh scratch, break in the skin or comes in contact with mucous membranes (eyes, mouth, nose).
Rabies is found on all continents except Antarctica. In developing countries, rabies in dogs is still a major problem, and in these areas, tens of thousand of people die of the disease each year.
The majority of cases in the United States occur in wild animals like raccoons, skunks, bats and foxes. Feral cats and groundhogs are also at high risk for carrying rabies. Coyotes and opossums can also be infected. In the United States, rabies is uncommon in pet cats, dogs, horses, cows and other domesticated animals but can occur, especially if the animal is not up to date on rabies immunizations. Small, wild, free-living mammals such as mice, rats, squirrels, gophers or indoor pet rodents such as hamsters, gerbils and guinea pigs are almost never infected with rabies. In California, most cases of rabies occur in skunks and bats. In 2009, 226 rabid animals were identified in California, including 41 foxes, 44 skunks and 141 bats. In San Mateo County, 2 bats tested positive for the rabies virus in 2009.
Q: How is rabies spread and how does a person get rabies?
A: The virus is usually passed to humans through the bite of a rabid animal. Occasionally, rabies can be transmitted if the saliva of an infected animal gets into a fresh scratch, break in the skin or comes in contact with mucous membranes (eyes, mouth, nose). On very rare occasions, it has been transmitted at the time of organ transplantation.
Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, feces) does not constitute an exposure and does not require postexposure prophylaxis. In addition, contact with someone who is receiving rabies vaccination does not constitute rabies exposure and does not require postexposure prophylaxis.
Because most bats’ teeth are extremely small and needle-thin, people can be bitten in their sleep and not have any visible wound or mark. For this reason, if you find a bat in your room when you wake up or see a bat in the room of an unattended child, mentally impaired or intoxicated person, you should seek medical advice and have the bat tested, if possible, even in the absence of an obvious bite wound. To have the bat captured/removed, call the Peninsula Humane Society at 650-340-8200.
Q: What are the symptoms of rabies?
A: Rabies symptoms in humans usually appear 3 to 8 weeks after exposure, but can appear within a few days or after several years. The early symptoms can be very similar to those of the flu, including general weakness or discomfort, fever, and headache. As the disease progresses, more specific symptoms appear such as discomfort or a prickling, itching sensation at the site of the bite, anxiety, confusion, insomnia, agitation, partial paralysis, hallucinations, difficulty swallowing, hypersalivation (increase in saliva) and hydrophobia (fear of water). Once symptoms develop, the disease is almost always fatal.
Q: What is the treatment for rabies?
A: Once people develop symptoms, the disease is almost always fatal. So far, only one person, a teenager from Wisconsin who was bitten by a bat and presented to the hospital with symptoms one month later, survived. For this reason, if you think you may have been bitten by a rabid or possibly rabid animal, you should wash the wound thoroughly with soap and warm water and consult a physician immediately.
The physician, in consultation with the Health System will determine if you need rabies vaccination. Decisions to start vaccination, known as postexposure prophylaxis (PEP), will be based on your type of exposure and the animal you were exposed to, as well as laboratory and surveillance information for the geographic area where the exposure occurred.
In the United States, postexposure prophylaxis usually consists of a regimen of one dose of Human Rabies Immune Globulin (HRIG) and four doses of rabies vaccine over a 14-day period. Human Rabies Immune Globulin and the first dose of rabies vaccine should be given by your health care provider as soon as possible after the exposure. Additional doses of rabies vaccine should be given on days 3, 7, and 14 after the first vaccination. Current vaccines are relatively painless and are given in your arm, much like a flu or tetanus vaccine. PEP is 100% effective at preventing human rabies. There have been no vaccine failures in the United States (i.e. someone developing rabies) when PEP was given promptly and appropriately after an exposure.
Q: How do I protect myself from rabies?
A: Rabies in humans is 100% preventable through prompt appropriate medical care. If you think you may have been exposed to rabies, please contact your healthcare provider who will decide if rabies postexposure prophylaxis (PEP) is required.
Rabies can also be prevented by:
1) Being a responsible pet owner. Keep your cats and dogs up to date on all their rabies vaccinations. Maintain control of your pets by keeping them under direct supervision to reduce their exposure to wildlife. Spay or neuter your pets to help reduce the number of unwanted pets that may not be properly cared for or vaccinated regularly. Call animal control to remove all stray animals from your neighborhood since these animals may be unvaccinated or ill.
2) Avoiding contact with unfamiliar animals. Enjoy wild animals from a distance. Do not handle or feed wild animals. Place litter in closed garbage cans. Never adopt or bring wild animals into your home. Teach your children to never handle unfamiliar animals, wild or domestic, even if they appear friendly. Prevent bats from entering areas where they may come in contact with people or pets. When traveling abroad, be sure to avoid contact with animals, especially dogs in developing countries, where rabies is common.
3) Receiving pre-exposure vaccination, when it is indicated. Pre-exposure vaccination may be recommended for veterinarians, animal handlers, field biologists, cavers, certain laboratory workers and some international travelers.
Information for Medical Providers
Please help the San Mateo County Health System Communicable Disease Program by filling out and submitting an animal bite report form every time you provide care to an individual who has been bitten by an animal. Download Animal Bite Report Form. Please fax the form to the Peninsula Humane Society and SPCA at (650) 685-0102.
If you have questions or need more information regarding rabies or the management of animal bites, please call (650) 573-2346. Whether PEP is indicated or not should be based on the type of animal involved, its health and behavior, the type and circumstances of the exposure and the availability of the animal for diagnostic testing or observation, a usually complex situation that requires evaluation on a case by case basis.
Additional Information and Useful Link
Peninsula Humane Society & SPCA