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Rabies is a relatively rare disease, but several well-publicized scares—including one at a Virginia summer camp—make this a good time to review the basics.

First and foremost, rabies is very serious and essentially uniformly fatal for humans once the disease takes hold. However, it is very rare, with only one to two cases annually in the U.S. Because there is an effective post-exposure therapy that prevents the disease nearly 100 percent of the time, it behooves us to know when to seek care.

Rabies is caused by a virus, which is transmitted via saliva of infected animals, usually through a bite in the skin. Rarely, it can be transmitted through a mucous membrane such as the eyes, nose or mouth. After infection, the virus travels from peripheral nerves to the central nervous system, brain and spinal cord. Although initially symptoms are very non-specific (fever, headache and malaise) central infection leads to the classic neurological symptoms of rabies, including

Rabies virus is found only in mammals. More than 90 percent of cases in the U.S. are caused in association with exposure to wild animals; fortunately, animal vaccination programs have dramatically decreased the instance of rabies in domestic animals and livestock. Worldwide, however, 90 percent of cases are associated with bites from stray dogs, an important consideration when traveling internationally. Pre-travel immunization is recommended prior to travel in high-risk areas, particularly in the developing world.

Georgetown’s Chief of the Emergency Department Dr. Brendan Furlong explains the basics of rabies precautions.

Determining whether an exposure warrants treatment is the critical first step. One must consider the animal source and the type of exposure. The type of exposure is also important. Rabies is most commonly transmitted by animal bites, but transmission through scratches, wounds and mucous membranes is also possible. Casual contact by itself, such as petting a rabid animal, does not constitute a significant exposure.

Further, the rabies virus needs water to live. When dry, the virus is generally harmless. Dry materials containing the virus (e.g., dried feces) are generally non-infectious. Exposure requires that the virus pass from the infected animal’s saliva, blood or other bodily fluid to your bodily fluid through an open scratch or a mucous membrane such as your eyes, mouth or nose. If you are concerned about an exposure, first clean the site of exposure thoroughly. Then contact your doctor or come to the emergency department for urgent evaluation.

If a doctor recommends treatment, you will likely receive an injection of Human Rabies Immune Globulin (HRIG) at the site of the exposure. This shot provides passive protection immediately. You will also receive Human Diploid Cell Vaccine (HDCV) immediately and on subsequent days 3, 7, 14 and 28. Usually in 7-10 days, your body will develop immunity that lasts for approximately 2 years. If you have been previously immunized against rabies, you will likely receive the HDCV booster immediately and again 3 days later.

Avoiding potential exposure is your best protection. Should you be exposed, rapid evaluation and intervention will prevent rabies from developing.

WASHINGTON - An increasing number of bats found in D.C. homes are testing positive for rabies, and the city health department is urging residents to "bat proof" their homes.

Dena Iverson of the D.C. Department of Health says the city's caught 74 bats recently and 13 of those caught tested positive for rabies.

Prince George's County reports finding nine bats that tested positive for rabies since Aug. 1, and says one person who came in contact with an infected bat was treated preemptively for rabies.

No humans have reported being bitten yet. D.C. health workers are recommending the public take steps to keep it that way.

Among the city's bat protection suggestions:

Close windows and doors;
Fix broken window screens;
Repair or screen-off points of entry such as loose shingles, vents and chimneys.

The health department says if someone is bitten by a bat or gets infectious material, such as saliva from a bat in the eyes, nose, mouth or a wound, he should wash the affected area thoroughly with soap and water and seek medical advice immediately.

The city warns citizens should not attempt to capture a bat on their own. If a bat is found in a house, animal control should be called immediately at 202-576-6664.

The rabies virus attacks the central nervous system causing convulsions, paralysis and finally death. The virus is present in the saliva of a rabid animal and is transmitted primarily by animal bites. The virus can affect all warm-blooded animals, but it is most often found in wildlife, such as raccoons, skunks, foxes and bats. Dogs and cats may contract rabies if they have not been vaccinated against it. All mammals, including humans, are susceptible to rabies.

WASHINGTON - An increasing number of bats found in D.C. homes are testing positive for rabies, and the city health department is urging residents to "bat proof" their homes.

4/6/10 Removed 1 way tunnel trap from a DC townhouse for a successful removal of squirrels. Removed nesting birds from bathroom exhaust vent before they had babies. Inspected a job in DC for squirrels, had been at the house 2 doors down 6 months ago, it seams that the middle house is still the squirrel entrance for both. Inspected behind siding for rat entrances, none to be found, to much dog poop in yard, Rat attractant. Removed squirrels from house at bottom of apex, entrance due to rotten wood.

4/7/10 DC Customer thought he has mice, removed 5 baby squirrels Installed concrete and 1 way exit door to remove rats from under concrete shelf. Insulated 300 square Feet of insulation under addition, removed dead raccoon last week. Squirrel in wall , cut hole in wall and removed 1 baby, when leaving we heard a new baby in different part of wall, cut hole to remove it also, cut 2 additional holes and found nothing.

4/8/10 Installed exit door / entrance trap device to remove squirrel, later that day customer noticed the returning squirrel carrying twigs back to entrance, so we decided to remove device and give the job 2 weeks for the suspect momma to raise her babies. I asked one of my old employees to remove it for me because I was no where close to job, he did and ill return the favor to him soon. Went to customers house and waited for her to show up........and waited.......and waited......20 min......i left, she showed up and asked me to return.....of she called when i wasn't there... i told her monday we will try again..... hope she shows on time Inspected job in DC, saw baby squirrels, boy the were big, big enough to leave on their own, with no desire to with momma the milk truck delivering every meal, so we excluded them and as of

4/10/10 the customer reports complete silence....YEA! inspected a DC snake infestation, summited an estimate

4/9/10 DC Customer reported squirrel or raccoon infestation, HAD MICE, gave him traps, I didn't charge him anything, however he gave me 100.00 for my time, love it when that happens. Customer has squirrels, again another older litter excluded them with exit door, as of

4/10/10 DC customer reports 1 out ,momma out and one more to come out. Returned to estimated job to remove bats that customer has received special permission from state to remove bats from her vents, set up nets exclusion nets. Estimated elderly care facility for squirrel infestation, vent ridge has blown off and building in dis repair. Removed 1 way door for raccoon that customer reported was a success. Customer had home improvement contractor close gable end vent, trapped raccoon in, we set exit door to get raccoon out. Started Squirrel exclusion at facia board above gutter.

4-12-10 Removed 3 skunks from A DC property. Installed a negative air machine to remove the smell from underneath the resisdence. Will be back to remove air machine and disinfect. the lady called me her god for solving her problems. That made the rest of the day go by good.

4-12-10 Arrived at a DC clients house who previously had an animal under her concrete porch removed. I trenched around the entire porch and poured concrete to prevent further intrusion.

4-13-10 I had previously excluded a raccoon out of a DC clients attic, and the raccoon punched out 8 soffitt vents, and I replaced them for free.

4-14-10 I applied eviction fluid in A DC customers attic to get rid of her raccoons. All is quiet and job is complete.

4-14-10 Once again applied eviction fluid for baby raccoons and noticed over hanging branches on clients roof. I offered to trim the branches to keep them from getting back on the roof.

4-17-10 A DC Client was complaining of hearing noises from his chimney flue. After further inspection of chimney I saw a mother and 4 babies at the bottom. I applied eviction fluid so the mother could safely remove the babies.

4/19/10 Started a bat removal job. Calked 30 feet of facia board to brick and installed bat tubes to allow bats to exit, their pervious bat removal estimate by a competitor was 4500.00 dollars and we charged them $750.00 and gave a 5 year warranty. Squirrel removal from soffet, three babies removed and mother moved them to a nearby tree, closed entrance hole with sheet metal. Set groundhog trap, customer was severely scared of animal in yard.

4/20/2010 Started contaminated attic insulation removal, Cut hole in roof so as not to remove insulation through interior of house, removed insulation, 600 sq ft. removed dead mouse from house, that was the slinkiest mouse I have ever smelt. Removed raccoon exit door from attic fan, closed entrance permanently. Set up rat exclusion and installed rat exit door, surrounded with concrete. Took of two 1 way doors because customer hasn't heard any more squirrel noise. Set raccoon trap at metro rail yard for raccoon, set trap in sewer. Excluded a bird and squirrels at an enclosed porch.

4/21/2010 Set up squirrel exclusion and closed side vents on house with wire mesh, removed 1 piece of soffet material, and installed 1 way door @ soffet for squirrel exit. Inspected strange attic noise to see if animals were present, attic was animal free, now the customer really has to figure out what noise was, neighbor to his house has raccoons in chimney. drove 1 hour to next job and when I got there the customer was difficult, he wanted to dictate to me how I was to do his job, so I respectfully declined his job and referred him to my competitors, One bad egg can spoil your basket. I went Home

4/22/10 Set up squirrel exclusion at rear facia, return next week to complete. removed 1 baby squirrel from job an bug / pest company tried to do, they just screened entrance hole and were to let the babies die inside, opened their work and found 1 baby close to death, tried to revive him, and he died hrs later, never let an exterminating company do wildlife work. Started raccoon with babies eviction at house, hope all goes well. Customer called with a mother raccoon with babies in a yard drain, opened grate, took out babies, placed them in a box 20 ft from yard drain, mother came out for them, closed yard drain and she took babies up the tree.

4/24/2010 My helper finished Attic insulation removal and replacement on 4/22/10 so I replaced the wood and shingles that we removed earlier in week, just in time for the rain that's coming today. Started another raccoon mother with babies job, this raccoon is hold up in a dormer.

The mention of rabies still causes alarm and exaggerated fears among many people, but the truth is that the virus presents much less of a danger to humans now than ever before. Largely thanks to widespread pet vaccinations, aggressive post-exposure treatment policies, and humans' relative resistance to the disease, the numbers of rabies-related human deaths in the United States has steadily declined to an average of only one or two per year. Human fatalities caused by lightning strikes and bad hamburgers far exceed the number of human deaths caused by rabies.

This doesn't mean you shouldn't be concerned about rabies. Sensible precautions should still be taken to protect yourself, your family, and your pets. Preventing exposure to rabies, vaccinating your companion animals, and seeking prompt post-exposure treatment when advised to do so by a physician or local health department are the best ways to guard against this disease.

What is Rabies?

Rabies (Lyssavirus) is an infectious disease that affects the central nervous system in mammals. Saliva provides the primary transmission medium when an animal is in the clinical stage of rabies. The virus is not transmitted through the blood, urine, or feces of an infected animal, nor is it spread airborne through the open environment.

For the rabies virus to get to the salivary glands, it must travel first from the site of entry (usually a bite wound), through the animal's nervous system, and then to the brain. This is what causes most rabid animals to exhibit abnormal behaviors, depending on what part of the brain is infected. Rabies may manifest in a "furious" form, in which an animal may be agitated, bite or snap at both imaginary and real objects, and salivate excessively. The "dumb" form of rabies manifests in animals as creeping paralysis; wild animals may appear "tame" and seem to have no fear of humans.

The rabies virus travels to the salivary glands during the final stage of the disease—this is the time when an animal is most infectious. But the virus cannot penetrate intact skin; people can get rabies only via a bite from a rabid animal or through scratches, abrasions, open wounds, or mucous membranes contaminated with saliva or brain tissue from a rabid animal. And the virus is short-lived when exposed to open air—it isn't viable after saliva dries up. If you are handling a companion animal who has been in a fight with a potentially rabid animal, take precautions such as wearing gloves to prevent any still-fresh saliva from entering an open wound.

Any warm-blooded mammal can carry or contract rabies, but the primary carriers in North America are raccoons, skunks, bats, foxes, and coyotes. Since 1960, rabies has been more frequently reported in wild than in domestic animals in the United States. Wildlife now account for more than 90 percent of all reported rabies cases. Raccoons suffer the most from this fatal disease in the eastern United States, while skunks are the dominant rabies victims in the north and south central states (although skunk rabies also occurs in the East). The occurrence of bat rabies is not limited to any particular geographic area, and cases are scattered widely across the continental United States. Strains of fox rabies occur in western Alaska, parts of Arizona and Texas, and the eastern United States. Coyote rabies has occurred in southern Texas in the past but has been very rare in recent years.

Vaccination programs targeting wildlife have been instituted in many regions over the past 15 years and are helping to reduce the transmission of rabies between wildlife and people. Administered by federal or state wildlife officials, these programs entail the strategic distribution of baits containing oral rabies vaccines for wildlife.

Human Deaths from Rabies

Given all the media attention that rabies regularly receives, it may be somewhat surprising to learn that very few people die from rabies nationwide each year. During the past 10 years, rabies caused a total of 28 human fatalities in the United States, largely because the victims failed to recognize the health risks associated with bite wounds and did not seek medical advice or treatment. Seven of those people died after contracting rabies in a foreign country; five others included an organ donor and organ transplant recipients who tragically succumbed to rabies after the donor was misdiagnosed.

The few human deaths resulting from rabies have been almost entirely due to a domestic bat strain or from a canine strain that victims contracted in a foreign country. Despite the fact that raccoons suffer from rabies more than any other mammal in the United States (about 35 percent of all animal rabies cases), only one human death from the raccoon strain of rabies has ever been recorded in the United States. Most of the bat cases have been of the silver-haired bat strain, which is surprising, since this solitary species is rarely found in or around human dwellings. Only a very small percentage of bats carry rabies—less than one-half of one percent of all bats in North America.

Despite the long odds, the remote possibility of infection exists and should not be taken lightly. If you suspect that a rabid bat has bitten you or if a bat is found in the room where a person is sleeping—scrub any visible bite wound with soap and water right away and seek immediate treatment from a physician or local health department. Immediate medical treatment for any bite wound is always advised. The Centers for Disease Control and Prevention recommend that any bat discovered to have been in a room with a sleeping person be captured and submitted to local or state health authorities for rabies testing. The reason for this is that the bite from a bat can be so insignificant that it could be overlooked by an adult or unreported by a child.

Often the mere sight of a wild animal during the day—such as a fox, raccoon, or skunk—is enough for some people to fear that the animal may have rabies. But wild animals haven't read the textbooks telling them they should be nocturnal. For example, it's actually quite common for foxes to be active during the day. And during the spring and early summer, mother raccoons who are hard pressed to feed their young adequately through their nightly forays often take to foraging during the daylight hours. You many also see orphaned animals active by day. (Learn more about how to recognize if a wild animal is orphaned or injured here.)

Some wild mammals, such as small rodents and rabbits, rarely get rabies. A more common, fatal problem for squirrels is the roundworm brain parasite, which infects the brain and results in clinical signs that look similar to rabies. And no one knows exactly why, but opossums are amazingly resistant to rabies. Hissing, drooling, and swaying are part of the opossum's bluff routine, which is intended to scare away potential predators.

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While the Risk Is Low Be Aware of Rabies

Rabies & Wildlife


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