Rabies (hydrophobia)

Updated: September 2008

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What is rabies?

Rabies is a deadly disease caused by a virus that attacks the central nervous system (brain and spinal cord). It can be transmitted from infected mammals to humans and is almost always fatal once symptoms appear. Fortunately, only a few human cases are reported each year in the United States.

Who gets rabies?

All mammals including humans can get rabies. Among wild animals, rabies is most often seen in raccoons, bats, skunks and foxes. Reptiles (for example, lizards and snakes), amphibians (like frogs), birds, fish and insects do not get or carry rabies.

How do people get rabies?

Rabies virus is found in the saliva and nervous tissue of rabid animals. Rabies is most commonly transmitted to people who are bitten by and therefore exposed to the saliva of a rabid animal. Although rare, exposure can also occur if saliva or nervous tissue from a rabid animal gets into a scratch or other fresh wound (one that has bled within 24 hours) or mucous membrane (eyes, nose, mouth). There have also been a few cases of person-to-person transmission among persons who received organ transplants when it was not known that the organ donors were infected with rabies.

Can people be exposed to rabies and not know it?

While unlikely, it is possible that a person may be exposed to rabies from a bat and not realize it. Bats have small, sharp teeth and a person who is unaware or unable to tell someone else about their exposure (for example, a small child or a sleeping person) may not recognize a puncture wound or notice pain from a minor bite. Therefore, it is possible for someone to be bitten by a bat without knowing it as described in the following scenarios. These scenarios are examples of situations where an exposure could have occurred and should be discussed with a doctor or your local health department:

  • contact between a bat and a person's bare skin
  • bat found in a room with a sleeping person
  • bat found in a room with an unattended child
  • bat found close to an unattended young child outdoors
  • bat found in a room with a person under the influence of alcohol or drugs or with other sensory or mental impairment

What are the symptoms of rabies?

Early symptoms include irritability, headache, fever and sometimes itching or pain at the site of exposure. Within days, the disease progresses to paralysis, spasms of the throat muscles, convulsions, delirium and death.

How soon after exposure do symptoms appear?

The incubation period (time between exposure to the virus and the start of symptoms) is variable but is normally several weeks to several months. Incubation periods of over one year have been reported in rare cases.

How is a person treated if they are exposed to rabies?

First, the wound should be washed with lots of soap and water as soon as possible. People should then call their healthcare provider and have a doctor evaluate and treat the wound if necessary. The healthcare provider, person exposed, or that person's parent/guardian should then contact the local health department, where someone will assist in determining whether rabies treatment is needed. Treatment for rabies exposure consists of one dose of rabies immune globulin (dosage dependent on body weight) and five doses of rabies vaccine given on days 0, 3, 7, 14 and 28 after exposure. The rabies immune globulin should be given as soon as possible after exposure. The full amount of immune globulin should be injected into and around the wound, if possible. The first dose of vaccine should be given at the same time but in a different site, usually in the upper arm.

What happens if a rabies exposure goes untreated?

Exposure to a rabid animal does not always result in rabies. If treatment is initiated promptly following a rabies exposure, rabies can be prevented. If a rabies exposure is not treated and a person develops clinical signs of rabies, the disease almost always results in death.

What should be done if a bat is found indoors?

If the bat is found in any situation where a person or pet may have had contact with it, the bat should be captured and kept until the local health department can be contacted to determine whether the bat should be tested for rabies. To avoid losing the bat, if possible, leave one person in the room watching it with doors and windows closed, while another person goes to get a coffee can, lid, gloves, or similar equipment to capture it. It may be helpful to keep capture supplies in sleeping areas, especially if your home has had problems with bat infestation in the past. Your local health department may also be contacted for advice on how to capture the bat and submit it for rabies testing. If it is certain the bat did not have contact with a person or pet, the bat can be allowed to leave through an open window. Do not exit the room until you observe the bat leaving through the window. Close the window when the bat leaves.

How can I prevent bats from coming into my home?

You can inspect your home for evidence of bat infestation and possible ways that they can enter, and then take corrective measures to keep bats out of your home. Information about bats in homes can be found in the NYSDOH Fact Sheet for Bat Inspection in Homes.

What can be done to protect a pet from rabies?

New York State law requires all cats, dogs and ferrets to be currently vaccinated against rabies. Initial vaccination must done by the time the animal is four months of age, or as soon as the animal is acquired if it is older. After initial vaccination, all animals must be revaccinated one year later and then every one, three or four years according to the type of vaccine used. You should consult your veterinarian to determine the appropriate schedule for your pet.

Licensed rabies vaccines are also available for horses, cattle and sheep. For other animals, it may be worthwhile to vaccinate them if they are valuable and/or have the potential to be exposed to rabies. Consult your veterinarian to discuss vaccinating your animals against rabies.

Why is pet vaccination important?

Pet vaccination is important because vaccinated pets act as a barrier between wild animals and people to keep the rabies virus from spreading.

What should be done if a vaccinated pet fights with another animal?

Any time your pet fights with a wild animal, or another pet, contact your local health department for advice about what to do. Even though your pet has been vaccinated, a booster dose of rabies vaccine may be needed within five days of the incident. If your pet fought with a known or suspect rabid animal a booster vaccine will prevent your pet from getting rabies as a result of the incident.

What can be done to prevent the spread of rabies?

Exposure to rabies may be minimized by:

  • having all pets vaccinated and keeping them up-to-date on their vaccinations
  • avoiding contact with all wild animals, especially those acting abnormally.

To control the spread of rabies in wild animals such as raccoons, the New York State Department of Health oversees projects to distribute a special bait containing rabies vaccine. Baits are placed in areas frequented by raccoons in order to immunize them against rabies.

Where can I get more information about rabies?

Contact your county health department. Each county health department in New York State has a plan to respond to rabies that includes information on human treatment and submitting animal specimens for rabies testing. You can find the phone number for your county health department in the Government--County section of your local telephone directory.