Rabies is a virus that infects the brain and central nervous system of humans and animals.
Early symptoms of rabies infection include fever, headaches, weakness, and discomfort, as well as a prickling or itching sensation at the site of the bite.
Later symptoms include agitation, anxiety, insomnia, confusion, delirium, hallucinations, hydrophobia (fear of water), difficulty swallowing, drooling, partial paralysis, and eventual death (nearly 100% fatal).
It may take weeks or months to get sick after exposure. This can vary depending upon the location of the bite, type of rabies virus, and any existing rabies immunity.
The rabies virus is found in the saliva of infected animals. The virus is spread through a bite or scratch from an infected animal.
Animals most often affected by rabies are bats, skunks, foxes, and raccoons. Bats are the most common source of human rabies exposure in the United States. Domestic cats and dogs are rarely found to be rabid. Small rodents, such as squirrels, chipmunks, mice, rats, hamsters, rabbits or hares are almost never found to be infected with rabies and have not been known to transmit rabies to humans.
Rabies treatment is usually recommended for a wild animal bite, and sometimes for a domestic animal bite, when the animal is not available for testing/observation. Rabies treatment is also recommended after exposure to a bat while sleeping.
Two types of treatment must be used together to prevent rabies disease once a person has been exposed:
For more information about possible rabies exposure, call 248-858-1286, or toll free 1 (800) 848-5533, Ext 8-1286. If bitten after Health Division business hours, seek medical attention for wound care. Your provider will work with the Health Division to report the bite and assess for potential rabies exposure.
Persons who have not previously received post-exposure or pre-exposure prophylaxis and are not immunocompromised:
Persons who have not previously received post-exposure or pre-exposure prophylaxis and are immunocompromised:
Patients should do serum testing to assess immune response to vaccination 1-2 weeks after treatment is complete.
Persons who have previously received post-exposure or pre-exposure prophylaxis:
The Centers for Disease Control and Prevention (CDC) recommends that treatment be initiated, if warranted, within 2 weeks (14 days) of an animal exposure. Unless the wounds are to the neck or the face, there is plenty of time to assess the situation, wait for an animal to be quarantined, or wait for test results.
Skunks, Raccoons, Foxes, Groundhogs, Beavers - Treatment should be initiated for any person that has been bitten or scratched and the animal is not available for testing. If the animal is available for testing, so long as the wound is not to the neck of face, initiation of treatment can wait until the test results on the animal come back.
Feral or Stray Cats - Treatment should be initiated for any person that has been bitten or scratched by a feral or stray cat that is not available for quarantine or testing. If the cat is a known stray (i.e. a cat the victim feeds every day) the victim can monitor the cat to make sure they continue to see it for 10 days after the bite. If the animal disappears or cannot be found on or after the 10-day mark, rabies treatment should be initiated. If the animal displays neurological symptoms/symptoms of rabies during the 10-day quarantine, the animal should be tested. If testing is not possible, treatment should be initiated.
Domestically Owned Dogs, Cats, and Ferrets - Rabies in domestic animals is exceedingly rare in the United States. If the animal has an owner, the animal can be quarantined for 10 days. If the animal displays neurological symptoms/symptoms of rabies during the 10-day quarantine, the animal should be tested. If the animal is alive, well, eating and drinking 10 days after the bite, no treatment is needed.
Squirrels, Rabbits, and Rodents (Hamsters, Guinea Pigs, Gerbils) - These animals are considered too small to survive an attack by a rabid animal. Oakland County Health Division does not recommend rabies treatment for exposures to these animals.
Per the CDC: "Recent data suggest that transmission of rabies virus can occur from minor, seemingly unimportant, or unrecognized bites from bats".
CDC and Oakland County Health Division recommend consideration of post-exposure prophylaxis (PEP) if:
Testing of animals that have come in contact with humans or domestically owned animals can be facilitated by animal control agencies. Most of Oakland County is serviced by Oakland County Animal Control, however, certain cities and townships have their own animal control departments. Please contact Oakland County Animal Control at 248-858-1090 during business hours for assistance with animal testing.
For the animal control webpage regarding animal testing, please visit our Animal Bite Investigations page.
The National Association of State Public Health Veterinarians (NASPHV) publishes the Compendium of Animal Rabies Prevention and Control. The recommendations in this document serve as a basis for animal rabies prevention and control programs throughout the United States and facilitate standardization of procedures among jurisdictions, thereby contributing to an effective national rabies control program.