Rabies

Rabies is a serious infection that affects the brain and nervous system. The rabies virus is transmitted through the saliva of an infected animal, most commonly by a bite; however, it may also be transmitted through scratches contaminated with saliva, or if saliva from the infected animal comes in contact with the eyes, nose, mouth, or an open wound. It can take weeks to months for infection to develop after an exposure if someone does not receive treatment. Once clinical signs appear, rabies is almost always fatal.

Rabies in humans is rare. Only mammals can get and spread rabies – meaning animals like birds, reptiles and amphibians pose no risk of rabies. Small rodents like mice, rats, squirrels, chipmunks and rabbits rarely transmit rabies, so they are also not generally considered a concern.

In Ontario, animals at higher risk of rabies include bats, raccoons, skunks, foxes and coyotes. Rabies in domestic animals like dogs, cats and livestock is less common. Rabies vaccination in domestic animals is highly effective. For unvaccinated animals, the risk of rabies depends on several factors, like the situation of the incident, how the animal is kept, the animal’s history, and its health status at the time of and immediately after the incident. Reports of animals found positive for rabies are publicly posted on the Canadian Food Inspection Agency’s Website here: Rabies in Canada - inspection.canada.ca.

To be at risk of contracting rabies, an animal must bite your skin or lick an open wound, or saliva from an animal must get in the eyes, nose, or mouth, or scratches must occur where there is a risk that saliva was introduced to the wound. Blood, urine, feces and fur do not pose a risk for rabies. Touching a dead animal or the surfaces an animal may have touched is considered very low risk, unless there is risk of saliva entering a fresh open wound or the eyes, nose or mouth.

Because bats have such small teeth and claws, any direct touch from a live bat is considered an exposure, unless it's certain that thick clothes or gloves suitably protected the person’s skin from touching the bat. Touching a dead bat (unless in children) or other high-risk animals where there are no bites or scratches is not considered to be a risk for rabies.

If the incident involves a domestic animal like a dog or cat, if possible, collect information from the animal owner to help verify the animal’s health and vaccination status. If you are bitten by a wild animal that was captured or is now deceased as part of the incident, try to keep the animal in a safe, controlled area, as testing may be recommended.

1. Immediately wash the wound with soap and lots of running water, ideally for at least 15 minutes. Apply an antiseptic if available.
2. Seek medical attention; exposures should be treated as soon as possible. The healthcare facility you visit will report the incident to public health. Then, your physician will conduct a risk assessment to determine if rPEP is needed.
3. Public Health investigates all reports of animal exposures to support risk assessment for rabies exposure. Ideally, Public Health will identify the animal involved and verify its health and vaccination status through a 10-day observation period (14 days for livestock, like horses and cows). If the animal is wild or deceased, it may be sent for testing to determine if it was infectious with rabies at the time of the incident. If the animal is not available for either observation or testing, Public Health and your healthcare provider will collaborate to decide risk and next steps.

Being in the same room as a bat does not present a risk of rabies unless there was direct contact (touching). Most people will know if a bat has touched them and would wake up if a bat landed on them or potentially bit or scratched them. Though the bite may be too small to feel, contact with the bat’s body and flapping wings would likely be felt and would generally wake someone up if the bat landed on them directly.

If you find a dead bat in your home or yard and there has been no direct contact, you can safely dispose of the bat by double-bagging it and disposing of it with household waste. Avoid touching the bat directly; either handle it with gloves or with the bag it will be disposed of in. Touching a dead bat with intact skin should not pose a risk of rabies but should still be avoided.

The rabies virus does not survive well outside the body of an infected animal, so the risk of getting rabies from touching an animal’s fur, or touching surfaces or objects an animal with rabies may have touched, is low.

Rabies virus is not considered to spread through the air, except in highly specific scenarios, such as caves that are infested with infected bats. Being near a bat or other animal with rabies does generally not present a risk of infection unless there is direct contact (touching).

Only animals involved in human exposures are eligible for testing through Public Health. Public Health cannot submit any animal for testing if no exposure occurred (e.g. if a bat or other wild animal is found in a room or deceased in a yard), or if the exposure occurred between the animal and a pet. Public Health does not order pets to be euthanized. Generally, a domestic pet (like a family dog or cat) would only be sent for testing if there was high suspicion of rabies.

If your pet has been scratched or bitten by another animal, contact your veterinarian; animal exposure assessments and testing are completed at their discretion.

Treatment consists of a series of vaccinations given over two weeks. On the first day of treatment (called day 0), the vaccine is given alongside injectable rabies immunoglobulin at a dose calculated according to your weight. Additional vaccine doses are given on days 3, 7, and 14. People who are immunocompromised may get an additional dose on Day 28. Ideally, post-exposure treatment is started soon after the exposure has occurred; however, in certain situations, including when an animal has been sent for testing, treatment may be delayed a few days while results are pending.

Assessing the risk of rabies and need for vaccine is context-specific and requires collaborative decision-making by healthcare providers, the person involved, and public health. This decision may also include findings from any assessments made by a veterinarian caring for the animal. Many factors are considered, including the type of injury or exposure, the animal type, and local rabies epidemiology.

Pre-exposure vaccine for humans is often received by people working in the animal-care sector or those travelling internationally to higher-risk countries. People at higher risk of rabies exposures should speak with their healthcare provider if they are interested in receiving the rabies vaccine. The vaccine is not publicly funded and is usually paid for by the individual. It does not offer lifelong immunity, so protection must be routinely monitored and vaccination repeated if protection levels drop.

Animal exposures are reportable to public health. Healthcare providers, veterinarians, police and animal service organizations must notify Public Health any time they are aware of a potential exposure. People may also self-report an incident to Public Health using our online form.

Public Health does not seize or order removal or euthanization of animals.

If a bite is reported, Public Health will contact the owner to confirm the animal’s identity and review its health and vaccination status. After exposure to a domestic pet, Public Health will advise completing a 10-day observation period (14 days for livestock such as horses and cows), during which the animal’s health is monitored. During this time, minimize the animal's interactions with other humans or animals. If the pet is not up to date on immunizations, it must wait until after the observation period to receive its vaccine. If, after the observation period, the animal remains healthy, it is considered that there is no risk of rabies transmission during the exposure. If the animal becomes ill or goes missing during this period, owners are asked to contact Public Health immediately.

Pet health and potential exposures should be discussed with your veterinarian. A bite or scratch to your pet from another animal, with no exposure to a human, generally would not warrant a public health investigation. Public Health also cannot submit animals such as bats or other wild animals for testing in scenarios where only the pet came into contact with the wild animal.

Domestic dogs and cats over three months of age must be vaccinated against rabies, as required by Ontario Regulation 567/90. Rabies vaccination in animals is highly effective. Generally, rabies vaccines last for one to three years, depending on the type of vaccine used. You should keep a record of your pet's vaccination status. If you’re uncertain whether your animal is up to date, check with your veterinarian.