Throughout human history, few illnesses have provoked as much anxiety as has rabies. Known as a distinct entity since at least 500 B.C., rabies has been the subject of myths and legends across time and cultures. And while the incidence of human cases in the US has declined markedly over several decades, rabies continues to inspire dread today. Amidst this concern is a great deal of misinformation about the disease.

Rabies (or hydrophobia), is a viral disease transmitted via the bite of an infected (rabid) animal or by its lick over an open cut. The rabies virus is present in the infected animal's saliva.  After a person is bitten by an infected animal, the virus multiplies at the bite site, and then travels along nerves to the brain. Once in the human brain, inflammation causes delirium, painful muscle spasms in the throat, and usually death. Pet vaccination programs and prompt treatment of animal bites has reduced the number of rabies cases in the United States to 5 per year. There are an estimated 65,000 human rabies cases each year throughout the world.

The incubation period ranges from 10 days to more than a year, depending on the entry site. Rabies infection characteristically produces a rapidly progressive encephalomyelitis (inflammation of the brain and spinal cord), and should be considered as a possible cause of any such illness in humans or other animals. The early symptoms are fever, headache, and loss of appetite which are nonspecific. After a while the patient becomes restless and disoriented and may experience seizures. The term hydrophobia (Greek for "fear of water") comes from the patient's failed attempts to satisfy a characteristic thirst because painful throat spasms prevent swallowing. Coma and death usually follow 3 to 20 days after the onset of symptoms.

Once symptoms have appeared, treatment is limited to sedatives and painkillers. Few people with rabies have survived. If a bite has occurred and there is a risk of rabies, patients are passively immunized with antirabies serum followed by a series of rabies vaccinations. If this routine is begun within two days of the bite, rabies is usually prevented. An animal suspected of being rabid is killed. Veterinarians, animal handlers, some laboratory workers, and persons visiting countries where rabies is a constant threat are routinely vaccinated with an inactivated form of the rabies virus.

Rabies is primarily a disease of non-human animals. It appears that any mammal species can develop rabies. The prevalence of rabies in specific animal species varies greatly by geographical region. Knowing which animals are most likely to be rabid in a given location is essential to implementing appropriate preventive and postexposure measures.

Animal Rabies

Traditionally, rabies exists in two forms in a community. The urban form, propagated chiefly by unimmunized cats and dogs, and sylvatic, propagated in North American by bats, coyotes, foxes raccoons and skunks. Infection in domestic animals represents a "spillover" from sylvatic reservoirs of infection. In the United States today, wildlife accounts for over 90% of reported cases of animal rabies. Every opportunity should be taken to educate the public on the risks of trauma and infectious diseases associated with contact with wild animals. The control of rabies in bats and terrestrial mammals is very difficult. Selective population reduction may be useful in terrestrial rabies outbreaks, but the success of these efforts depends on the circumstances surrounding each rabies outbreak episode. It is generally not feasible or desirable to attempt wild carnivore or bat population reductions as a means of rabies control. Wildlife vaccination in California is not currently indicated due to the rabies strain types present here and the lack of a spreading epizootic.

Animals with rabies may exhibit telltale signs that something is physically wrong. Excessive salivation, avoidance of food and water, unusual aggression, daytime activity in a nocturnal animal (bat, skunk, raccoon, etc.), impaired locomotion, varying degrees of paralysis (frequently beginning in the hind legs), extreme depression, or bizarre behavior are potential signs of rabies. These signs indicate that extreme caution must be taken when approaching or attempting to interact with the animal. Generally, a lack of fear of humans is also unusual behavior for wild animals. Special procedures are often required to trap animals for observation and/or rabies testing. If wild animals drink or eat out of a pet's bowl, there is little or no risk of rabies virus transmission to the pet. However, the practice should be discouraged because it may expose the pet to other illnesses.

By 1960, mandatory vaccination of dogs in the United States largely controlled canine and human rabies. This immune barrier has been established nationwide at a cost of over $300 million annually. Cats are also vaccinated for rabies but it is not mandatory and feline rabies is now more common than canine rabies in the United States. With the widespread vaccination of cats and dogs in the United States, most endemic human rabies is a result of contact with rabid wildlife, particularly bats.

Animal Rabies Outside of the United States

Rabies has traditionally been associated with dogs more than any other animal, and in parts of the world where domestic animal control and vaccination programs are limited, dogs remain the most important reservoir of the disease for people. Other domestic and farm animals can be rabid, too, though, and rabies occurs in a variety of wild animal species found in other countries.

Consequently, persons who have been bitten by any animal in another country should be fully evaluated as soon as possible by health authorities in that country and by their personal physician in the US. Local health departments can assist physicians with this evaluation.

Animal Rabies Within the United States

While dog rabies is a major problem in much of the world, in the United States, animal control and vaccination programs assure that rabies remains rare in dogs, cats, and other domestic animals. In this country, over 90% of animal rabies cases occur in wildlife. Rabies has been detected in many different wild animal species. However, certain geographically distinct reservoirs of terrestrial rabies exist, each with its own variants of the virus. The boundaries of these reservoirs shift constantly. Within each area, rabies transmission occurs predominantly within the dominant reservoir species -- with occasional "spillover infection" to other species. There are currently four terrestrial reservoir species in the U.S.: raccoons, skunks, foxes and coyotes. In addition to these reservoirs of terrestrial rabies, indigenous rabid bats have been found in every state except Hawaii.

Animal Rabies in California

In 2001, there were 321 laboratory confirmed cases of rabies in animals. Wildlife accounted for over 99% of the rabid animals. Bats accounted for 52 percent of the rabid animals in California during 2001. Rabies is well established in skunk and bat populations in California. Every opportunity should be taken to educate the public on the risks of trauma and infectious diseases associated with contact with wild animals.

Animal Rabies in Los Angeles County

Bats are the most commonly rabid animal in Los Angeles County. The virus has been identified in several bat species. In 1979 the last rabid skunk was detected and our last case of domestic animal rabies occurred in 1987 when a woman visiting Acapulco, Mexico, adopted a wandering cat who was later bitten by a stray dog. The cat was ill when it arrived at the Los Angeles International Airport and was diagnosed as a rabies suspected within 48 hours by a San Fernando Valley veterinarian.

Types of Rabid Animals Within the United States

The four most common terrestrial reservoir species harboring rabies in the U.S. are: raccoons, skunks, foxes and coyotes. In addition to these terrestrial, indigenous rabid bats have been found in every state except Hawaii.

Raccoons: Raccoons remain the most frequently reported rabid animal in the United States. The raccoon rabies reservoir extends throughout the southeastern, mid-Atlantic, and northeastern states. No other reservoirs of raccoon rabies have been identified. Rabid raccoons occasionally detected outside of the reservoir area have been found to have non-raccoon variants of the rabies virus, suggesting that they were infected by other species.

Skunks: Skunks are the second most frequently reported rabid animal in this country. Three virus variants are responsible for rabies in skunks. There are two large geographically distinct reservoirs of skunk rabies due to three different variants of the virus: one in California; the other in the central US from Montana to Texas. Rabid skunks reported in eastern states outside the reservoir areas apparently were infected by raccoons rather than by other skunks.

Foxes: Two variants of the rabies virus are associated with persistent reservoirs of rabies in foxes. One long-standing reservoir involves arctic and red foxes in Alaska (and Canada) and to a lesser extent, areas of New York, Vermont, New Hampshire, and Maine. A different variant of the virus has been associated with gray foxes, resulting in reservoirs in Texas and Arizona.

Coyotes: A rabies variant found in domestic dogs along the Texas-Mexico border has been seen in coyotes in southern Texas. Northward spread of this reservoir has been limited by an aggressive (and expensive) airdrop vaccination program.

Bats: Rabid bats of many different species have been found in all of the 48 contiguous states. To date, only one rabid bat has ever been identified in Alaska -- in the southeastern part of the state. Also, one rabid bat was found in a shipping container in Hawaii. Rabid bats are found yearly in Los Angeles County.

Rodents/Small Mammals: Providers are often asked about the risks associated with small wild mammals -- such as rats, mice, squirrels, chipmunks, rabbits and hares. Rodent bites are common, so rodents are often tested for rabies in the US. Despite the large number of rodents examined, it is exceedingly uncommon for one to be infected with rabies virus. It has been postulated that these animals are so small that they are unlikely to survive an attack of a larger rabid animal (such as a raccoon, skunk, or fox).  Furthermore, although there have been several case reports of humans infected by rabid rodents in other countries, no transmission of rabies from a rodent to a human (or any other mammal) has ever been documented in the United States.

Other wild animals: Other wild animals in the US are occasionally found to be rabid. Most are infected with virus strains associated with terrestrial animal species, rather than bats. In 2001, 116 rabid non-reservoir wild animals were reported from the 50 states, including 49 groundhogs and 28 bobcats.

Rabies in People

Worldwide: At least 50,000 humans develop rabies each year. The overwhelming majority of cases occur in areas where dog rabies is common. Most have a history of having been bitten by a dog. In this country, human rabies is very rare; furthermore, most of the recent human rabies infections in the United States have been caused by variants of the rabies virus associated with bats.

U.S.: From 1980 through September 2002, there were 46 human rabies cases reported in the United States. Of those, 14 appeared to have been exposed in other countries. Of the remaining 32 people, two were infected with the canine strain of rabies present along the Texas/Mexico border and one was infected by a rabid skunk. The other 29 cases were caused by bat variants of the virus. A definite history of a bat bite was documented for only two of these 29 cases, and only 13 others had any known contact with a bat; no definite history of an encounter with a bat could be established for the remaining cases.

California: Between 1980 and September 2002, ten people in California died of rabies in California, most diagnosed after death.

Los Angeles County The last person to die of laboratory confirmed rabies in Los Angeles County was in 1975. A 16-year-old girl from Mexico, who had been living in Los Angeles for eight months, became ill and was hallucinating. When the girl developed hydrophobia rabies was suspected. She was bitten by a dog while in Mexico. The dog later disappeared.

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Historical Rabies Episodes In LAC
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1898 First Confirmed Case of Animal Rabies in Los Angeles

An English gentleman, living close to the intersection of Third and Flower Street, told the Health Officer his dog, which was uncontrollable, might have rabies. Confirmatory tests were run in Chicago.

City Council Required All Dogs Running at Large on Streets or Other Public Places to Be Muzzled

1899 First Human Rabies Death in the City of Los Angeles

A Pasadena man was bitten on the nose by his cocker spaniel. A few weeks prior to biting his owner, the dog had left home and was suspected of contracting rabies.

1906 Second Outbreak of Canine Rabies

In the spring, the City Health Officer visited the Soldiers Home, twelve miles west of Los Angeles, where an officer's pet dog acted strangely, biting a man, five horses, several dogs, and hogs. The head of the dog and the man were transported to Chicago for testing and treatment. The dog tested positive and the man was given the Pasteur treatment and survived. Back in Los Angeles, the dogs that were attacked were immediately destroyed and the horses quarantined. Two of the horses and a hog developed rabies.

1909 Another Outbreak of Rabies in Los Angeles

In June, a police officer shot a collie dog with rabies. Within a month, the police officer shot three more suspected rabid dogs found within five blocks of the original dog. Three months later, rabies was diagnosed in a horse by a Pasadena veterinarian. A muzzling ordinance was passed the same month by the board of health.

Some people denied that rabies existed. Strong opposition by a few dog lovers, the humane animal officer, and some members of the board of health resulted in repeal of the ordinance the following week. With the repeal of the muzzle ordinance, rabies spread rapidly in Los Angeles. Numerous rabid dogs were reported in various locations within the city. Four horses and a mule died of rabies.

1910 A Child Died of Rabies and the Dog Muzzling Ordinance Was Reinstated

1913 Second Largest Outbreak of Cattle Rabies in Los Angeles County, One Human Death

One evening, in a small retail dairy on the east side of Los Angeles, a dog with furious rabies ran into a corral attacking eight cows. When the dairyman chased the dog away, it went to a different corral attacking another cow before leaving.

1936 Most Rabid Livestock (10 Cattle, 2 Goats, 1 Horse) in Los Angeles County, Detected on 13 Premises

The livestock Department reported stray, homeless, and occasionally rabid dogs running rampant in all parts of the county south of the mountains, frequently attacking other animals and people.

1937 Most Confirmed Rabid Dogs (847) in the City of Los Angeles. Three People Died of Rabies

In the spring, a 57-year-old man saw a dog attack a group of school children, rushing over, he grabbed the rabid dog and was bitten several times, he held it until police arrived. He later died of rabies. In the fall, an Altadena veterinarian died of rabies.

1955 A Rabies Epidemic Occurred in Dogs in the City of Los Angeles

70 rabid dogs. 52 people were bitten by known rabid dogs (most in the Watts/Compton area) with 1/300 reported dog bites from rabid dogs. No human deaths.

1956 Largest Rabies Outbreak in Cattle Occurred at the Spanish American Institute in Gardena

24 cows and 1 hog were diagnosed with rabies at the charitable home and trade school for boys, operated by the Methodist church. One milk cow chased chickens, others pawed the ground pushing their heads against the fence and corrals. An epidemic of rabies in dogs was occurring at the time and a stray dog had roamed though the boys home earlier.

Los Angeles County Required that all dogs within the County be vaccinated against rabies as a prerequisite to licensing

1958 Southern California Veterinary Medical Association Started Public Rabies Vaccination Clinics for Dogs

Over 30,000 dogs were vaccinated that year at a cost of $1.50/dog

1964 Epidemic of Rabid Skunks (64) in Malibu and San Fernando Valley

Skunk rabies persisted in the area until the Malibu fire destroyed the population of rabid skunks.

Last Case of Rabies in Cattle in Los Angeles County

A Brahma steer from Mexico, three weeks after entering a feedlot in Newhall, charged other cattle attempting to bite them.

1966 Last Locally Acquired Rabies in a Dog

A Malibu dog had contact with a rabid skunk and later died of rabies.

1973 Last rabid raccoon in Los Angeles County

1975 Last Person to Die of Laboratory Confirmed Rabies in Los Angeles County

A 16-year-old girl from Mexico, who had been living in Los Angeles for eight months, became ill and was hallucinating. She was bitten by a dog while in Mexico. The dog later disappeared.

1979 Last Rabid Skunk in Los Angeles County

The Malibu fire in the early 1970s apparently wiped out the population of rabid skunks.

1987 Last Domestic Animal (cat) with Rabies in Los Angeles County

A woman visiting Acapulco, Mexico, adopted a wandering cat who was later bitten by a stray dog. The cat was ill when it arrived at the Los Angeles International Airport and was diagnosed as a rabies suspected within 48 hours by a San Fernando Valley veterinarian.

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Rabies Fact Sheet
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What is rabies?

Rabies is a viral disease that affects the nervous system of mammals. In the last stages of the disease, the virus moves from the brain into the salivary glands and saliva. From there the virus can be transmitted through a bite or by contact with mucous membranes (nose, mouth, and eyes). Rabies is almost always fatal once symptoms occur.

How is rabies transmitted?

Rabies is transmitted by a bite of an infected animal.

There are a few documented cases of rabies being contracted in caves where bats reside and in laboratories that work with the virus. It has occasionally been passed with a corneal transplant from a person unknowingly infected rabies.

Who can get rabies?

Any mammal can get rabies, including humans. Rabies is seen in domestic animals such as; dogs, cats, cows, and horses. In North America, wildlife accounts for 99% of the rabies. Wildlife most commonly diagnosed with rabies includes; raccoons, bats, skunks, foxes, and coyotes. However, in Mexico and other Latin American countries, dogs are the common carrier of rabies.

What wildlife in Los Angeles County has rabies?

Rabies is detected yearly in bats. About one out of every 12 bats tested by the health department has rabies. Rabies can occur in other wildlife but has not been detected in other wildlife in the County for over twenty years.

What are the symptoms of rabies in people?

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

What are the symptoms of rabies in animals?

Changes in behavior are common in rabid animals: nocturnal animals are seen during the day, animals are not afraid from humans, become aggressive, attack other animals or people without provocation, may have paralysis of the limbs or throat, or just lay down.

How soon after infection do symptoms appear?

The incubation period is variable but is normally 3 to 8 weeks. Incubation periods up to several years have been reported. Patients having severe bites or bites about the head usually have the shortest incubation periods.

Can people spread rabies?

Person to person transmission is extremely rare, however, precautions should be taken to prevent exposure to the saliva of the diseased person.

How can I protect my animals and myself?

The best protection against rabies is vaccination of pets and avoidance of risk. Vaccination of dogs is required by law. Cats are required to be vaccinated in the unincorporated areas of the County. Keep your pets indoors and make sure their vaccinations are current.

What should I do if my pet gets bitten by a rabid animal?

If the attacking animal is captured, the brain will be tested for rabies. If your pet is not vaccinated, and the attacking animal was rabid, your pet may be disposed of as required by law.

What should I do if I am exposed to rabies?

If you are bitten or scratched by a suspect rabid animal, or saliva from the animal enters an open wound, or becomes in contact with your nose, mouth, or eyes, wash the wound or contact area with soap and water. Call your physician or the health department and get medical attention immediately. Remember, rabies is a fatal disease. Post-exposure prophylaxis should be started soon after the exposure. The treatment, when needed, consists of 5 vaccine doses in the arm, and one dose of rabies immune globulin.

What is the preventive treatment for a potential rabies exposure (e.g., animal bite or scratch)?

Preventive treatment requires prompt scrubbing of the bite site with soap and copious amounts of water, followed by the administration of rabies immune globulin (dosage depending on weight) and five doses of human diploid cell rabies vaccine administered into the arm muscle on days 0, 3, 7, 14 and 28 after exposure.

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Recent Rabies In People
Printable Version

Between 1980 and September 2002, 46 people in the United States died of laboratory confirmed rabies. ¹ The majority of cases were diagnosed at postmortem. The presence of hydrophobia or aerophobia was significantly associated with antemortem diagnosis. None of the people received complete postexposure prophylaxis prior to the onset of clinical disease. This is unfortunate as treatment with modern tissue culture vaccines, coupled with the appropriate use of immune globulin, is regarded as essentially 100% effective. ² Of the 46 human cases, 63 percent were associated with rabies virus variants found in insectivorous bats. Nevertheless, clear evidence of a bite was found in only two of the bat-associated cases.

More people died of rabies in California (10) than any other state and most cases were diagnosed after death (table 1). In California, during 1995, two men died of bat-associated rabies virus. Rabies postexposure prophylaxis was administered to 88 people exposed to the two men. ³ In 1995, four cases of human rabies were documented in the United States. All were associated with insectivorous bats; however, a definite history of bite exposure was not identified. It is likely that human rabies is under reported in the United States. There is little to distinguish rabies from other viral encephalitides. Any patient who presents with encephalopathy of unknown etiology should be considered a rabies suspect, even in the absence of known exposure to the virus through an animal bite. The most helpful clue to the diagnosis of rabies is a history of animal exposure. An early clinical sign suggestive of rabies is the complaint of paresthesia and/or fasciculations at or around the site of virus inoculation.

Animal Rabies

Traditionally, rabies exists in two forms in a community. The urban form, propagated chiefly by unimmunized cats and dogs, and sylvatic, propagated in North American by bats, coyotes, foxes raccoons and skunks. Infection in domestic animals represents a "spillover" from sylvatic reservoirs of infection. In California, between January 1 and December 31 of 2001, there were 321 laboratory confirmed cases of rabies in animals. Wildlife accounted for close to 99% of the rabid animals. Bats accounted for 52 percent of the rabid animals in California during 2001.

Rabies in Los Angeles County

By 1960, mandatory vaccination of dogs in Los Angeles County largely controlled canine and human rabies. This immune barrier has been established nationwide at a cost of over $300 million annually. Cats are also vaccinated for rabies but it is not mandatory nationwide and feline rabies is now more common than canine rabies in the United States. With the widespread vaccination of cats and dogs in the United States, most endemic human rabies is a result of contact with rabid wildlife, particularly bats. Bat rabies is diagnosed yearly in Los Angeles County.

Animal Bites

Bites by wildlife such as: coyotes, foxes, raccoons and skunks are usually obvious and often prompt suspicion of the possibility of rabies. Bats weigh only a few ounces and they have very sharp claws and teeth. Their scratches and bites are difficult to detect. In one instance, a 37-year-old woman was in her bathroom and felt something brush against her bottom. When she turned on the lights there was a bat hanging on the ceiling which flew out the open bathroom window. She looked at her skin and found nothing unusual. Later that day, when her physician scrutinized the area with 6X magnification, he found two pinpoint punctures about one-half centimeter apart. ⁴

During the past 20 years, the only rabid wildlife detected in Los Angeles County has been bats. The last domestic animal with laboratory confirmed rabies was a cat in 1987 (table 2). Any bite of a wild carnivore should be considered a possible source of rabies until proven otherwise. In April of 1998, an opossum was found under the hood of a Orange County employee's car. When the employee went to remove the opossum, he was bitten numerous times. The opossum tested positive for rabies. Rabies in opossums had not been diagnosed in Orange County for over thirty years.

Prevention

Rabies precautions should be taken with all animal bites, particularly wildlife. Pre-exposure vaccination of high risk people is recommended (animal handlers, cave explorers, laboratory workers and veterinarians). A healthy domestic cat or dog that bites a person should be confined and observed for 10 days and evaluated by a public health veterinarian at the first sign of illness during confinement or before release. Signs of rabies in wildlife cannot be interpreted reliably. If wildlife bites or scratches a person, the animal should be immediately tested for rabies.

Bat rabies is enzootic in the United States. Since 1980, indigenously human rabies in the United States has been caused primarily by insectivorous bats. Contact with a bat should be taken seriously. Bats should not be captured, handled, or kept as pets. Human and domestic animal contact with bats should be minimized. The physical exclusion of bats from human dwellings should be standard practice.

In the past, the Centers for Disease Control (CDC) recommended rabies post-exposure vaccinations be given to anyone with an obvious bite mark or scratch from a potentially rabid animal. CDC has revised its guidelines to include a recommendation that vaccination be given to anyone who has slept in a room where a bat was known to be present, even if a bite is not visible.⁵

References

1. Noah DL, Drenzek CL, Smith JS, et al: Epidemiology of Human Rabies in the United States, 1980 to 1996. Annuals of Internal Medicine. 128(11):922-930. 1998

2. Childs JE, Noah DZ, Rupprecht: Rabies. Infectious Diseases (Gorbach SL, Bartlett JG, Blacklow NR editors) Second Edition. Saunders. p. 1545-59. 1997

3. Human Rabies - California, 1995. MMWR 45(17):354-56. 1996

4. Feder HM: Bat bite? Lancet 350 (9087):1300. 1997

5. Experts concerned about rabies in bats. JAVMA213(2):190. 1998

Table 1. Between 1980 and 2002 seven people in California died of laboratory confirmed rabies*

California Cases 1980-2002
Year	Exposure History	Variant	Type	Diagnosis
1984 1987 1992 1993 1994 1995 1995 2000 2001 2002	Dog - Guatemala unknown Dog - India Dog - Mexico unknown unknown unknown unknown unknown unknown	dog dog dog dog dog bat bat bat dog bat	exotic exotic exotic exotic exotic indigenous indigenous indigenous exotic indigenous	postmortem postmortem antemortem antemortem postmortem antemortem postmortem antemortem postmortem antemortem

*Noah DL, Drenzek CL, Smith JS, et al: Epidemiology of Human Rabies in the United States, 1980 to 1996. Annuals of Internal Medicine. 128(11):922-930. 1998

CDC. Human rabies - California, Georgia, Minnesota, New York and Wisconsin, 2000.  MMWR 49(49):1111-5. 2000

CDC. Human rabies - California, 2002. MMWR 51(31):686-688. 2002

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Clinical Features of Rabies
Printable Version

Rabies is caused by members of the RNA virus genus Lyssavirus, family Rhabdoviridae. Rabies infection characteristically produces a rapidly progressive encephalomyelitis (inflammation of the brain and spinal cord), and should be considered as a possible cause of any such illness in humans or other animals.

Rabies in Humans

The incubation period in humans is typically between 20 and 90 days, although incubation periods as short as 4 days and longer than 6 years have been documented. This variation is probably related to the site of inoculation, the severity of the wound, and the amount of virus introduced. It is thought that the closer the inoculation is to well-innervated areas and to the brain, the more severe the wound, and the more virus introduced, the shorter the incubation period.

Early symptoms of rabies are non-specific, but often include pain or paresthesia at the inoculation site. The disease progresses to an acute neurologic phase characterized by delirium, convulsions, muscle weakness, and paralysis. Spasms of the swallowing muscles can lead to a fear of water (hydrophobia), and may be precipitated by blowing on the patient's face (aerophobia). Not all persons exposed to rabies virus develop disease, but if symptoms do occur, rabies is almost invariably fatal -- usually within 10 days. There are case reports of three people who survived the disease in the 1970s. All three had received some pre- or post-exposure treatment with the duck embryo vaccine or suckling mouse brain vaccine (vaccines that are no longer used in this country). A fourth documented case was reported in 1992 in a boy who received partial postexposure treatment.

Diagnosing Rabies in Humans: Because rabies is often not considered during the evaluation of patients with acute encephalitides, human rabies cases are usually identified after death. Antemortem diagnosis is possible, however, by analyzing the saliva, cerebrospinal fluid, skin (from the posterior neck), and serum of a symptomatic patient. Brain biopsy material can also be examined for rabies. Providers wishing to submit specimens for testing should contact the Acute Communicable Disease Control at (213) 240-7941.

Rabies in Other Animals

The clinical features of rabies in other animals are highly variable and resemble a number of toxic and infectious illnesses of the central nervous system. In dogs, a common viral disease known as canine distemper often produces seizures and neurological disease resembling rabies. Rabid animals can appear aggressive, known as "furious rabies" or lethargic, known as "dumb rabies". Aggressive rabies is common in cats but seldom seen in bats. As the disease progresses over a matter of days, the rabid animal typically develops difficulty with coordination. This is usually followed by generalized paralysis and death. Rabies can not be diagnosed reliably by an evaluation of behavior or clinical signs alone. Laboratory testing of the brain is essential.

All cases of suspected rabies in animals should be reported immediately to Veterinary Public Health at (323) 730-3723.

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Bats and Rabies
Printable Version

Bat rabies is enzootic in the United States and detected yearly in Los Angeles County. However, it is neither feasible nor desirable, however, to control rabies in bats by programs to reduce bat populations. Bats should be excluded from houses and adjacent structures to prevent direct association with humans beings. Such structures should then be made bat-proof by sealing entrances used by bats. Since 1980, indigenously human rabies in the United States has been caused primarily by insectivorous bats. Contact with a bat should be taken seriously. Bats should not be captured, handled, or kept as pets. Human and domestic animal contact with bats should be minimized.

Bats weigh only a few ounces and they have very sharp claws and teeth. Their scratches and bites are difficult to detect. Bites by wildlife such as: coyotes, foxes, raccoons and skunks are usually obvious and often prompt suspicion of the possibility of rabies. In one instance, a 37-year-old woman was in her bathroom and felt something brush against her bottom. When she turned on the lights there was a bat hanging on the ceiling which flew out the open bathroom window. She looked at her skin and found nothing unusual. Later that day, when her physician scrutinized the area with 6X magnification, he found two pinpoint punctures about one-half centimeter apart.

Between 1980 and 2002, 29 people in the United States died of rabies associated with bats. The majority of cases were diagnosed at autopsy. None of the people received complete post-exposure prophylaxis prior to the onset of clinical disease. This is unfortunate as treatment with modern tissue culture vaccines, coupled with the appropriate use of immune globulin, is regarded as essentially 100% effective. Clear evidence of a bite was found in only two cases.

In the past, the Centers for Disease Control (CDC) recommended rabies post-exposure vaccinations be given to anyone with an obvious bite mark or scratch from a potentially rabid animal. CDC has revised its guidelines to include a recommendation that vaccination be given to anyone who has slept in a room where a bat was known to be present, even if a bite is not visible.

Capturing a bat: Bats are not aggressive but may bite if grabbed. They should not be handled with bare hands. Wear leather or other heavy gloves whenever contact with the animal is possible. Only one person should be in the room when attempting to capture a bat. Wait for the bat to land, then cover the animal with an empty coffee can (or similar container). Slide a piece of cardboard between the container and the surface on which the bat is resting, trapping it inside. Secure the covering to the can (by heavy tape, for example) so that the bat cannot escape.

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Prevention
Printable Version

Rabies in humans can be prevented either by eliminating exposures to rabid animals or by providing exposed persons with prompt local treatment of wounds combined with appropriate passive and active immunization. This can be done by: 1) reducing encounters between humans and potentially rabid animals; 2) immunizing domestic animals; 3) providing pre-exposure immunization to people at high risk for being exposed to rabies; and 4) giving post-exposure preventive therapy to people who -- despite these other efforts -- may have been exposed to the virus.

Appropriate management of those who may have been exposed to rabies infection depends on the evaluation of the risk of infection (type of exposure, location of wound, rabies vaccination status of biting animal, etc.) and the efficacy and risk of prophylactic treatment. All available methods of systemic prophylactic treatment are complicated by instances of adverse reactions. These are rarely severe. Decisions on management must be made immediately; the longer treatment is postponed, the less likely it is to be effective. The urgency for treatment must be tempered by recognition that human rabies is an extremely rare event.

Although the purpose of animal code enforcement is focused upon rabies prevention, reporting animal bites is directly aimed at prevention of this disease. Anyone having knowledge of an animal biting or scratching so as to break the skin is required by California State Law to report the incident to the local health authority. Children should be cautioned to never play with wild animals, especially bats in Los Angeles County.

Local governments should initiate and maintain effective programs to ensure vaccination of all dogs, cats, and ferrets and to remove strays and unwanted animals. Local health departments and animal-control officials can enforce the removal of strays more effectively if owned animals are confined or kept on a leash. Strays should be impounded for at least 3 days to give owners sufficient time to reclaim animals and to determine if human exposure has occurred. Such procedures in the United States have reduced laboratory confirmed rabies cases in dogs from 6,949 in 1947 to 89 in 2001. Since more rabies cases are reported annually involving cats than dogs, vaccination of cats should be required. The control of rabies among wildlife reservoirs is difficult. Vaccination of free-ranging wildlife or selective population reduction may be useful in some situations, but the success of such procedures depends on the circumstances surrounding each rabies outbreak.

Rabies Vacinations of Animals

1. Rabies Vaccination of Dogs and Cats: All owners or harborers shall have their dog(s) currently vaccinated against rabies by a California licensed veterinarian. All owners or harborers shall ensure that the dog(s) is wearing the vaccination tag at all times. Dogs can be vaccinated for rabies starting at four months of age and revaccinated according to California law. It is recommended that cats also be vaccinated.
2. Livestock: It is neither economically feasible nor justified from a public health standpoint to vaccinate all livestock against rabies. However, consideration should be given to the vaccination of livestock, especially animals that are particularly valuable and/or may have frequent contact with humans beings.
3. Wildlife: No parenteral rabies vaccine is licensed for use in wild animals. Because of the risk of rabies in wild animals (especially raccoons, skunks, coyotes, foxes, and bats), Veterinary Public Health strongly recommends the enactment of state laws prohibiting the importation, distribution, relocation, or keeping of wild animals or hybrids as pets.
4. Maintained in exhibits and in zoological parks: Captive animals not completely excluded from all contact with rabies vectors can become infected. Moreover, wild animals may be incubating rabies when initially captured; therefore, wild-caught animals susceptible to rabies should be quarantined for a minimum of 180 days before exhibition. Employees who work with animals at such facilities should receive pre-exposure rabies immunization. The use of pre- or post-exposure rabies immunizations of employees who work with animals at such facilities may reduce the need for euthanasia of captive animals.

Management Of Animals that Bite People

1. A healthy dog, cat, that bites a person should be confined and observed for 10 days; it is recommended that rabies vaccine not be administered during the observation period. Such animals should be evaluated by a public health veterinarian at the first sign of illness during confinement. Any illness in the animal should be reported immediately to the local health department. If signs suggestive of rabies develop, the animal should be euthanized, its head removed, and the head shipped under refrigeration (not frozen) for examination of the brain by a qualified laboratory designated by the local or state health department.
2. Any stray or unwanted dog, cat, may be quarantined at the local animal shelter.  Other biting animals which might have exposed a person to rabies should be reported immediately to the local health department. Prior vaccination of an animal may not preclude the necessity for euthanasia and testing if the period of virus shedding is unknown for that species. Management of animals other than dogs, cats, and ferrets depends on the species, the circumstances of the bite, the epidemiology of rabies in the area, and the biting animal's history, current health status, and potential for exposure to rabies.
3. Any unowned, unvaccinated dogs, cats, exposed to a rabid animal should be euthanized immediately. If the owner is unwilling to have this done, the animal should be vaccinated and then placed in strict isolation for 6 months. Animals with expired vaccinations need to be evaluated on a case-by-case basis. Dogs, cats, and ferrets that are currently vaccinated should be revaccinated immediately, quarantined for 30 days, and then kept under the owner's control for an additional two months.
4. Any animal bitten or scratched by either a wild, carnivorous mammal or a bat that is not available for testing should be regarded as having been exposed to rabies. Indigenous rabid bats have been reported from every state except Hawaii and have caused rabies in at least 29 humans in the United States.
5. All species of livestock are susceptible to rabies; cattle and horses are among the most frequently infected. Livestock exposed to a rabid animal and currently vaccinated with a vaccine approved by USDA for that species should be revaccinated immediately and observed for 45 days. Unvaccinated livestock should be slaughtered immediately. If the owner is unwilling to have this done, the animal should be kept under very close observation for 6 months.

If the animal is slaughtered within 7 days of being bitten, its tissues may be eaten without risk of infection, provided liberal portions of the exposed area are discarded. Federal meat inspectors must reject for slaughter any animal known to have been exposed to rabies within 8 months.

Neither tissues nor milk from a rabid animal should be used for human or animal consumption. However, because pasteurization temperatures will inactivate rabies virus, drinking pasteurized milk or eating cooked meat does not constitute a rabies exposure.

It is rare to have more than one rabid animal in a herd, or herbivore to herbivore transmission; therefore, it may not be necessary to restrict the rest of the herd if a single animal has been exposed to or infected by rabies.

Pre-Exposure Vaccination Of People

Pre-exposure vaccination should be offered to persons among high-risk groups, such as veterinarians, animal handlers, certain laboratory workers, and persons spending time (e.g., 1 month) in foreign countries where canine rabies is endemic. Other persons whose activities bring them into frequent contact with rabies virus or potentially rabid dogs, cats, skunks, raccoons, bats, or other species at risk of having rabies should also be considered for pre-exposure prophylaxis.

Pre-exposure prophylaxis is given for several reasons. First, it may provide protection to persons with inapparent exposures to rabies. Second, it may protect persons whose post-exposure therapy might be delayed. Finally, although pre-exposure vaccination does not eliminate the need for additional therapy after a rabies exposure, it simplifies therapy by eliminating the need for human rabies immuno globulin (HRIG) and decreasing the number of doses of vaccine needed - a point of particular importance for persons at high risk of being exposed to rabies in areas where immunizing products may not be available or where they may carry a high risk of adverse reactions.

Intramuscular (IM) Primary Vaccination: Three 1.0-ml injections of human diploid cell vaccine (HDCV) or rabies vaccine adsorbed (RVA) should be given intramuscularly (deltoid area), one each on days 0, 7, and 21 or 28.

Intradermal (ID) Primary Vaccination: A regimen of three 0.1-ml doses of HDCV, one each on days 0, 7, and 21 or 28, is also used for pre-exposure vaccination. The ID dose/route has been recommended previously by the Advisory Committee on Immunization Practices (ACIP) as an alternative to the 1.0-ml IM dose/route for rabies pre-exposure prophylaxis with HDCV.

Booster Doses of Vaccine

Persons who work with live rabies virus in research laboratories or vaccine production facilities (continuous risk category) are at the highest risk of inapparent exposures. Such persons should have a serum sample tested for rabies antibody every 6 months.

Booster doses (IM or ID) of vaccine should be given to maintain a serum titer corresponding to at least complete neutralization at a 1:5 serum dilution by the Rapid Fluorescent Focus Inhibition Test (RFFIT). The frequent risk category includes other laboratory workers, such as those doing rabies diagnostic testing, spelunkers, veterinarians and staff, animal-control and wildlife officers in areas where animal rabies is epizootic, and international travelers living or visiting (for >30 days) in areas where canine rabies is endemic. Persons among this group should have a serum sample tested for rabies antibody every 2 years and, if the titer is less than complete neutralization at a 1:5 serum dilution by the RFFIT, should have a booster dose of vaccine.

Alternatively, a booster can be administered in lieu of a titer determination. Veterinarians and animal control and wildlife officers working in areas of low rabies enzooticity (infrequent exposure group) do not require routine pre-exposure booster doses of HDCV or RVA after completion of primary pre-exposure vaccination.

Post-Exposure Prophylaxis (PEP) of People

There are three components to PEP: 1) local treatment of wounds; 2) provision of passive immunity with purified specific immunoglobulin; and 3) the induction of active immunity with rabies vaccine. All three components are critical to the effective prevention of rabies.

1. Local treatment of wounds: Immediate and extensive washing of all bite wounds, scratches, or other sites of potential exposure for 10 minutes with soap and water is arguably the most important measure for preventing rabies following an exposure to a rabid animal. Experiments done in animals suggest that thorough and vigorous cleansing to the depth of the wound with a 20% soap solution can reduce the risk of developing rabies by up to 90%¹³. Tetanus booster vaccine (Td) should be given if indicated.
   
   
2. Immunoglobulin Administration: Purified human anti-rabies immunoglobulin (HRIG) provides rapid protection against rabies for one to two weeks after exposure -- while the more lasting vaccine-induced immune response is developing. HRIG should be given to any previously unvaccinated person regardless of their age, type of exposure, or time since exposure. HRIG can be given through the seventh day following administration of the first dose of vaccine but should not be given after this time because it could interfere with the antibody response to the vaccine. HRIG is not given for preexposure prophylaxis. Nor should HRIG be given as part of PEP in a person who has previously been vaccinated with HDCV, RVA, or PCECV or who has a documented rabies antibody titer to any vaccine.

   The recommended dose of HRIG is 20 IU/kg body weight (0.06 ml/lb body wt). As much of the dose as is anatomically feasible should be infiltrated in the area around the wound(s). The remaining volume is administered intramuscularly at a site distant from vaccine inoculation, such as the gluteal area.¹⁴
   
   

3. Vaccine Administration: Primary post-exposure immunization with HDCV, RVA, and PCECV is given intramuscularly (IM) in a regimen of five 1-ml doses. The first dose is given as soon after exposure as possible (day 0). The remaining four doses are given on days 3, 7, 14 and 28 following the first dose.

For adults and older children, the vaccine should be injected into the deltoid muscle. For small children and infants, the muscles of the antero-lateral thigh can be used. Vaccine should never be given in the gluteal area or in the same anatomical site as HRIG. If an individual misses any vaccine doses during the first two weeks of the regimen, providers should consult the vaccine manufacturer. The schedule should be adjusted to ensure that four doses of vaccine are received during the first 14 days. The fifth dose can be given on day 28. Persons who have already received pre-exposure prophylaxis still require two booster doses of vaccine on day 0 and day 3.

Assesing the Need for Post-Exposure Anti-Rabies Treatment: The need for post-exposure treatment should be based on careful consideration of four basic areas: TYPE OF EXPOSURE, ANIMAL BEHAVIOR, ANIMAL SPECIES, and LABORATORY TEST RESULTS.

Type of Exposure: Rabies can only be transmitted when the saliva or neural tissue of an infected animal is introduced into an open cut or wound (less than 24 hours old) in a person's skin or contacts the mucous membranes in such areas as the eyes, nose, or mouth. Categories of exposure are:

1. Bite - Any penetration of the skin by an animal's teeth. Bites in general are high-risk exposures. Bites to the head and neck carry the highest risk.
2. Non-bite - Scratches or abrasions received from an animal, or the contamination of open cuts or wounds with an animal's saliva or neural tissue.
3. Non-exposure - Animal contact by itself, such as being in the vicinity of, petting, or handling an animal; or coming into contact with the blood, urine, or feces of an animal does not constitute exposure and, therefore, does NOT require post-exposure rabies treatment.

Animal Behavior: Consideration should be given to whether the animal appeared to be behaving normally or whether there were signs of rabies such as unusual aggression, impaired locomotion, varying degrees of paralysis (frequently beginning in the hind legs or throat), excessive salivation (foaming at the mouth), avoidance of water or food, extreme depression, or bizarre behavior such as no fear of humans by a wild animal or daylight activity by a normally nocturnal species. Consideration should also be given to whether the attack was provoked or unprovoked.

1. Provoked Attack - An attack is considered to be "provoked" if an animal (dog/cat) is placed in a situation such that an expected reaction would be to bite or attack. This includes, but is not limited to, invasion of an animal's territory; attempting to pet or handle an unfamiliar animal; startling an animal; running or bicycling past an animal; assisting an injured or sick animal; trying to capture an animal; or removing food, water, or other objects in the animal's possession.
2. Unprovoked Attack - An "unprovoked" attack or bite occurs when a domestic animal strikes for no apparent reason. The behavior should be unusual for the particular animal. A confirmation of chronic aggressive behavior in a domestic animal can often be made by interviewing the animal's owner. This will assist in determining whether the attack was indeed "unprovoked."

Animal Species: The risk of rabies is very much dependent upon the species of biting animal.

High Risk Animals - Bats and carnivorous wild animals (skunks, raccoons, foxes, coyotes, and bobcats) are the animals most commonly infected with rabies in California. Exposures from these animals are considered to carry a high risk of rabies. Rabid bats are detected routinely in Los Angeles County.

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Los Angles County Title 11 - Health and Safety
Printable Version

Chapter 11.04 Communicable Disease Control
Part 2. Rabies Control and Vicious Animals

Sections

11.04.200 Persons bitten by certain animals -- Report required -- Treatment.

11.04.210 Confinement of biting animals -- Procedure generally.

11.04.220 Confinement of biting animals -- Alternate procedures.

11.04.225 Fee for Confinement of Biting Animals.

11.04.230 Owner of biting animal -- Report required -- Examination of confined animal.

11.04.240 Owner of biting animal -- Quarantine requirements -- Examination of dead animal.

11.04.250 Destroying quarantined animal prohibited -- Exception.

11.04.260 Suspected rabid animals -- Owner report and confinement duty.

11.04.270 Quarantine of animals coming in contact with rabid animals.

11.04.280 Vicious animals -- Identification procedure -- Confinement requirements.

11.04.290 Vicious animals -- Appeal from quarantine requirement -- Hearing procedures.

Expanded Codes11.04.200 Persons bitten by certain animals -- Report required -- Treatment.

It shall be the duty of each physician to report to the director any case coming to the physician's attention in which a person has been bitten by, or otherwise exposed to, an animal of a species subject to rabies, giving the full name, age and address of the person who has been bitten. If no physician is in attendance on said case, said report shall be made by the person bitten or otherwise exposed, or, in the case of a minor, by his parent or guardian. The director shall ascertain that said individual is treated as the director, in his opinion and discretion, deems necessary for the protection of said individual, and the director shall order the quarantine and observation of the biting animal until it is established by the director that such animal does not have symptoms of rabies. (Ord. 10728 § 1 (part), 1973: Ord. 7583 Part 2 § 218, 1959.)

11.04.210 Confinement of biting animals -- Procedure generally.

The biting animal shall be quarantined, confined and observed for at least 14 days (dogs and cats, 10 days) after the day of infliction of the bite, with the exception that the following alternative to the 10-day isolation of dogs and cats is permitted: dogs or cats which have been isolated in strict confinement, under proper care and under observation of a licensed veterinarian, in a pound, veterinary hospital or other adequate facility, in a manner approved by the local health officer, may be released from isolation by the local health officer after five days of veterinary observation if, upon conducting a thorough physical examination on the fifth day or more after infliction of the bite, the observing veterinarian certifies that there are no clinical signs or symptoms of any disease. (Ord. 10728 § 1 (part), 1973: Ord. 7583 Part 2 § 219, 1959.)

11.04.220 Confinement of biting animals -- Alternate procedures.

A. The quarantine described in Section 11.04.210 may be made on the property of the person having charge, custody or control of such animal when adequate quarantine facilities are available; or, at the discretion of the director, such animal may be placed under quarantine and observation in any licensed boarding kennel.

B. Should the animal be relinquished by the owner to the director to be disposed of upon release from quarantine, the director may, at his discretion, impound such animal in an approved animal control facility. (Ord. 10728 § 1 (part), 1973: Ord. 7583 Part 2 § 220, 1959.)

11.04.225 Fee for Confinement of Biting Animals.

1. Under the conditions described in subsection B of this section, the county shall recover a fee of $50.00 for the costs incurred by the department in the confinement of a biting animal as described in Sections 11.04.200, 11.04.210 and 11.04.220. The county shall also recover any related costs, including care and feeding of the confined animal, and any reasonable costs that it may incur in connection with the collection of such fees.
2. The fee shall be assessed when:
   1. The director or his designee confines an animal described in Section 11.04.200 on the owner or custodian's premises and the victim of the bite is not the owner or custodian of the animal; and
   2. The victim was not engaged in an illegal activity against the person or on the property of the owner or custodian.
3. Notwithstanding the above, the fee shall not be assessed when the animal is a police dog or guide dog as defined in California Health and Safety Code Sections 1919 and 1919.1.
4. The director or his designee may waive, in full or in part, the above fee, if necessary to accomplish the protection of animal or public health, safety or welfare. (Ord. 93-0055 §11, 1993.)

11.04.230 Owner of biting animal -- Report required -- Examination of confined animal.

Whenever the owner or person having charge, custody or control of any animal observes or learns that such animal has bitten or otherwise exposed a human being, such owner or person having charge, custody or control of such animal shall report the incident at once to the director and shall confine such animal in an enclosure, or shall securely hold and restrain said animal, by chain or other device, for examination and observation by the director. No owner or person having charge, custody or control of such animal shall fail, refuse or neglect to allow the director to make an inspection or examination of such animal for the purpose of determining whether such animal has symptoms of rabies. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 221, 1959.)

11.04.240 Owner of biting animal: Quarantine requirements - Examination of dead animal.

No owner or person having charge, custody or control of any animal biting or otherwise exposing a human being shall fail, refuse or neglect to confine in an enclosure, or securely hold and restrain such animal by chain or other device, upon the premises of the owner or person having charge, custody or control of such animal, for the period of quarantine as shown in Section 11.04.210. Should such animal die while under quarantine and observation, the owner or person having charge, custody or control of such animal shall surrender the carcass of such animal or such portion of the carcass as may be demanded by the director. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 222, 1959.)

11.04.250 Destroying quarantined animal prohibited -- Exception.

It is unlawful for any owner or person having charge, custody or control of any animal that has bitten or otherwise exposed a human being or is suspected of having rabies to destroy such animal, or have such animal destroyed, during the quarantine period, unless permission is granted by the director. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 223, 1959.)

11.04.260 Suspected rabid animals -- Owner report and confinement duty.

Whenever the owner or person having charge, custody or control of any animal learns or observes that such animal has shown symptoms of rabies or has acted in a manner which would give said person or owner reason to believe that said animal has rabies, it shall be unlawful for such owner or person having charge, custody or control of such animal to fail, refuse or neglect to notify the director at once and to confine such animal in an enclosure, or to securely hold and restrain such animal by chain or other device until it shall be established that such animal does not have symptoms of rabies, or to fail, refuse or neglect to allow the director to inspect or examine such animal for symptoms of rabies. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 224, 1959.)

11.04.270 Quarantine of animals coming in contact with rabid animals.

Animal contacts of a known rabid or suspected rabid animal shall be quarantined in a place and manner, and for a period of time, designated by the director. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 225, 1959.)

11.04.280 Vicious animals -- Identification procedure -- Confinement requirements.

A. It shall be the duty of the director, upon receipt of an affidavit from any person who has been bitten by an animal or from a person who has witnessed such an occurrence, to investigate and, upon reasonable indication of the animal's viciousness, to notify the owner or custodian of such animal, in writing, to keep such animal at all times confined strictly to the premises of said owner or custodian in such a manner that the animal may not do bodily harm to any person having legitimate reason to be upon the premises of said owner or custodian.

B. Permanent Quarantine. After the receipt by the owner or custodian of such animal of the notice as provided in subsection A of this section, the owner or custodian shall at all times thereafter keep such animal, or cause such animal to be kept, on the property or premises where such owner or custodian resides, in the manner specified in subsection A above. Such animal shall not be moved from the place of quarantine or disposed of in any manner without the permission of the director, and in the event of the death of the animal, the carcass of the animal shall be surrendered by the owner or custodian to the director on demand, as proof of the death of the animal. (Ord. 10728 § 2 (part), 1973: Ord. 7583 Part 2 § 226, 1959.)

11.04.290 Vicious animals -- Appeal from quarantine requirement -- Hearing procedures.

Any person whose animal has been declared vicious and placed on permanent quarantine may petition the director for a hearing. Such a petition shall be in writing, signed by the applicant, and shall set forth in detail the facts and reasons upon which his petition is based. If the director finds that the facts upon which he based his order of quarantine no longer exist, he shall rescind the quarantine. Otherwise, he shall set the matter for a public hearing not less than 60 days after the filing of the petition and, in writing, either by registered or certified mail, postage prepaid, or in the manner required for the service of summons in civil actions, not less than five days prior to the hearing, notify the applicant of the time and place thereof.

The director shall give the petitioner and all other persons who desire to be heard an opportunity to testify and to present any relevant facts. The director may place any witness under oath. The director, when he deems it necessary, may continue the hearing at any time and shall give notice thereof at the hearing or as required when the matter is first set for hearing. At the close of the hearing or within 10 days thereafter, from the evidence presented, the director shall determine the facts and shall take the action required thereby, continue the quarantine, set aside the quarantine, or such other action as is required by law under the facts. He may notify the petitioner at the close of the hearing as to his ruling if the petitioner is present, either in person or by counsel. Otherwise, he shall notify the petitioner of his action by a notice in writing served by first class mail, postage prepaid, or in the manner required for the service summons in a civil action. (Ord. 10728 § 4, 1973: Ord. 7583 Part 2 § 227, 1959.)

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California Code of Regulations Health and Safety Code
Printable Version

Division 105. Communicable Disease Control

Chapter 1 Rabies Control

Sections

121575 Rabies defined.

121580 Quarantine defined.

121585 "Rabies area" defined.

121595 Preliminary investigation of rabies.

121600 Quarantine, animals; area.

121605 Investigation.

121610 Regulations in lieu of quarantine.

121615 Duty to enforce.

121620 Power to destroy or detain animals.

121625 Power to enter and examine premises.

121630 Violation; punishment.

121635 Rabies treatment and eradication fund.

121640 Dog license tax; deposit in fund; use for other purposes.

121645 Special dog license tax.

121650 Rate of special tax.

121655 Termination of special tax.

121660 Disposition of fines.

121665 Special control measures.

121670 Expenditures; payment from fund.

121675 Expenditures in excess of fund; payment from general fund; repayment

121680 Guide dogs for blind persons.

121685 Law enforcement agency dogs; quarantine after biting people; availability for examination; notice of abnormal behavior.

121690 Regulation and control of dogs; maintenance of pound and rabies control. programs; vaccination clinics; issuance of license, duration.

121695 Construction of chapter.

121700 Persons and firms to whom vaccines deliverable.

121705 Concealment of information; misdemeanor.

121710 Violation of isolation or quarantine order; misdemeanor; penalty.

Expanded Codes

121575 Rabies defined.

"Rabies," as used in this chapter, includes rabies, and any other animal disease dangerous to human beings that may be declared by the department as coming under this chapter.

121580 Quarantine defined.

"Quarantine," as used in this chapter, means the strict confinement, upon the private premises of the owner, under restraint by leash, closed cage, or paddock, of all animals specified in the order of the department.

121585 "Rabies area"; defined.

"Rabies area" shall mean any area not less than a county as determined by the director within a region where the existence of rabies constitutes a public health hazard, as found and declared by the director. A region shall be composed of two or more counties as determined by the director. The status of an area as a rabies area shall terminate at the end of one year from the date of the declaration unless, not earlier than two months prior to the end of the year, it is again declared to be a rabies area in the manner provided in this section. If however, the director at any time finds and declares that an area has ceased to be a rabies area its status shall terminate upon the date of the declaration.

121595 Preliminary investigation of rabies.

Whenever any case of rabies is reported as existing in any county or city, the department shall make, or cause to be made, a preliminary investigation as to whether the disease exists, and as to the probable area of the state in which the population or animals are endangered.

121600 Quarantine, animals; area.

If upon the investigation the department finds that rabies exists, a quarantine shall be declared against all animals as are designated in the quarantine order, and living within the area specified in the order.

121605 Investigation.

Following the order of quarantine the department shall make or cause to be made a thorough investigation as to the extent of the disease, the probable number of persons and animals exposed, and the area found to be involved.

121610 Regulations in lieu of quarantine.

The department may substitute for the quarantine order regulations as may be deemed adequate for the control of the disease in each area.

121615 Duty to enforce.

All peace officers and boards of health shall carry out the provisions of this chapter.

121620 Power to destroy or detain animals.

During the period for which any quarantine order is in force any officer may kill or in his or her discretion capture and hold for further action by the department any animal in a quarantine area, found on public highways, lands, and streets, or not held in restraint on private premises as specified in this chapter.

121625 Power to enter and examine premises.

Any proper official within the meaning of this chapter may examine and enter upon all private premises for the enforcement of this chapter.

121630 Violation; punishment.

Except as provided in Sections 121705 and 121710, every person who possesses or holds any animal in violation of the provisions of this chapter is guilty of an infraction, punishable by a fine not exceeding one thousand dollars ($1,000).

121635 Rabies treatment and eradication fund.

For the purpose of providing funds to pay expenses incurred in connection with the eradication of rabies, the rabies treatment and eradication fund is continued in existence in each county or city in this state.

121640 Dog license tax; deposit in fund; use for other purposes.

All money collected for dog license taxes shall be deposited to the credit of this fund with the treasurer of the county or city; but funds now collected from any dog tax may continue to be collected and used for other purposes specified by local ordinances.

121645 Special dog license tax.

Upon the determination by the department that rabies exists in any county or city, a special dog license tax shall immediately become effective, unless a dog tax is already in force the funds from which are available for the payment of expenditures in accordance with this chapter.

121650 Rate of special tax.

This tax shall be levied as follows: An annual tax of one dollar and fifty cents ($1.50) for each male, two dollars and fifty cents ($2.50) for each female, and one dollar and fifty cents ($1.50)for each neuter dog. It shall be collected by the proper authority at the same time and in the same manner as other taxes are collected; except that at the first collection the proportion of the annual tax as corresponds to the number of months the tax has been in operation plus one year advance payment shall be collected.

121655 Termination of special tax.

After this dog license tax has been established in a county or city, it shall be continued in force until an order has been issued by the department declaring that county, or the portion of that county as may be deemed advisable, to be free from rabies or further danger of its spread.

121660 Disposition of fines.

One half of all fines collected by any court or judge for violations of this chapter shall be placed to the credit of the rabies treatment and eradication fund of the county or city where the violation occurred.

121665 Special control measures.

Whenever it becomes necessary in the judgment of the department, to enforce this chapter in any county or city, the department may institute special measures of control to supplement the efforts of the local authorities in any county or city whose duties are specified in this chapter.

121670 Expenditures; payment from fund.

All expenditures incurred in enforcing the special measures shall be proper charges against the special fund referred to in this chapter, and shall be paid as they accrue by the proper authorities of each county or city where they have been incurred; but all expenditures that may be incurred after the issuance of the order establishing the tax and before the first collection of the tax, shall be paid as they accrue from the general fund of the county or city.

121675 Expenditures in excess of fund; payment from general fund; repayment.

All expenditures in excess of the balance of money in this fund shall likewise be paid as they accrue from the general fund. All money thus expended from the general fund shall be repaid from the special fund when the collections from the tax have provided the money.

121680 Guide dogs for blind persons.

Notwithstanding any other provision of this chapter a guide dog serving a blind master shall not be quarantined, in the absence of evidence that he or she has been exposed to rabies, unless his or her master fails: (a) To keep him or her safely confined to the premises of the master. (b) To keep him or her available for examination at all reasonable times.

121685 Law enforcement agency dogs; quarantine after biting people; availability for examination; notice of abnormal behavior.

Notwithstanding any other provision of this chapter, a dog used by any state, county, city, or city and county law enforcement agency shall not be quarantined after biting any person if the bite occurred while the dog was being used for any law enforcement purpose. The law enforcement agency shall make the dog available for examination at any reasonable time. The law enforcement agency shall notify the local health officer if the dog exhibits any abnormal behavior.

121690 Regulation and control of dogs; maintenance of pound and rabies control programs; vaccination clinics; issuance of license, duration.

In rabies areas, all of the following shall apply:

(a) Every dog owner, after his or her dog attains the age of four months, shall no less than once every two years secure a license for the dog as provided by ordinance of the responsible city, city and county, or county. License fees shall be fixed by the responsible city, city and county, or county, at an amount not to exceed limitations otherwise prescribed by state law or city, city and county, or county charter.

(b) Every dog owner, after his or her dog attains the age of four months, shall, at intervals of time not more often than once a year, as may be prescribed by the department, procure its vaccination by a licensed veterinarian with a canine antirabies vaccine approved by, and in a manner prescribed by the department.

(c) All dogs under four months of age shall be confined to the premises of, or kept under physical restraint by, the owner, keeper, or harborer. Nothing in this chapter and Section 120435 shall be construed to prevent the sale or transportation of a puppy four months old or younger.

(d) Any dog in violation of this chapter and any additional provisions that may be prescribed by any local governing body, shall be impounded, as provided by local ordinance.

(e) It shall be the duty of the governing body of each city, city and county, or county to maintain or provide for the maintenance of a pound system and a rabies control program for the purpose of carrying out and enforcing this section.

(f) It shall be the responsibility of each city, county, or city and county to provide dog vaccination clinics, or to arrange for dog vaccination at clinics operated by veterinary groups or associations, held at strategic locations throughout each city, city and county, or county. The vaccination and licensing procedures may be combined as a single operation in the clinics. No charge in excess of the actual cost shall be made for any one vaccination at a clinic. No owner of a dog shall be required to have his or her dog vaccinated at a public clinic if the owner elects to have the dog vaccinated by a licensed veterinarian of the owner's choice. All public clinics shall be required to operate under antiseptic immunization conditions comparable to those used in the vaccination of human beings.

(g) In addition to the authority provided in subdivision (a), the ordinance of the responsible city, city and county, or county may provide for the issuance of a license for a period not to exceed three years for dogs that have attained the age of 12 months or older and have been vaccinated against rabies. The person to whom the license is issued pursuant to this subdivision may choose a license period as established by the governing body of up to one, two, or three years. However, when issuing a license pursuant to this subdivision, the license period shall not extend beyond the remaining period of validity for the current rabies vaccination. A dog owner who complies with this subdivision shall be deemed to have complied with the requirements of subdivision (a).

121695 Construction of chapter.

Nothing in this chapter and Section 120435 is intended or shall be construed to limit the power of any city, city and county, or county in its authority in the exercise of its police power or in the exercise of its power under any other provisions of law to enact more stringent requirements, to regulate and control dogs within the boundaries of its jurisdiction.

121700 Persons and firms to whom vaccines deliverable.

121700. Rabies vaccines for animal use shall not be supplied to other than a veterinary biologic supply firm, a person licensed to practice veterinary medicine under Chapter 11 (commencing with Section 4800) of Division 2 of the Business and Professions Code, or a public agency.

121705 Concealment of information; misdemeanor.

121705. Any person who willfully conceals information about the location or ownership of an animal subject to rabies, that has bitten or otherwise exposed a person to rabies, with the intent to prevent the quarantine or isolation of that animal by the local health officer is guilty of a misdemeanor. Any person who violates this section is guilty of a misdemeanor.

121710 Violation of isolation or quarantine order; misdemeanor; penalty.

121710. Any person who, after notice, violates any order of a local health officer concerning the isolation or quarantine of an animal of a species subject to rabies, that has bitten or otherwise exposed a person to rabies or who, after that order, fails to produce the animal upon demand of the local health officer, is guilty of a misdemeanor, punishable by imprisonment in the county jail for a period not to exceed one year, or by fine of not less than one hundred dollars ($100), nor more than one thousand dollars ($1,000)per day of violation, or by both fine and imprisonment.

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Biting Animals
Printable Version

Injuries to humans by biting animals are significant public health problem. Serious injury, viral and bacterial infections, psychological trauma, and even death can be complications of animal bites. The number of animal bites can be reduced if the public practices responsible pet ownership, by controlling stray animals, and by enforcement of animals control laws and ordinances.

Most animal bites wounds that come to the attention of medical and/or public health practitioners will consist of puncture wounds, scratches and abrasions. Severe attacks may produce crushing injuries to bones, especially in children. One of the most steps in preventing rabies and other infections following an animal bite is vigorously wash bite wounds with soap and water for 15 minutes. A tetanus booster is often given to previously immunized victims if more than 5 years have elapsed since the last administration. If no history of tetanus vaccination the individual is often vaccinated.

Young children are especially vulnerable to animal bites and should be properly protected. Rabies is a viral infection of the nervous system that may affect almost any warm-blooded animal. In Los Angeles County, this disease is commonly present in bats. About 10 percent of the bats tested by the health department have rabies. The last rabid skunk in Los Angeles County was detected in 1979. The last domestic animal with rabies was a cat which came from Mexico in 1987.

Man is usually exposed to rabies by direct contact (bites) with rabid wildlife or by contact with dogs or cats which have acquired the infection from rabid wildlife.

Although rabies is almost always fatal, vaccination is highly effective in preventing it. Control of rabies depends on public awareness of the signs and hazards of the disease, stringent enforcement of animal control regulations, and upon immunization of dogs and cats.

Common Questions

When a known rabid animal bites a dog or a cat what should be done?

Unvaccinated dogs and cats bitten by a known rabid animal should be destroyed immediately. If the owner is unwilling have this done, the animal should be vaccinated and placed in strict isolation for 180 days. If the dog or cat has been vaccinated within one year, it should be revaccinated immediately, quarantined for 30 days and then restrained by the owner (leashing and confinement) for an additional 60 days.

When a dog or cat bites a person what should be done?

Unvaccinated and vaccinated dogs and cats that bite a person, must be quarantined for 10 days. If the dog or cat was infective at the time of the bite, sign of rabies in the animal will usually follow rather quickly and certainly within 10 days.

When a wild animal is involved in an attack on a person what should be done?

The animal should be euthanized immediately and the head should be submitted to the lab for rabies testing.

When a person has been exposed to a rabid animal what should be done?

The person should contact their physician and explain the situation. If the physician feels that the person is at risk of contracting rabies, he/she will begin anti-rabies treatments on the person.

Who should be treated for rabies?

Person who are bitten by, or have significant exposure to the saliva or nervous tissue of a confirmed rabid animal should begin treatment as soon as possible. Persons exposed to a suspected rabid animal should begin treatment, if the animal is not available for quarantine or testing.

What is the treatment for a person exposed to a rabid animal?

The person is given rabies vaccines and rabies immunoglobulin. The rabies vaccine and anti-serum in current use have excellent safety records and when given early are highly effective. The immunoglobulin is called the Human Anti-Rabies Immunoglobulin or HRIG (dosage depends on weight) given on day 0. The rabies vaccine is given on day 0, 3, 7, 14, and 28.

Since the chances of developing the disease are much greater than the chances of adverse reaction to the vaccine, anti-rabies treatment should be administered in all cases of known or uncertain exposure.

What is the most important measure in preventing infection of an animal bite?

Immediate and thorough washing of any bite or scratch wound with soap and water. Simple local wound cleaning has been shown to markedly reduce the likelihood of rabies in animal experiments. Tetanus and antibiotic prophylaxis should be given as indicated.

Investigation of Animal Bites

All animal bites must be investigated in California. In general, data on the biting animal, the victim, the circumstances of the bite, the name of the animal's owner (if any), and the rabies vaccination status of the biting animal should collected. The circumstances of the bite are especially important for determining if the bite was provoked. Provoked bites are considered to be of lower rabies risk, all things being equal, than an unprovoked bite.

A rapid investigation of the bite should be completed in order to identify and capture, if possible, the biting animal and to determine whether rabies post-exposure prophylaxis for the victim is needed.

Although the bites of rodents, rabbits, etc. are at extremely low risk for transmitting rabies, such bites still need to be attended to in order to prevent infections with other diseases.

Management of Animals that Bite People

A healthy dog, cat, or ferret that bites a person should be confined and observed for 10 days; it is recommended that rabies vaccine not be administered during the observation period. Such animals should be evaluated by a public health veterinarian at the first sign of illness during confinement. Any illness in the animal should be reported immediately to the local health department. (Los Angeles County Veterinary Public Health: 877-747-2243) If signs suggestive of rabies develop, the animal should be euthanized, its head removed, and the head shipped under refrigeration (not frozen) for examination of the brain by a qualified laboratory designated by the local or state health department.  All biting animals which might have exposed a person to rabies should be reported immediately to the local health department. Prior vaccination of an animal may not preclude the necessity for euthanasia and testing if the period of virus shedding is unknown for that species. Management of animals other than dogs, cats, and ferrets depends on the species, the circumstances of the bite, the epidemiology of rabies in the area, and the biting animal's history, current health status, and potential for exposure to rabies.

For legal authority see Los Angeles County law and California law.

Evaluation of Encounters with Rabies Suspects

When a person or domestic animal has encountered a potentially rabid animal, an evaluation is necessary to determine: 1) whether a true exposure occurred; and 2) whether the potentially rabid animal should be quarantined or tested for rabies.

Has a true exposure occurred?

Encounters with a rabid animal can lead to rabies transmission when virus from the animal's saliva, brain tissue, or spinal fluid enters open cuts or wounds in skin or mucous membranes. Therefore, not every encounter with a rabid animal is a true exposure requiring intervention. Treatment is often provided unnecessarily to people who have encountered but had no true exposure to a potentially rabid animal.

Bite exposure is considered any penetration of the skin by an animal's teeth. Local wound care should be performed immediately on anyone bitten by an animal. A health care provider should be consulted to determine whether or not other measures are necessary. Animal bites are reportable in California.

Non-bite exposures include any scratches, abrasions, or contamination of mucous membranes by an infected animal's saliva, brain tissue, or spinal fluid. Other types of contacts (such as with the blood, urine, feces, or fur of an animal) would not by themselves be considered exposures capable of transmitting rabies even if the animal were known to be rabid. The virus is not hardy; once dry, saliva containing rabies virus is considered non-infectious.

If a true exposure occurred, should the potentially rabid animal be quarantined or be tested?

Whether to a) quarantine or to b) test an animal depends on the type of animal involved. These guidelines are derived from the Advisory Committee on Immunizations Practices (ACIP) and the recommendations of National Association of State Public Health Veterinarians.

Dogs and cats: A dog (excluding dog-wolf hybrids) or cat that has bitten, scratched, or otherwise exposed a human should be confined and observed for 10 days under local health department supervision, regardless of whether or not the animal is currently vaccinated. Any dog or cat that is sick at the time it exposed a human should be evaluated by a veterinarian immediately.

In most places in Los Angeles County, such an animal can be confined at home by its owner. Rabies vaccination should not be administered to the animal during this period. If the confined animal develops any illness during the 10 days, a veterinarian should evaluate it immediately.

If signs of rabies are present, the local health department should be contacted, and the animal euthanized and tested for rabies. A dog or cat that develops no signs of rabies during this observation period did not have transmissible rabies at the time the exposure occurred.

Note that the 10 day observation applies only to dogs or cats that have exposed a human. Quarantine periods for animals that have themselves been potentially exposed to rabies are much longer.

All other animals: All other animals that expose humans should be reported to the local health department immediately. No observation periods have been established for such animals (including wolf hybrids). If the animal is available, laboratory testing may be indicated depending upon the circumstances of the exposure (such as whether it was provoked or not) and the species involved. The risks associated with different animals varies from place to place.

Bats: A bat that bites or otherwise exposes a human should be safely captured, euthanized, and submitted to the Public Health Laboratories (PHL) for rabies testing..

Determining whether an exposure to a rabid bat occurred is often difficult. Bats are small and have small teeth, so their bites may be difficult to recognize. Exposure may have taken place when there is reasonable probability that such contact unknowingly occurred (e.g., a sleeping person awakes to find a bat in the room or an adult witnesses a bat in the room with a previously unattended child, mentally disabled or intoxicated person, or incompletely vaccinated pet). When available the bat should be tested immediately. The presence of a bat inside a building is not by itself sufficient to result in rabies transmission.

If an unvaccinated animal is bitten by a rabid animal what should be done?

When the exposed animal is unvaccinated, euthanasia is recommended. Alternatively, the owner has the option of arranging for a 6-month strict confinement. Confinement must be strict because of the special public health risks associated with these animals (i.e., those potentially incubating rabies), and the need to prevent human and other animal exposures form occurring should rabies symptoms develop.

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Submission of Animals for Rabies Testing
Printable Version

When the decision is made either to euthanize an animal or submit a dead animal for rabies examination, several procedures must be followed to obtain quick and accurate results. Many times rabies prophylaxis of an individual is dependent on these results.  Contact Los Angeles County Veterinary Public Health (877-747-2243) for information on appropriate sample handling and to arrange for specimen pick-up.  The rabies specimens will be transported to the Public Health Laboratory.

Animals that bite humans

Wild carnivores & bats

In California, wildlife account for close to 99% of the rabid animals. Any wild carnivore that bites a person should be immediately tested for rabies. The four most common terrestrial reservoir species harboring rabies in the U.S. are: raccoons, skunks, foxes and coyotes. In addition to these terrestrial, indigenous rabid bats have been found in every state except Hawaii.

Healthy cats and dogs

A healthy dog, cat, or ferret that bites a person should be confined and observed for 10 days. Such animals should be evaluated by a veterinarian at the first sign of illness during confinement. If signs suggestive of rabies develop, the animal should be euthanized, its head removed, and the head shipped under refrigeration (not frozen) for examination of the brain by the Public Health Laboratory. 

Collection and submission of animal specimens for rabies testing

This information is supplied to facilitate the handling and to provide the most accurate and rapid diagnosis of specimens submitted for rabies testing. The Public Health Laboratory accepts specimens for rabies testing from private veterinarians or animal shelters who adhere to the following guidelines.

A. Listed below are animals that will be tested for rabies.

1. Domestic mammals that bite/expose humans (except fully-vaccinated dogs, cats, and caged animals raised indoors).

2. All wild carnivores that bite humans. Signs of rabies in wildlife cannot be interpreted reliably.

3. All bats should be tested regardless of human exposure. The bite of a bat is so minuscule that often the individual is not aware of it. Also, because rabies is endemic in bats, we test them for surveillance purposes to determine the prevalence of bat rabies.

4. Ill animals with signs of rabies.

B. Listed below are animals that will NOT be accepted for rabies testing:

1. Cage raised pets will NOT be tested. These include all gerbils, guinea pigs, and hamsters.

2. Rodents and rabbits will NOT be tested, except when a Veterinary Public Health Veterinarian deems that extraordinary circumstances exist which indicate rabies infection is likely.

3. Baby bats submitted with the mother will NOT be tested regardless of exposure history. Only the mother will be tested if an exposure has occurred.

4. No live animals will be accepted for testing.

Guidelines to Ensure Proper Rabies Testing of Specimens

1. Avoid damage to the brain by shooting or other traumatizing procedures.

2. Have a qualified person separate the suspect animal's head from the body immediately after death. Submit only the head of the animal.

3. If only the brain is submitted rather than the entire head, be sure to include parts of the cerebellum, hippocampus, and brain stem. Specimens that do not include at least two of these three areas of the brain will be considered unsatisfactory due to a lack of sufficient material. DO NOT FORMALIN FIX BRAIN TISSUE.

4. Pour chloroform over the specimen or use flea spay in sufficient quantity to kill any fleas which may be present. Wrap the specimen in several layers of newspaper. Place wrapped specimen in a plastic bag, seal the bag and attach completed lab transmittal form to the outside of the plastic bag. Place this entire package inside a second plastic bag to protect the lab slip. Seal the bag.

5. Keep the head refrigerated until time to deliver to the laboratory. Do not freeze.

6. Brains submitted from larger animals such as livestock nominally should include labeled portions from the hippocampus, cerebral cortex, cerebellum and brain stem from both sides of the brain.

7. Bats should be submitted whole.

Routine and emergency laboratory processing of rabies specimens

The processing of rabies specimens is performed daily. Results are telephoned or faxed to the submitter. Positive results are also telephoned to Acute Communicable Disease Control (ACD) and Veterinary Public Health.

Routine Processing:

Processing is initiated on all specimens submitted to the laboratory by 1:00 p.m. of that day, smears are made and fixed overnight for direct immunofluorescent antibody (IFA) staining the following morning. Results are ready before noon of the day following submission.

Emergency Processing:

Specimens deemed to be of an emergent nature are processed including staining on the same day of submission. These results are ready within six hours of specimen receipt in the laboratory. Special arrangements must be made for emergency testing by contacting Veterinary Public Health (877-747-2243) before the laboratory can proceed with testing. All IFA results done by six hour fixation are considered to be preliminary, therefore retesting of brain material will be performed on the next regular laboratory work day, using slides that had at least an overnight fixation.

Questions on Laboratory Testing for Rabies

What animals will be tested by the Public Health Laboratory (PHL)?

In general, the following animals will be tested.

1. Mammals that bite/expose humans (except fully-vaccinated dogs, cats, ferrets, and caged animals raised indoors).

2. Ill animals with signs of rabies.

3. All bats.

What test is performed for rabies at the Public Health Laboratory (PHL)?

The test of choice for detecting rabies in animals is the direct immunofluorescent antibody (IFA) test. A slide containing fresh brain tissue is reacted with fluorescein labeled anti-rabies virus antibody. When viewed under a fluorescence microscope, rabies virus antigen will fluoresce. Any animal excreting virus in its saliva should have detectable virus in its brain.

What types of specimens are required for IFA testing?

Rabies IFA testing requires fresh, unfixed brain tissue.

What does PHL accept for testing?

No living animal will be accepted for rabies testing. For testing of bats, the entire animal should be sent to the PHL. For other species, just the animal's head and upper neck should be submitted.

Euthanizing a bat that needs to be tested: Captured bats should be euthanized before being shipped to the PHL. Many local veterinarians or animal shelters can safely and humanely euthanize bats. 

Who should remove the head for testing?

Because the brain, spinal cord, salivary glands, and saliva may contain rabies virus, only veterinarians, animal control officers, or others who have been appropriately trained (and adequately vaccinated) should remove animal heads. This work should be done in a properly ventilated area using adequate protective gear.

How should specimens be shipped to the PHL?

Wrap the specimen in several layers of newspaper. Place wrapped specimen in a plastic bag, seal the bag and attach completed lab transmittal form to the outside of the plastic bag. Place this entire package inside a second plastic bag to protect the lab slip. Seal the bag. Keep the head refrigerated until time to deliver to the laboratory.

What are the possible outcomes of the testing?

Rabies IFA testing at the PHL can result in the following outcomes:

Positive: A "positive" specimen is one in which rabies virus antigens have been detected. Any animal with a confirmed positive rabies IFA test is considered capable of transmitting rabies. The IFA test is highly specific for rabies (other diseases do not cause a positive test).

Negative: A "negative" specimen is one in which adequate brain tissue was examined yet no rabies antigens were detected. A negative IFA test performed with an adequate specimen reliably rules out the possibility that the animal tested was capable of transmitting rabies.

Unsatisfactory: An "unsatisfactory" test is one in which the specimen submitted was inadequate for testing.

In addition, non-specific or indeterminant fluorescence patterns are found rarely. In such instances, additional studies will be performed.

What is the turnaround time for test results?

Processing is initiated on all specimens submitted to the laboratory by 1:00 p.m. of that day, smears are made and fixed overnight for IFA staining the following morning. Results are ready before noon of the day following submission.

How are the test results disseminated?

Results are telephoned or faxed to the submitter. Positive results are also telephoned to Acute Communicable Disease Control (ACD) and Veterinary Public Health.

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Quarantines
Printable Version

Quarantine International: CDC regulates the importation of dogs and cats into the United States, but current PHS regulations (42 CFR No. 71.51) governing the importation of such animals are insufficient to prevent the introduction of rabid animals into the country. All dogs and cats imported from countries with endemic rabies should be currently vaccinated against rabies as recommended in this Compendium. The appropriate public health official of the state of destination should be notified within 72 hours of any unvaccinated dog or cat imported into his or her jurisdiction. The conditional admission of such animals into the United States is subject to state and local laws governing rabies. Failure to comply with these requirements should be promptly reported to the Division of Quarantine, CDC, 404-639-8107.

Interstate: Prior to interstate movement, dogs, cats, and ferrets should be currently vaccinated against rabies.

Los Angeles County

11.04.210 Confinement of biting animals -- Procedure generally.

The biting animal shall be quarantined, confined and observed for at least 14 days (dogs and cats, 10 days) after the day of infliction of the bite, with the exception that the following alternative to the 10-day isolation of dogs and cats is permitted: dogs or cats which have been isolated in strict confinement, under proper care and under observation of a licensed veterinarian, in a pound, veterinary hospital or other adequate facility, in a manner approved by the local health officer, may be released from isolation by the local health officer after five days of veterinary observation if, upon conducting a thorough physical examination on the fifth day or more after infliction of the bite, the observing veterinarian certifies that there are no clinical signs or symptoms of any disease. (Ord. 10728 § 1 (part), 1973: Ord. 7583 Part 2 § 219, 1959.)

11.04.220 Confinement of biting animals -- Alternate procedures.

A. The quarantine described in Section 11.04.210 may be made on the property of the person having charge, custody or control of such animal when adequate quarantine facilities are available; or, at the discretion of the director, such animal may be placed under quarantine and observation in any licensed boarding kennel.

B. Should the animal be relinquished by the owner to the director to be disposed of upon release from quarantine, the director may, at his discretion, impound such animal in an approved animal control facility. (Ord. 10728 § 1 (part), 1973: Ord. 7583 Part 2 § 220, 1959.)

11.04.225 Fee for Confinement of Biting Animals.

A. Under the conditions described in subsection B of this section, the county shall recover a fee of $50.00 for the costs incurred by the department in the confinement of a biting animal as described in Sections 11.04.200, 11.04.210 and 11.04.220. The county shall also recover any related costs, including care and feeding of the confined animal, and any reasonable costs that it may incur in connection with the collection of such fees.

B. The fee shall be assessed when:

1. The director or his designee confines an animal described in Section 11.04.200 on the owner or custodian's premises and the victim of the bite is not the owner or custodian of the animal; and

2. The victim was not engaged in an illegal activity against the person or on the property of the owner or custodian.

C. Notwithstanding the above, the fee shall not be assessed when the animal is a police dog or guide dog as defined in California Health and Safety Code Sections 1919 and 1919.1.

D. The director or his designee may waive, in full or in part, the above fee, if necessary to accomplish the protection of animal or public health, safety or welfare. (Ord. 93-0055 §11, 1993.)

11.04.230 Owner of biting animal -- Report required -- Examination of confined animal.

Whenever the owner or person having charge, custody or control of any animal observes or learns that such animal has bitten or otherwise exposed a human being, such owner or person having charge, custody or control of such animal shall report the incident at once to the director and shall confine such animal in an enclosure, or shall securely hold and restrain said animal, by chain or other device, for examination and observation by the director. No owner or person having charge, custody or control of such animal shall fail, refuse or neglect to allow the director to make an inspection or examination of such animal for the purpose of determining whether such animal has symptoms of rabies. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 221, 1959.)

11.04.240 Owner of biting animal: Quarantine requirements - Examination of dead animal.

No owner or person having charge, custody or control of any animal biting or otherwise exposing a human being shall fail, refuse or neglect to confine in an enclosure, or securely hold and restrain such animal by chain or other device, upon the premises of the owner or person having charge, custody or control of such animal, for the period of quarantine as shown in Section 11.04.210. Should such animal die while under quarantine and observation, the owner or person having charge, custody or control of such animal shall surrender the carcass of such animal or such portion of the carcass as may be demanded by the director. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 222, 1959.)

11.04.250 Destroying quarantined animal prohibited -- Exception.

It is unlawful for any owner or person having charge, custody or control of any animal that has bitten or otherwise exposed a human being or is suspected of having rabies to destroy such animal, or have such animal destroyed, during the quarantine period, unless permission is granted by the director. (Ord. 10728 § 3 (part), 1973: Ord. 7583 Part 2 § 223, 1959.)

11.04.260 Suspected rabid animals -- Owner report and confinement duty.

Whenever the owner or person having charge, custody or control of any animal learns or observes that such animal has shown symptoms of rabies or has acted in a manner which would give said person or owner reason to believe that said animal has rabies, it shall be unlawful for s