Rabies in Pennsylvania

What is Rabies?
Rabies is a virus affecting the central nervous system (the brain and spinal cord) that can infect any mammal. Rabies is widespread throughout Pennsylvania.

What are the signs (symptoms) of Rabies?

  • Rabies signs are grouped into two forms known as either the “Furious” form of rabies or the “Paralytic” (or “Dumb” form).
  • An animal may show signs of only one type or of both. Some animals may show no obvious signs of rabies other than sudden death.
  • The “Furious” form of rabies is more familiar to most people. Signs may include aggression, loss of fear, daytime activity by nocturnal species, attraction to noise, dogs, and human activity, excess vocalization, dilated pupils, difficulty swallowing, loss of appetite, restlessness, and/or biting at objects and other animals. Animals may or may not drool or “froth at the mouth”.
  • The “Paralytic” form of rabies may include signs such as decreased activity, incoordination (wobbly or “drunk” movements), hind limb weakness, or acting “out of it”. As the disease progresses, the animal may be unable to close its mouth, may drool due to an inability to swallow, become paralyzed and finally die.
  • Note: It is important to realize that not all animals show every sign. Many rapidly progressing
    neurological abnormalities potentially could be rabies.
Incubation Period
  • This is the period of time from when an animal is exposed to the rabies virus until that animal actually becomes sick with rabies.
  • Although the length of the incubation period varies, it usually lasts between two weeks and four months with occasional longer or shorter incubation periods possible.
  • During most of the incubation period, the animal cannot transmit rabies and its behavior remains normal.
  • During the incubation period, there may be time for vaccination to prevent the animal from developing disease and shedding or transmitting virus.

CAUTION: rabid animals may have virus in their saliva and be able to transmit virus for a short time before signs of illness are recognized.

Exposure
  • Exposure to rabies generally occurs by one or more of the following, although there are other rare possible routes of exposure:
    • A bite from a rabid mammal
    • A scratch from a rabid mammal that breaks the skin
    • Saliva, brain or spinal cord tissue from a rabid animal contacting a fresh open wound
    • Saliva, brain or spinal cord tissue from a rabid animal contacting the eyes or mucus membranes such as the inside of the nose or mouth
  • Immediately washing the bite, scratch or open wound with soap and water can greatly reduce the risk of rabies.
  • Rabies virus is fragile outside of a rabid animal; it becomes non-infectious when it dries out or is exposed to sunlight or many common disinfectants. On the other hand, freezing and moisture can help to preserve the virus in an infectious state.
    • There has never been a documented case of rabies transmitted to humans from an inanimate object.
  • While bats are valuable members of our ecosystem, helping to reduce mosquito populations, unfortunately they can carry rabies. Bats continue to be the number one source of infection resulting in human rabies cases in the United States. The Centers for Disease Control now recommends that every bat found inside a building or home be tested for rabies if there was possible human contact (e.g. if people were sleeping in the room).
What if a person thinks they may have been exposed to rabies or has been bitten by a mammal?

Please Note: All issues relating to possible human exposure to rabies are addressed by the Health Department, not the PA Department of Agriculture (PDA).

Rabies in humans is a preventable disease if exposure is recognized and treatment is begun in a timely manner

  • By PA law, all animal bites to people must be reported by the medical professional to the PA Department of Health or appropriate municipal public health authority.
  • If the person has been bitten, scratched or otherwise exposed by a mammal that is suspected of having rabies, the animal must be tested for rabies. The only way to test for rabies is to euthanize the animal and submit specimens to an approved laboratory for rabies testing (see section “Submitting Animals for Rabies Testing”). The Health Department should be notified by the medical professional and consulted for advice on whether or not the exposed person should start receiving rabies treatment.
  • If a person has been bitten by a domestic mammal (not a wild animal) which is not suspected of having rabies (the biting animal does not appear to be sick with rabies), then the animal must be observed for a period of time, usually ten days. The Health Department must be notified by the medical professional and will provide advice on how to proceed.
    • If the animal is not showing signs of rabies by the end of the observation period
      then it was very unlikely to have had rabies in its saliva when it bit the person.
    • If the animal shows signs of rabies or dies during the observation period, it should be submitted for rabies testing.
    • If there are any concerns about submitting the animal for rabies testing, the Health Department should be contacted for guidance.
    • In some situations, the Health Department may recommend euthanasia over a period of observation.
  • If a mammal showing signs of rabies has bitten or exposed a person then the animal must immediately be euthanized and submitted for rabies testing. The Health Department and PDA should both be notified.
  • What if the animal runs away? If a human has been bitten or scratched by a mammal, either domestic or wild, but the animal is not available for observation or testing, the person should seek medical assistance. The medical professional must notify the Health Department.

What happens to my pet or other domestic mammal if it is bitten or scratched by a rabid animal?

According to the General Quarantine Order of October 6, 2018 [48 Pa.B. 6390], a domestic animal that is exposed to a confirmed or suspected rabid animal must be quarantined or observed as follows:

  • Unvaccinated domestic animals, animals without any proof of prior vaccination, and animals that received their first rabies vaccination ever in the last 28 days will be placed under official quarantine on the owner’s property for a minimum of 120 days.
  • Currently vaccinated domestic animals will be observed by their owners for a period of 45 days. Owners must notify PDA of any suspicion of rabies.
  • Domestic animals that have been vaccinated previously but are overdue for vaccination will be managed on a case by case basis by PDA and may or may not be placed under official quarantine based on a risk assessment.
  • Post-exposure vaccination of the exposed animal is permitted by PDA.
  • PDA will NOT seize or euthanize your pet or any other domestic animals for being exposed to rabies!
  • However, in some circumstances, euthanasia of the exposed domestic animal may be recommended.
What does it mean for my pet to be quarantined?
  • The pet or other domestic animal must be under the owner’s control and on his/her property during the period of quarantine. The owner must take precautions to prevent exposure to other people and animals during this time. A small quarantine sign will be posted by PDA. It is unlawful to remove a quarantine sign.
Submitting Animals for Rabies Testing How can you help to prevent rabies infection?
  • Vaccination of domestic mammals for rabies is very effective.
  • Vaccination is recommended for all species for which there is an approved rabies vaccine. Discuss vaccination of species for which there is not an approved rabies vaccine with your veterinarian.
  • By PA law, dogs and cats must be vaccinated for rabies between 12 and 16 weeks of age, one year after the initial vaccination (regardless of age at first vaccination) and revaccinated regularly according to the vaccine label requirements.
Questions?

Links for additional rabies information:

What to do?

Domestic animal with current rabies vaccination exposed to known rabid animal

  • 45 day observation period by owner at home (additional rabies vaccination allowed)*

Domestic animal with no known history of rabies vaccination exposed to known rabid animal

  • Minimum 120 day PDA quarantine to owner’s property (rabies vaccination(s) allowed)*

Domestic animal with expired rabies vaccination exposed to known rabid animal

  • Case by case risk evaluation by PDA determines 45 day home observation by owner or minimum 120 day
    PDA quarantine to owner's property (additional rabies vaccination(s) allowed)

Domestic animal of any vaccination status exposed to suspected rabid animal e.g. dog seen in fight with raccoon during the day, but raccoon not caught for testing, etc.

  • Veterinary practitioner reports suspected rabies exposure to PDA for evaluation
  • Minimum 120 day PDA quarantine to owner’s property (rabies vaccination(s) allowed)*
  • OR
  • 45 day observation period by owner at home (additional rabies vaccination allowed)*

Domestic animal, suspected of being clinically rabid, with human exposure

  • Report to Public Health Department (1-877-PA-HEALTH or local health department office) for guidance on whether or not immediate euthanasia and testing is required
  • Report to PDA Regional Office

Domestic animal, suspected of being clinically rabid, with no human exposure

  • Report to PDA Regional Office
  • Euthanasia and testing if other domestic animal exposed in prior 10 days
  • OR
  • PDA quarantine until rabies no longer suspected or death/euthanasia (testing required in most cases)

Domestic animal, not suspected of having rabies, that bites a person (PDA BAHDS IS NOT INVOLVED)

  • Ensure that the bite is reported to the health department (1-877-PA-HEALTH or local health dept. office)
  • Severe dog bites should be reported to the PDA Bureau of Dog Law Enforcement Officer (dog warden) or police
  • Most will be observed for 10 days (in most cases may be confined at home)
  • Discuss any issues such as if testing will be required if animal dies during the 10 days with health dept.

Domestic animal, not suspected of having rabies, that bites a domestic animal

  • Severe dog bites should be reported to the PDA Bureau of Dog Law Enforcement Officer (dog warden) or police
  • Practitioner may recommend 10 day confinement and observation but not legally required
  • May test for rabies if the biting animal dies during the 10 days but not legally required

Wild animal showing abnormal behavior indicative of rabies

  • Prevent contact with people or domestic animals
  • If humans/domestic animals in danger, call Pennsylvania Game Commission, police or animal control

Please refer to the Department of Agriculture, General Quarantine Order

*Euthanasia is always and option at owner discretion

Understanding Rabies Quarantines for Veterinary Clinics

There are three different types of quarantines: (1) “Quarantines” which are imposed after a domestic animal bites a human (2) Quarantines which are imposed after a domestic animal is exposed (bitten, scratched, or other) to a rabid or suspected rabid animal; and (3) Quarantines which are imposed for when a domestic animal is showing clinical signs of active rabies infection and is suspected of being rabid. This document is intended to clarify some of the differences. Please note that this document is based on the PA Rabies Act, the Rabies General Quarantine Order (GQO) of October 6, 2018, and the PA Health and Safety Code Title 28 Chapter 27, Communicable and Noncommunicable Diseases, which may differ from the recommendations listed in the “Rabies Compendium”. When the Compendium and the Commonwealth Laws, GQO or regulations do not agree, the Laws, GQO and regulations supersede the Rabies Compendium. Additionally, if you are in an area with municipal rabies ordinances, you must comply with the local requirements.

A key concept in understanding rabies quarantines relates to whether the domestic animal is (1) the biter or (2) the bitten or (3) showing clinical signs of rabies. See appropriate numbered section for the details of how each situation should be handled.

I. THE BITER:

From the Human Health and Safety Code (which is enforced by the Pennsylvania Department of Health). Department here refers to the “Health Department”:

Title 28 § 27.162. Special requirements for animal bites.
  1. “… When an animal bites or otherwise potentially exposes a human to rabies, the Department or local health authority shall, after the case of an animal bite is reported, determine whether the animal shall be immediately destroyed and its head submitted to one of the State or county diagnostic laboratories for a rabies examination or whether some other action shall be pursued.
  2. Notwithstanding paragraph (1), when a healthy dog or cat bites or otherwise potentially exposes a human to rabies, the dog or cat shall be quarantined in a place and manner approved by the Department or the local health officer for 10 days after the date of the bite, unless the Department or local health officer directs otherwise.
  3. If a quarantine is imposed, the Department or the local health officer may order the owner or custodian of a biting animal to have the animal examined for symptoms of rabies during the quarantine period by a veterinarian licensed by the State Board of Veterinary Medicine. The cost of the examinations and other associated costs shall be borne by the owner or custodian of the biting animal.”

One might ask: “What is the rationale for the 10-day period of confinement for dogs or cats?” This is because if the biter was a dog or cat and it had rabies virus in its saliva when it did the biting, research states that the dog or cat will most likely die or show obvious clinical signs of rabies within 10 days of the bite (rare exceptions may exist).

If biter is showing clinical signs consistent with rabies, see Number 3 below. Contact your PDA BAHDS regional office as well as the Health Department. Different rules now apply!

II. THE BITTEN ANIMAL (EXPOSED):

The options provided by the Rabies GQO of October 6, 2018 for the management of domestic animals exposed to a confirmed or suspected rabid animal include (1) euthanasia, or (2) if currently legally vaccinated against rabies owner observation at home for 45 days, or (3) if unvaccinated for rabies (including animals without proof of prior rabies vaccination, off label vaccinates, and animals which received their first vaccination within the 28 days prior to exposure), PDA administered home quarantine for a minimum of 120 days

Domestic animals with expired rabies vaccinations will be evaluated on an individual case basis by PDA Regional staff, who will make a risk based decision as to whether a 120-day quarantine is required or if a 45-day period of observation period is acceptable. (Please note: There are NO ten-day quarantines for animals bitten by a confirmed or suspected rabid animal.

The quarantine or observation period imposed on an exposed domestic animal reflects the period it might take for the bitten (or otherwise exposed) animal to develop clinical rabies. The incubation period for rabies varies from about two weeks up to several months. However, there are rare reports of both shorter and longer incubation periods. During a quarantine or observation period, the exposed animal is confined and observed to see if abnormal behavior suggestive of active rabies infection develops. Clinical signs may suggest rabies, but the only definitive diagnosis is made in the laboratory.

The bitten animal is not infectious unless the rabies virus successfully travels from the bite site to the animal’s brain and salivary glands at which time they may have virus in their saliva. During the time the virus is traveling from the bite site, and before the virus has reached the brain and salivary glands, the animal does not have virus in its saliva and is therefore not able to transmit rabies.

In summary, the quarantine or observation period is based on vaccination status:

  1. Animals current on rabies vaccination: For currently vaccinated domestic animals exposed to a confirmed or suspected rabid animal, PDA recommends observation by the owner at home for 45 days with immediate reporting of any suspicion of rabies to the Department. Note: It is common practice to vaccinate any domestic animal that has been exposed to rabies, even if current on rabies vaccination*. However, this is not required by law for dogs or cats that are up to date on rabies vaccine. It is up to the veterinary clinician to determine the best post-exposure protocol for each case.
  2. Unvaccinated Animals: For unvaccinated domestic animals exposed to a confirmed or suspected rabid animal, euthanasia might be considered as the safest option. PDA does not mandate euthanasia for exposed unvaccinated domestic animals, but does mandate a formal quarantine for a minimum of 120 days, usually on the owner’s premises. A risk assessment may help determine whether the owner elects to euthanize their animal(s) vs. have it quarantined by PDA. Note: protocols exist for vaccinating post-exposure. See Wilson PJ, Oertli EH, Hunt PR, Sidwa TJ. Evaluation of a post-exposure rabies prophylaxis protocol for domestic animals in Texas: 2000-2009. J Am Vet Med Assoc 2010;237: 1395-1401. This article describes one protocol option for exposed naïve animals.
    *Based on the more recent publication: Moore MC et.al. Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status. J Am Vet Med Assoc 2015;246: 205-211, current and/or expired vaccinates appear to benefit from one immediate booster. It is up to the veterinary clinician to determine the best post-exposure protocol for each case.
  3. Animals with expired vaccination status: For expired vaccinates exposed to a confirmed or suspected rabid animal, PDA staff will assess whether the animal is low risk and can be observed at home for 45 days by the owner or if the animal is higher risk and will be quarantined at home by PDA for a minimum of 120 days. Previous vaccination history, post exposure vaccination, and severity of exposure will be some of the factors taken into consideration. Practitioners should consider previous vaccination history when determining appropriate post-exposure vaccination protocol.

III. ANIMALS SHOWING CLINICAL SIGNS OF RABIES:

From the Rabies GQO of October 6, 2018:

“a. General Restrictions. A dog, cat or other domestic animal suspected of having rabies may not be released from quarantine until suspicion of rabies is dispelled or until the animal has died or has been euthanized. No tissues or secretions from that animal may be sold, transported, or used for human or animal consumption unless that animal was negative on an official rabies test.

b. Required Testing of Dead Quarantined Animals. A dog, cat, or other domestic animal that dies or is euthanized while quarantined for suspicion of having rabies that has exposed a human, dog, cat or another domestic animal shall be subjected to an official rabies test, and disposed of in accordance with Sections 2351 – 2357 of the Act (relating to disposal of dead domestic animals and animal waste).”

  • Report any domestic animal showing clinical signs of rabies to your PDA Regional office.
  • Domestic animals suspected of having rabies that bite or otherwise expose people must also be discussed with the Health Department to determine the required course of action. All human treatment/biter management recommendations will be made by human health professionals only.
  • If the domestic animal is showing clinical signs consistent with rabies and did not bite a human, the law mandates quarantine. It is kept quarantined until the suspicion of rabies has been dispelled or the animal has died or been euthanized. The law does not mandate euthanasia. If the domestic animal showing signs of rabies has exposed another animal and dies within the 10 subsequent days, it must be tested for rabies.
  • Although in some cases it is a legal option, quarantining a rabies suspect poses potentially significant risks to people and other domestic animals and should not be taken lightly. Appropriate risk mitigation should be implemented if a rabies suspect will be quarantined. Euthanasia is the safest option for rabies suspects.

PLEASE NOTE: Regardless of the type of rabies quarantine, it may be prudent to submit an animal that has died under quarantine to an official laboratory for rabies testing. Remember that when the animal was under quarantine due to clinical signs consistent with rabies, if a person or domestic animal is exposed, testing of the deceased animal for rabies virus is required. For questions related to human exposures, contact the Health Department. For questions related to a domestic animal’s exposure, contact PDA. Please note: PDA may not answer questions related to human exposure.

Rabies Testing:
Rabies testing is a free service offered to the public, although there may be costs incurred in shipping the sample to the lab. If the specimen is to be sent to the laboratory from a PDA regional office, call your regional office first as this service is not always available. PDA Regional office can no longer submit human exposure samples to the lab. Please refer to the PDA lab submission handout for more information..

Questions?

Specimens for Rabies Testing:

Acceptable Specimens for Rabies Testing:


  • Whole Carcasses
  • Animal Heads
  • Animal Brains
  • Bats (must be intact for identification)

Unacceptable Specimens for Rabies Testing:


  • Any live animal or bat (Euthanasia and decapitation, if necessary, must be performed by the local veterinarian at the submitter’s expense)
Specimen Handling:

Specimens must be chilled, but not frozen, as soon as possible after death. Care must be taken to minimize damage to the animal head prior to submission to the laboratory.

Transportation of Specimens to PVL:

Hand Delivery:


  • Hand delivery of specimens for rabies testing to PVL between 8:00am and 4:00pm weekdays is recommended when possible.
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  • A refrigerator is available for after-hour submissions.
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  • Specimens other than whole large livestock carcasses being hand delivered must be in a waterproof container.
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  • If plastic bags are used when delivering specimens, double bagging is necessary to prevent puncture by claws, teeth or bone fragments.
  •  

Courier:


  • The PA Department of Agriculture (PDA) has a contract with a courier service to carry samples and smaller animal carcasses for rabies testing.
    QUICKCOURIER
    1-800-355-1004
    (Account #PAVETE23)
    Calls made to the courier service Monday-Thursday before noon will be picked up the same day. Calls made to the courier service after noon will bepicked up the following business day.
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  • When using the courier services, federal packing regulations apply. If leakage occurs during shipment, the package may be rejected.
  •  
  • The courier can refuse packages if not packaged properly.
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  • There is a $25 charge to use the courier service to ship a specimen to PVL. You will be billed by PVL, not the courier service.
  •  

*NOTE: Only PVL has a contract with the current courier service. The Pennsylvania Department of Health (DOH) in Lionville does not have the same contracts and may have different shipping policies. Please contact PA DOH laboratory in Lionville at 610-280-3464 with inquiries regarding shipping to that lab.
Specimens must be accompanied by a Rabies Submission Form. The submission form for PVL can be accessed at Submission form or search PADLS, then using the Tests and Submissions tab Find Forms. Blank submission forms are also available at PVL. The submission form must be filled out completely.

Specimen Packaging:

  • Specimens must be packaged in at least two plastic bags tightly closed to insure a leak proof seal.
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  • The bagged specimen is then put into a leak-proof, unbreakable, insulated container along with some type of refrigeration.
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  • Do not use ice cubes, crushed ice, block ice, snow or dry ice.
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  • Include absorbent packing material adequate enough to absorb all fluids in the event of leakage.
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  • NEVER ship on a Friday or the day before a government/postal holiday. The lab will not be staffed to receive samples.
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  • Do not wrap submission forms around samples: If the sample leaks, the form may be unreadable. Enclose the submission forms for all samples in a single zip-lock bag and place it on top of the samples.
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  • Label the outside of the box clearly. Remove old conflicting labels that could confuse delivery.
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  • Mark packages with a Diagnostic Specimen label on the outside of the box.
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  • Include your return address. This is one way to track packages received by the laboratory.
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  • Do not ship in unprotected Styrofoam containers: These break easily if squeezed or dropped. Styrofoam within a cardboard box is recommended.
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Testing and Results:
  • If further diagnostic work is to follow a negative rabies test, the laboratory must be informed at the time of submission.
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  • Please Note: For the safety of laboratory personnel, no additional tests (except for chronic wasting disease or scrapie) will be performed on specimens following a positive rabies test.
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  • No part of any animal submitted for rabies testing will be returned, regardless of the test result.
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  • A Fluorescent Antibody test will be performed on all rabies suspect cases to be tested at PVL.
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Negative Results:
  • Results are reported to all parties listed on the submission form via email, fax, or US Mail if provided.
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  • Providing an email address or fax number will ensure the most prompt reporting of results.
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Positive Results:
  • The PDA Bureau of Animal Health and Diagnostic Services in Harrisburg and the regional or local Department of Health are notified.
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  • PDA regional staff will contact parties listed on the submission form by telephone and will, if necessary, administer the quarantine of exposed domestic animals.
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