Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal or, less commonly, when saliva from an infected animal gets into an open wound or onto a mucous membrane.

Rabies is almost always fatal once clinical symptoms appear; however, it is 100% preventable in humans through prompt and appropriate medical care.  In addition to washing any bite wound with soap and water as soon as possible, animal bite victims should consult with their doctor and promptly report the incident to the local health department.

Ohio's local health departments investigate approximately 20,000 animal bite and exposure incidents annually.  Because of health department activities and medical treatment, human rabies is rare in the United States.  Ohio's last human rabies case was in 1970.

Human Rabies

Where does rabies occur in Ohio?

Bat-strain rabies is present everywhere in Ohio with rabid bats having been identified from nearly all of Ohio's counties over the years.

In 1997, a new strain of rabies in wild raccoons was introduced into northeastern Ohio from Pennsylvania.  Every year, the Ohio Department of Health and other state and local agencies partner with the U.S. Department of Agriculture (USDA) Animal and Plant Health Inspection Service Wildlife Services to immunize wild raccoons for rabies using an oral rabies vaccine.  This effort has created a barrier of immune animals that reduced animal cases and prevented the spread of raccoon-strain rabies into the rest of Ohio.

The map below displays animal rabies cases by species in Ohio this year.

Source: Ohio Department of Health.
* Data as of May 25, 2023.

Please download the attached resource for animal rabies data for the previous five years.  Contact the Zoonotic Disease Program (ZDP) for animal rabies data for other years at Zoonoses@odh.ohio.gov.

How do you prevent rabies in people?

Human rabies is 100% preventable.  Here are a few things you can do to protect yourself from rabies.

In general:

• Avoid contact with wild animals and animals you do not know.
• Vaccinate your animals against rabies; your veterinarian can vaccinate your pet to prevent them from acquiring the disease from wildlife, and thereby transmitting it to humans.
• Maintain control of your pets to reduce their exposure to wildlife.
• Spay or neuter to decrease the number of stray animals.
• Eliminate food and nesting or hiding places for wild animals from residential areas.
• Do not feed wildlife.  If you must feed your pets outside, bring the food in at night or keep it covered.

If you are bitten by animal:

• Wash any wounds immediately.  One of the most effective ways to decrease the chance for infection is to wash the wound thoroughly with soap and water.
• Call your doctor and your local health department; they may recommend that you get a series of shots commonly known as "rabies post-exposure prophylaxis (PEP)."
• If your pet fought with a wild animal, call your veterinarian and the local health department to report the incident; your animal may need to get a rabies vaccine and be isolated for a period of time.

Note: Rabies pre-exposure prophylaxis (PrEP) is available for people working with wildlife or other animals on a frequent basis.  Ask your healthcare provider if you think you need rabies pre-exposure prophylaxis.

How does a person get rabies?

The rabies virus is found in the saliva and brain (neural tissue) of an infected animal.  The most common way people are exposed to rabies is from an animal bite.  Blood, urine, feces, and skunk spray do not contain rabies virus.

Rabies exposures:

• Bite from a rabid animal.
• Scratches, abrasions, open wounds, or mucous membranes contaminated with saliva or brain tissue from a rabid animal.

Rabies non-exposures:

• Petting a rabid animal.
• Being in the same room as a rabid animal (bats are an exception to this rule).
• Coming in contact with blood, urine, feces, or skunk spray of a rabid animal.

What kind of animals have rabies?

Any mammal can get rabies, but the animals most likely to expose humans or other domestic animals to rabies are:

• Bats.
• Cats.
• Dogs
• Ferrets.
• Horses.
• Livestock.
• Raccoons.
• Skunks.

Rabies is difficult to control in wildlife reservoir species; thus, private ownership of wild animals is not recommended (National Association of State Public Health Veterinarians 2016 Compendium, Part I, A, 8 Rabies in Wildlife).

Animals that are NOT considered carriers of rabies include:

• Amphibians.
• Birds.
• Chipmunks.*
• Gerbils.*
• Gophers.*
• Guinea pigs.*
• Hamsters.*
• Hares/rabbits.*
• Hedgehogs.*
• Moles.*
• Mice.*
• Rats.*
• Reptiles.
• Shrews.*
• Squirrels.*
• Voles.*

* Small rodents and rabbits are rarely infected with rabies; therefore, it is not recommended to test these species.  Rabies post-exposure prophylaxis for people exposed to these species is discouraged unless a unique situation has been identified.

What are the signs and symptoms of rabies in people?

The initial symptoms of rabies in people may mimic the flu.  An early diagnosis of rabies may be missed if an animal bite is not reported.  If you have been bitten by an animal, report the incident to your healthcare provider and the local health department as soon as possible.

Signs and symptoms of rabies may include:

• General weakness or discomfort.
• Fever.
• Headache.
• Discomfort or a prickling/itching sensation at the site of the bite.

Symptoms can progress within days to:

• Cerebral dysfunction.
• Anxiety.
• Confusion.
• Agitation.

Further progression will lead to:

• Delirium.
• Abnormal behavior.
• Hallucinations.
• Insomnia.

Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.  To date, less than 20 documented cases of human survival from clinical rabies have been reported.

How do you know for sure that a person has rabies (diagnosis)?

Several tests are necessary to diagnose rabies ante-mortem (before death) in humans; no single test is sufficient.  Your healthcare provider will also want to "rule out" other common diseases that may be a cause of your illness.

If rabies is highly suspected, your healthcare provider will collect the following samples:

• Saliva.
• Serum.
• Spinal fluid.
• Skin biopsy or hair follicles at the nape of the neck.

These samples must be sent to the Centers for Disease Control and Prevention (CDC) for testing.

What should I do if I am bitten by an animal (treatment)?

In addition to the risk of rabies, bite wounds can cause serious injury.  Your healthcare provider will determine the best way to treat your wound.

Rabies is a medical urgency and treatment should be initiated soon after the exposure.  If the biting animal is available for isolation or testing, you may not need rabies shots right away.

General suggestions for wounds:

• Wash the wound right away with soap and water or a dilute water povidone-iodine solution.
• Get a tetanus shot if you haven't had one in the last ten years.
• Your healthcare provider may suggest antibiotics and primary wound closure.

Rabies post-exposure prophylaxis (also known as rabies "PEP"):

These are shots given to a person that has been exposed to a suspected rabid animal unable to be isolated or tested.  Your healthcare provider or the local health department will help determine if you need to get rabies PEP.

The PEP may include:

• Human Rabies Immunoglobulin (HRIG), if you haven't received a rabies shot in the past.
• Several rabies vaccines that are given over a period of time.

Rabies PEP is costly.  Check with your insurance company to see if rabies PEP is covered under your plan.  If you are uninsured or under-insured, you may qualify for financial assistance through the Sanofi Patient Connection.

What is being done to protect people from rabies in Ohio?

The Ohio Department of Health's Zoonotic Disease Program (ZDP) conducts rabies prevention activities to protect Ohio residents from the spread of wildlife rabies to people, pets, and other animals.  Some of the program's activities include:

• Reviewing bat, raccoon, skunk, other wild animal, and domestic animal rabies cases to determine control initiatives.
• Assisting local health departments with rabies prevention programs and coordinating rabies control activities among local, state, and federal agencies.
• Developing educational materials for the public.
• Providing consultation for public health workers, veterinarians, the medical community, and others who work with animals and deal with animal bites and rabies exposures.
• Collecting and maintaining data on rabies and animal bites in Ohio.

Animal Rabies

Where does rabies occur in Ohio?

Bat-strain rabies is present everywhere in Ohio with rabid bats having been identified from nearly all of Ohio's counties over the years.

In 1997, a new strain of rabies in wile raccoons was introduced into northeastern Ohio from Pennsylvania.  Every year, the Ohio Department of Health and other state and local agencies partner with the U.S. Department of Agriculture (USDA) Animal and Plant Health Inspection Service Wildlife Services to immunize wild raccoons for rabies using an oral rabies vaccine.  This effort has created a barrier of immune animals that reduced animal cases and prevented the spread of raccoon-strain rabies into the rest of Ohio.

The map below displays animal rabies cases by species in Ohio this year.

Source: Ohio Department of Health.
* Data as of May 25, 2023.

Please download the attached resource for animal rabies data for the previous five years.  Contact the Zoonotic Disease Program (ZDP) for animal rabies data for other years at Zoonoses@odh.ohio.gov.

How do you prevent rabies in animals?

Most rabies cases occur in wildlife; however, your pet can become infected if they are bitten by a rabid wild animal, including bats that enter the house.  There are several things you can do to protect your pet from rabies:

• Maintain wellness visits for your pet and keep rabies vaccinations up-to-date (including indoor-only pets).
• Keep pets indoors or make sure pets are under direct supervision when outdoors.
• Spay or neuter your pet to help reduce the number of unwanted pets that may go unvaccinated.
• Call animal control to remove stray animals.
• Contact your veterinarian if your animal gets into a fight with a wild animal.

How does an animal get rabies?

The rabies virus is found in the saliva and brain (neural tissue) of an infected animal.  The most common way animals are exposed to rabies is from the bite of an animal.  Blood, urine, feces, and skunk spray do not contain rabies virus.

Rabies exposures:

• Bite from a rabid animal.
• Scratches, abrasions, open wounds, or mucous membranes contaminated with saliva or brain tissue from a rabid animal.

Rabies non-exposures:

• Petting a rabid animal.
• Being in the same room as a rabid animal (bats are an exception to this rule).
• Coming in contact with blood, urine, feces, or skunk spray of a rabid animal.

What kind of animals have rabies?

Any mammal can get rabies, but the animals most likely to expose humans or other domestic animals to rabies are:

• Bats.
• Cats.
• Dogs.
• Ferrets.
• Horses.
• Livestock.
• Raccoons.
• Skunks.

Rabies is difficult to control in wildlife reservoir species; thus, private ownership of wild animals is not recommended (National Association of State Public Health Veterinarians 2016 Compendium, Part I, A, 8 Rabies in Wildlife).

Animals that are NOT considered carriers of rabies include:

• Amphibians.
• Birds.
• Chipmunks.*
• Gerbils.*
• Gophers.*
• Guinea pigs.*
• Hamsters.*
• Hares/rabbits.*
• Hedgehogs.*
• Moles.*
• Mice.*
• Rats.*
• Reptiles.
• Shrews.*
• Squirrels.*
• Voles.*

* Small rodents and rabbits are rarely infected with rabies; therefore, it is not recommended to test these species.  Rabies post-exposure prophylaxis for people exposed to these species is discouraged unless a unique situation has been identified.

What are the signs and symptoms of rabies in animals?

The rabies virus causes an acute encephalitis in all warm-blooded hosts, and the outcome is almost always fatal.

The first symptoms of rabies may be nonspecific and include:

• Lethargy.
• Fever.
• Vomiting.
• Anorexia.

Signs can progress within days to:

• Cerebral dysfunction.
• Cranial nerve dysfunction.
• Ataxia.
• Weakness.
• Paralysis.
• Seizures.
• Difficulty breathing.
• Difficulty swallowing.
• Excessive salivation.
• Abnormal behavior.
• Aggression.
• Self-mutilation.

There is no approved treatment for animals infected with rabies, and euthanasia (humane death) is recommended.  Prevention is key as rabies is rare in properly vaccinated animals.  Please refer to your veterinarian for rabies vaccine requirements.

What does rabies look like in an animal?

You cannot tell if an animal has rabies just by looking at it.  Brain tissue from the animal must be tested at the Ohio Department of Health state laboratory (see Diagnosis below) for a diagnosis.

Below are examples of different behaviors that animals may exhibit when infected with rabies.

Pictured above are two dogs infected with paralytic rabies.  These dogs appear depressed and have isolated themselves.  (Photo from CDC)

The dog above was also diagnosed with paralytic rabies.  The dog appears lethargic and listless.  (Photo from CDC)

The photograph above shows a dog suspected of being rabid.  The dog had been exhibiting signs of restlessness and overall uncharacteristic aggressive behavior.  (Photo from CDC)

How do you know for sure that an animal has rabies (diagnosis)?

There is no ante-mortem (before death) test for animals.  The animal must be euthanized (humane death) so that a sample of brain tissue can be collected for the test.  Euthanasia and sample collection should only be performed by trained individuals.

For more information on submitting an animal specimen for rabies testing, please contact your local health department for assistance.

How do you treat rabies in animals?

There is no approved treatment protocol for animals infected with rabies, and euthanasia (humane death) is recommended.  Prevention is key as rabies is rare in properly vaccinated animals.  Please refer to your veterinarian for rabies vaccine requirements.

How many animals are tested for rabies in Ohio?

Animal rabies testing is done by the Ohio Department of Health's Bureau of Public Health Laboratory.  Please refer to the table below for animal testing results for the past five years.

* Includes USDA Wildlife Services Enhanced Rabies Surveillance data.

Please contact the Zoonotic Disease Program (ZDP) for animal testing data for other years at Zoonoses@odh.ohio.gov.

Animal Bites

Each year since 1990, the Ohio Department of Health (ODH) has distributed a survey to all of Ohio's local health departments to gather information pertaining to potential rabies exposure events (bite and non-bite exposures) reported in the state.

When a person or pet is bitten by an animal, regardless whether it's a pet or wild animal, the bite needs to be reported to the local health jurisdiction where the bite occurred.  Bites from animals can spread rabies or other infections, so prompt reporting allows public health to take preventative measures and make recommendations.

Bite wounds should be thoroughly washed with soap and water as soon as possible.  With any animal bite, consult with your healthcare provider.

How do you report animal bites?

Ohio law requires that a bite incident report should be made to the health commissioner in the local health jurisdiction where the bite occurred (Ohio Administrative Code 3701-3-28) when a person is bitten by an animal, specifically mammals.  This report should be made within 24 hours of the bite.  The local health department will then complete a rabies exposure risk assessment.  If the animal is a species at risk for rabies, they may quarantine it for a certain period of time or order the animal humanely killed for testing purposes.  In the event that an animal is positive or indeterminate for rabies, the local health department will advise additional medical care for those exposed.

When making a bite report, be prepared to provide the local health department with the following important information:

• Description of the biting animal.
• Owner of the animal.
• Person exposed.
• Location of where the bite happened.
• Rabies vaccination status of the animal (if known).
• How the bite occurred.

How do you prevent animal bites?

• Avoid contact with wild animals and animals you do not know.
• Vaccinate your dogs, cats, and ferrets for rabies and keep them current.
• Call your healthcare provider and your local health department if you are bitten.  If your pet fought with a wild animal, call your veterinarian and your local health department to report the incident.

How many animal bites are reported in Ohio?

Every year since 1990, the Ohio Department of Health has tracked potential rabies exposures events in the state by surveying all of Ohio's local health departments.  A human rabies exposure occurs when a human is bitten by a wild or domestic mammal (i.e., bite exposure) or when there is saliva contact with broken skin or mucous membrane (i.e., non-bite exposure).  Non-bite exposures also occur when a bat is found in a room with a young child, with someone who is sleeping, or with someone with a sensory or mental impairment.  Non-human rabies exposures occur when a domestic mammal is exposed to a suspected rabid mammal or when a mammal is investigated for showing signs compatible with rabies.

More than 18,000 bite exposures and 800 non-bite exposures were reported in Ohio in 2022, exposing more than 19,000 humans.  A costly treatment known as rabies post-exposure prophylaxis is the only treatment available to prevent rabies infection and is advised to all individuals in which the animal was unavailable for observation or testing.

* Excluding data from the following jurisdictions: Harrison County, Lawrence County, Madison County, Monroe County, Norwood City (Hamilton County), Pickaway County, Seneca County, and Warren City (Trumbull County).

Definitions of animal groups:
Wild: animal not normally confined or kept as a pet.
Other domestic: an animal (mammal) that does not fall into the dog, cat, ferret, or livestock category and is a species normally confined or kept as a pet.
Other wild: an animal (mammal) that does not fall into the raccoon, skunk, or bat category and is a species not normally confined or kept as a pet.

Please contact the Zoonotic Disease Program (ZDP) for animal bite data for other years at Zoonoses@odh.ohio.gov.