Rabies - NYC Health

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Rabies

Rabies is a preventable viral disease that is transmitted to people and other mammals through the bite of an infected animal. Though rare, people can get rabies if a rabid animal’s saliva or nerve tissue gets directly into their eyes, nose, mouth or an open wound. Rabies affects the brain and is considered fatal.

Most rabies cases in the U.S. occur in wild animals, such as raccoons, skunks, bats, and foxes. In New York, animal rabies occurs primarily in raccoons, bats, and skunks. Raccoons are the most commonly reported rabid animal in NYC. Animal rabies surveillance in NYC began in 1992. Since then, more than 600 animals have tested positive for rabies in the city, the majority of which are raccoons.

No dogs have tested positive for over 60 years. The last human case of rabies in New York City was reported in 1947.

New Yorkers should avoid wild animals and vaccinate their pets against rabies.

Signs in Animals

The rabies virus infects the central nervous system, causing disease in the brain and death. Raccoons and other animals with rabies may show some of the following symptoms:

Tiredness or low energy

Confusion or disorientation

Difficulty moving or walking, or paralysis

Unusual or extreme aggression

Eating or chewing objects, such as wood, soil, stones, plants or other unusual materials

Excessive drooling or foaming at the mouth

Voice changes or hoarseness

Dilated pupils (black center of the eye is larger) or vacant stare

Abnormal behavior, such as a wild animal that does not shy away from people

Raccoons can also get sick from canine distemper virus. Raccoons with distemper may look or act like they have rabies. They can act lethargic, have a runny nose and eyes, may appear confused or disoriented or become aggressive.

Human Risks for Exposure

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Possible Exposures

You may have been exposed to rabies if you were:

Bitten by a type of animal that is known to transmit rabies virus and the animal cannot be tested. In NYC this includes raccoons and bats. In other areas of the U.S. it includes skunks, foxes, coyotes, and mongooses.

Bitten by any animal that tests positive for rabies.

Bitten by an animal suspected of being rabid but the animal cannot be tested.

Bitten by a dog, cat, or ferret that is unavailable for testing or observation.

In contact with a bat, found a bat in the room of a previously unattended child, or woke up to find a bat in the room.

Petting a rabid animal, or having contact with the blood, urine, or feces of a rabid animal, is not considered an exposure.

Rabbits and small rodents — including squirrels, hamsters, mice and rats — are not normally found to be infected with rabies, nor have there been any human rabies cases associated with them. Bites by these animals are usually not considered a rabies risk unless the animal was showing signs of rabies.

What to Do When Exposed

If you think you were exposed to rabies, follow these steps:

Immediately wash the wound with soap and water for 10 to 15 minutes. This will help kill and remove any virus that may have entered the wound.

If the exposure was from a dog or cat, try to get the pet owner's name, address, and phone number or get information for any person that may be able to identify the animal.

Report it through 311 or to your health care provider. This will help the Health Department follow up with the pet owner.

Contact your health care provider and ask if you need to be vaccinated.

If it is a wild animal, call 311 to report the bite, so that steps can be taken to capture and test the animal for rabies, if necessary. If you were exposed to a bat found in your home, close all windows and doors so it cannot escape until it can be captured. If the animal is tested, you will only need to be vaccinated if the animal tests positive.

It can be difficult to tell if a rabies exposure occurred. You should tell your health care provider about any injury from an animal or exposure to a bat within the household.

Human Rabies Vaccine

If your health care provider thinks you may have been exposed to rabies, they will recommend a preventive treatment called rabies postexposure prophylaxis (rPEP).

For people who have never been vaccinated against rabies, rPEP includes:

Injection of rabies immune globulin and a dose of rabies vaccine (this is counted as day zero), followed by three additional doses of rabies vaccine on days three, seven and 14.

If you have a weakened immune system, your provider may recommend a fifth dose of vaccine on day 28, followed by a blood test to make sure your body responded to vaccination.

For people who have been previously vaccinated against rabies, rPEP includes:

Two doses of rabies vaccine, one on day zero and a second on day three.

If administered appropriately after an exposure, rPEP can prevent infection.

Symptoms of rabies usually start to appear one to three months after exposure. In rare cases, symptoms have not shown up for several years.

Where to Get Rabies Postexposure Prophylaxis

People who are exposed and have never been vaccinated against rabies should always start the rPEP series in a hospital emergency room to ensure they receive both rabies immune globulin and their first dose of rabies vaccine. Emergency rooms are the only healthcare facilities in NYC that reliably have rabies immune globulin.

For the additional three recommended vaccine doses, people can do one of the following:

Return to the emergency room or any other emergency room.

Visit an urgent care clinic. Many CityMD sites and some hospital-based urgent care clinics have rabies vaccine available; call the location of your choice to ensure they have the vaccine on site. Most other urgent care sites do not offer rabies vaccine.

Arrange with your health care provider. Your provider may be able to order and administer rabies vaccine, though most providers do not do so.

You may want to check with your health insurance regarding vaccination coverage at different sites.

People who have previously completed a rabies preexposure or postexposure prophylaxis vaccine series and only need two booster doses of rabies vaccine can receive vaccine at an emergency room or anywhere that rabies vaccine is offered, as outlined above.

NYC Health + Hospitals provides emergency room care, regardless of anyone’s ability to pay. If you do not have health insurance, or need a discounted fee program based on your income and ability to pay, NYC Health + Hospitals makes health care services affordable for all New Yorkers through its financial assistance programs.

Animal Observation

If a healthy dog or cat has bitten you and you are able to provide the owner’s information to your health care provider or the Health Department, the animal’s owner will be directed to watch their animal for 10 days at home. The Health Department will be in contact with the pet owner to see if the animal remains healthy at the end of the observation period.

If the animal is still alive and healthy after this period, you do not need to get a rabies vaccine. If the animal develops signs of rabies during this period, the Health Department will instruct the owner to immediately have the animal examined by a licensed veterinarian. The veterinarian will report their finding to the Health Department and a determination will be made whether rabies testing is required. In order to conduct this test, the animal must be euthanized.

If the animal is a healthy stray that is easy to identify and observe, you can try to observe it for 10 days in its home environment. Otherwise, call 311 to see if the animal can be captured and observed at a shelter.

Pets

In New York, rabies is usually transmitted to pets from raccoons. The best way to protect your pet from rabies is to get them vaccinated and keep them away from wild animals.

All dogs and cats in NYC are required to have up-to-date vaccinations against rabies. Even indoor dogs and cats are at risk if they escape outside or if a rabid bat enters your home. Puppies and kittens should get their first rabies shot by 4 months of age. Revaccination is required no later than one year after the primary vaccination. Revaccinations must be administered at intervals thereafter.

When Your Pet is Exposed

Any dog or cat that may have been exposed to a rabid animal should be reported to the Health Department. The Health Department will work with the pet owner and their veterinarian to determine appropriate follow up.

Dogs and cats that have never been vaccinated are required to either be euthanized or isolated for up to six months in a facility under daily veterinary observation. Dogs and cats whose rabies vaccinations are not current, and pets with bite wounds of unknown origin, will be managed on a case-by-case basis.

Dogs and cats that are currently rabies vaccinated should immediately receive a booster vaccine. They must also be confined and observed for 45 days in the owner’s home.

Additional Resources

Rabies Postexposure Prophylaxis: Poster for Medical Providers (PDF)

What to Expect With Rabies Post-Exposure Prophylaxis (PDF)

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Rabies: Protecting Your Pet (PDF)
Other Languages: Español | 中文 | Русский

Raccoons in New York City (PDF)

Rabies Information for Children

CDC: Rabies Information

Rabies Vaccine, Regulations and Guidelines

Information for Veterinarians, Poster (PDF)

Rabies Exposure and Biting Animals Management Flowcharts, Poster for Veterinarians (PDF)

More Information

Rabies: Statistics in New York City

Animals and Wildlife in NYC

Raccoons

Zoonotic and Vector-borne Diseases: Information for Providers