• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

Disease Prevention and Control, San Francisco Department of Public HealthPopulation Health Division SF Department of Public HealthPopulation Health Division SF Department of Public Health

  • Infectious Diseases A to Z
  • About
  • Contact
  • Home
  • Communicable Disease
    • 24/7 Disease Reporting
      • Disease Reporting: Additional Information for Medical Providers
      • Influenza Reporting
      • Frequently Requested Phone Numbers 
    • Healthy Habits
      • How to Put on and Remove a Face Mask 
    • Publications, Data, and Reports
    • Infection Control
      • Infection Prevention and Control for Health Care Settings
      • Infection Prevention and Control for Long-Term Care Facilities
    • Infectious Diseases A to Z
  • Immunizations
    • Vaccines You Need
      • Adults
      • Children & Adolescents
      • Vaccines for Gay and Bisexual Men
    • Where to Get Immunized
    • Influenza (Flu)
    • Vaccine Safety
    • Immunization Programs
      • Flu Vaccine Programs: Ordering Information for Health Care Providers
      • Hepatitis Programs
        • Hepatitis Education
        • Hepatitis Vaccine Distribution Program
        • Perinatal Hep B Program
        • Programs for Asian and Pacific Islanders
      • California Immunization Registry (CAIR)
      • Vaccines for Children
      • San Francisco Immunization Coalition
      • Emergency Mass Prophylaxis Clinic Planning
    • Schools and Child Care
    • Resources & Materials
      • Vax Facts: Vaccine Updates
      • Immunization Links
      • Request Materials
      • Vaccine Management Plan
    • Information for Medical Providers
    • Provider Spotlight
  • AITC Immunization & Travel Clinic
    • International Travelers
      • Promoting Travelers’ Health
      • Yellow Fever Vaccine FAQ (Frequently Asked Questions)
    • Immunization & Testing
    • Services for Businesses
    • Contact, Location, Hours, Payment
    • Plan Your Visit
    • Prices
      • Low-Cost or Free Vaccines at AITC
    • Forms
    • Links
    • About AITC
  • Health Alerts & Emergencies
    • Prepare
    • Health Alerts
      • Sign Up For Health Alerts
    • Infectious Disease Plan
      • Emergency Exercises
    • Clinician Emergency Guide
    • Recognizing Bioterrorism
    • Programs and Activities
  • Tuberculosis Control
    • Tuberculosis Services
    • Tuberculosis Information For Medical Providers
      • LTBI Referral (Specific to Civil Surgeons)
      • Tuberculosis Screening Guidelines
        • Tuberculosis Testing
      • Tuberculosis Clinic Referrals Criteria
      • Managing Positive Reactions
      • Suspected/Confirmed Active TB Reporting
      • LTBI Risk Assessment Tools and Treatment Guidelines
      • Hospital Discharge
      • QuantiFERON Information
      • Infection Control Guidelines
      • Shelter Client Screening Guidelines
      • TB Resources for the Public
    • Publications
    • Reports
    • Links
    • San Francisco Tuberculosis Prevention and Control Program (SFTBPCP) Supplemental Information
  • Public Health Laboratory
    • Laboratory Contact Information
    • Check COVID-19 and Influenza Test Results Online
    • Non-Diagnostic General Health Assessments (NGHA)
    • General Specimen Submission Guidelines
    • Forms for Specimen and Culture Submission
    • Laboratory Test Menu
  • STD Services
  • Infectious Diseases A to Z
  • About

Rabies

Please Note:

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) released recommendations in 2010 for a reduced (4-dose) vaccine schedule for Post Exposure Prophylaxis (PEP) to prevent human rabies (previously ACIP recommended a 5-dose rabies vaccination regimen).  San Francisco clinicians should call the SFDPH Communicable Disease Control Unit at (415) 554-2830 to report a potential rabies exposure or to discuss the need for post-exposure prophylaxis (PEP).

Clinicians should report all animal (mammal) bites to Animal Care and Control (ACC), even if the risk of rabies is low (e.g., bite from a domestic cat).  Call ACC or fax in an Animal Bite Report.  Please click here for ACC contact information.

What is Rabies?

Rabies is a preventable viral disease transmitted in the saliva of infected mammals. Rabies among wildlife occurs throughout the United States (only Hawaii remains consistently rabies-free) and is the most common source of infection for humans and domestic animals. Since 1980, most of the human cases of rabies diagnosed in the United States have been associated with bats. In most other regions including Asia, Africa, and Latin America, dogs are the most common source of transmission to humans.

More than 90% of all animal rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like raccoons, skunks, bats, and foxes. In San Francisco, all animal rabies cases in the past 60 years occurred in bats.  Since 2009, we have identified between 1-7 rabid bats each year.

  • Preventing Rabies after Animal Exposure including guidance on Post-Exposure Prophylaxis (PEP)
  • How to Order Rabies Vaccine and Human Rabies Immune Globulin
  • ACIP Recommendations on Use of a Reduced (4-Dose) Vaccine Schedule for PEP to Prevent Rabies
  • CDPH Rabies Brochure
  • California Department of Public Health Rabies Information

How Do You Get Rabies?

The rabies virus lives in nerve tissue and is present in saliva of a rabid animal. Rabies can be transmitted from the bite of a rabid animal, or when the animal’s saliva contacts a person’s mouth, eyes, or an open wound. Some bats have extremely small, needle-thin teeth, and there have been cases where a person became infected without knowing they had been bitten by a rabid bat.

How Do You Avoid Exposure to Rabies?

Avoid contact with wild animals. Put screens on all windows and use chimney caps. Place draft-guards beneath doors to attics and ensure that all doors to the outside close tightly. Do not keep doors or unscreened windows open, especially if people are sleeping. Evacuate any room with a live bat and close the door. Call Animal Care and Control emergency dispatch immediately at (415) 554-9400 if there is a live or dead bat inside your home or work place, or if you find a sick or dead bat outside your home. Do not touch bats even if appearing sick or dead. Keep your pets’ rabies vaccinations up-to-date.

Symptoms

Rabies symptoms in humans appear an average of 3 to 8 weeks after exposure to a rabid animal but can appear earlier and up to years after exposure. The typical symptoms include a sense of apprehension, headache, fever and malaise. The disease progresses to paralysis and spasm of the muscles used for swallowing, which leads to fear of water (hydrophobia), confusion, convulsions and eventually death.

Unfortunately, once symptoms have developed, no drug or vaccine will improve the chance for survival. Most persons with human rabies die from the disease, despite intensive medical care. Of the very few patients reported to have survived rabies infection, all but one had received some sort of prophylaxis with rabies vaccine before the onset of symptoms.

Post Exposure Prophylaxis – Rabies Prevention (PEP)

Although rabies among humans is rare in the United States, every year approximately 23,000 persons receive post-exposure prophylaxis. If you think you have been exposed to rabies from contact with a rabid or possibly rabid animal, wash the wound thoroughly with soap and warm water. It is critical to contact your health care provider immediately. Your health care provider, in consultation with SFDPH, will decide if anti-rabies treatment with Post-exposure prophylaxis (PEP) is necessary. Administration of rabies PEP is a medical urgency, not a medical emergency, but decisions must not be delayed. In San Francisco, rabies PEP is indicated for certain bat exposures even in the absence of a bite wound.

PEP consists of a regimen of one dose of Human Rabies Immune Globulin (HRIG) and four doses of rabies vaccine (except in immunosuppressed persons who should receive 5 doses of rabies vaccine). HRIG and the first dose of rabies vaccine should be given by your health care provider as soon as possible after exposure. Additional doses or rabies vaccine should be given on days 3, 7, and 14 after the first vaccination (immunosuppressed persons should receive a 5th dose on day 28 after the first vaccination). Post-exposure prophylaxis (PEP), combining wound treatment, HRIG, and vaccination is 100% effective in preventing human rabies. There have been no vaccine failures in the United States (i.e. no one has developed rabies) when PEP was given promptly and appropriately after an exposure.

For additional information about rabies PEP, please see: Preventing Rabies after Animal Exposure.

Additional Rabies Information

For more information, please contact your physician, the Communicable Disease Control Unit at (415) 554-2830, or visit the Centers for Disease Control Rabies Website.

Primary Sidebar

Quick Links

  • Campylobacter Infection
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Novel Coronavirus (COVID-19)
  • Influenza (Flu)
    • Flu (Influenza): Facts for the Public
    • Flu Prevention and Treatment Guidance for Specific Settings
    • Influenza Guidance for Providers
    • Flu Guidance for Long-Term Care Facilities
    • Flu and Infectious Disease Forum 2019
    • Flu Dashboard
  • Measles
  • Meningococcal Disease 
  • Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
  • Pertussis (Whooping Cough)
    • Prenatal Tdap Vaccination Toolkit for Health Care Providers
  • Rabies
  • Shigella Infection (Shigellosis)
  • Viral Gastroenteritis and Norovirus
    • Viral Gastroenteritis Disease Control Resources
  • Zika
    • Zika Virus Information for Healthcare Providers
  • Vaccine Preventable Diseases

Footer

Contact

SF Dept of Public Health
101 Grove Street
San Francisco, CA 94102
(415) 554-2500

Web Links

  • SF Dept. of Public Health
  • City and County of San Francisco

Privacy Policy | Sitemap | Contact Us
Website by MIGHTYminnow

© Copyright 1998 - 2022, Department of Public Health, City and County of San Francisco