Investigation of Suspect/Confirmed Rabies

Humans

If a LHD is contacted by a physician who suspects rabies in a human patient, the LHD should gather and assess clinical, laboratory, and epidemiologic information to determine if rabies is likely. If the available evidence indicates strong or uncertain suspicion of rabies, the LHD should contact CDPH for consultation. The CDPH Viral and Rickettsial Diseases Laboratory (CDPH-VRDL) provides diagnostic testing of human patients. CDPH must be consulted and approve rabies testing before specimens may be submitted to CDPH-VRDL.

Animals

• Testing protocol: Post-mortem testing of animals for rabies is performed at select local public health laboratories and CDPH-VRDL. Laboratories report positive test results immediately to the LHD from which the animal specimen was submitted. Laboratories and/or LHDs should report positive test results within one business day to the CDPH Veterinary Public Health Section (CDPH-VPHS) by completing Section I of the Animal Rabies Case Report form. Samples that test positive at local public health laboratories should be submitted to CDPH-VRDL for rabies virus variant typing. CDPH-VRDL is available to provide assistance, including confirmatory testing, to local public health laboratories.
  

• Managing exposures to an animal that tests positive for rabies: After a LHD is notified by a public health laboratory that an animal tested positive for rabies, LHD staff should determine if any humans or other animals had contact with the rabid animal and if the specific type of contact might have resulted in exposure to rabies virus. Decisions on rabies PEP for persons potentially exposed to rabies virus are made between a patient and health care provider following an assessment of the exposure incident and consultation with public health officials. Decisions on the disposition of any domestic animals (including dogs and cats) exposed to a rabid animal should be made by LHDs in coordination with city or county animal control authorities. After the LHD completes its epidemiologic investigation, Section II of the Animal Rabies Case Report ​form (and Sections III and IV if the rabid animal was a domestic animal or otherwise maintained in captivity) should be completed and submitted to CDPH-VPHS via email or fax. CDPH-VPHS is available to LHDs for consultation on possible rabies exposures.