Rabies is in the news again in Philly! On Saturday, January 18th 2025, a roughly 3-month-old stray puppy was found in Olney and reported to ACCT. The dog had a wound on its face, which was treated surgically. On Wednesday, January 22nd, the puppy developed abnormal behavior, including difficulty moving, lethargy, and extreme aggression. The puppy was euthanized and submitted for testing, and was diagnosed with rabies.
Rabies is an unfortunate reality in most places, including Philadelphia and Pennsylvania. In 2018, Pennsylvania reported the greatest number of rabid cats in the country. The Pennsylvania Department of Agriculture maintains a database of all positive cases of rabies in the state, broken down by county. It’s important to remember that this is far from the total number of animals with rabies, as only a small fraction are submitted for testing.
Here are some of the numbers for Pennsylvania and Philadelphia:
2025 (so far) | 2024 | 2023 | 2022 | |
Statewide Total | 19 | 305 | 252 | 289 |
Common Species | Racoon: 11 (58%) Bat: 0 Cat: 4 (21%) | Racoon: 111 (38%) Bat: 78 (27%) Cat: 51 (18%) | Racoon: 102 (40%) Bat: 61 (24%) Cat: 40 (16%) | Racoon: 124 (41%) Bat: 54 (18%) Cat: 54 (18%) |
Notable Species | 1 dog, 2 horses, 1 opossum | 1 bobcat, 1 cow, 1 pig, 1 donkey | 3 horses | |
Philadelphia Cases | 2 total -1 cat -1 dog | 20 total -10 racoons -4 cats -3 skunk -1 bat -1 groundhog -1 dog | 17 total -11 racoons -5 cats -1 bat | 14 total -6 racoons -6 cats -1 bat -1 groundhog |
At Art City Vets, we submit cases for testing about once or twice a month, and have had three positive results (all cats) in 6 years.
What is Rabies?
Rabies occurs worldwide, with only a few small areas (mostly island nations) designated as rabies-free. Each year, about 50,000 people die from rabies. Worldwide, the most common species to infect humans with rabies is dogs. While any mammal can be infected, some species (like opossum) are more resistant.
In the United States, rabies is mostly found in wildlife, such as racoons, skunks, bats, foxes, and coyotes, with racoons and bats typically being the main source of the virus. Bats are the most common source of transmission to humans in the United States.
Thankfully, human rabies is extremely rare in the United States, thanks to vigilance from the Department of Agriculture and Department of Health, as well as their tremendous effort to provide appropriate care to any possibly exposed people.
How Does Rabies Cause Disease?
Rabies is nearly 100% fatal if it reaches the brain or spinal cord. It is a virus that can only infect mammals, and most easily infects carnivores and bats.
The disease itself is unusual. Rabies is shed in the saliva of an infected animal, and can be transmitted through a bite or cut, as well as through the mouth, nose, or eyes. The virus first has an incubation phase, where it replicates at the site of infection, then slowly moves up the axons of nerves to the central nervous system. Once it reaches the brain is when symptoms develop due to inflammation of the brain and meninges, leading to death within 7-10 days.
The incubation phase can last from weeks to months, and depends on the site of the infection. An infection on a foot takes a lot longer to get to the brain than an infection on the face, for example. Once it reaches the brain, rabies is shed through the saliva and is contagious. Shedding of the virus into the saliva occurs a few days before symptoms start up until death.
How is Rabies Diagnosed?
The only reliable test for rabies requires brain tissue, and cannot be done on a living animal or human, which makes diagnosis initially based on clinical signs only.
There are a range of clinical signs which are more common in certain species. It often (but not always) occurs in 3 phases:
Classic prodromal phase: Often subtle, nonspecific symptoms like fever, lethargy, and weakness. Behavioral changes are common, such as nocturnal animals coming out during the day, typically hidden animals wandering into unusual places (neighborhoods, yards, streets), and loss of fear of people, dogs, cats, etc. A prodromal rabid animal may even seem friendly and approachable. In dogs and cats, the first signs are often very subtle, like a change in attitude, difficulty swallowing (drooling), or even a difference in the meow or bark.
Furious/excitement phase: This is what is often portrayed in movies. Symptoms include aggression, hypersalivation, excessive vocalization. Animals may bite or snap at imaginary objects. Cats more often have the furious phase than dogs.
Paralytic phase: Loss of control of the legs and body (beginning with where the transmission occurred), stupor, inability to swallow, seizures, and even coma.
Animals in ALL of the phases are contagious! It’s very important to note that not all individual animals show all of the symptoms or even have all of the phases. Dogs often do not have the furious phase, while cats typically show all three.
How is Rabies Treated?
There is no treatment for rabies, so avoiding exposure, pre-exposure vaccination, and post-exposure prophylaxis are the only ways to prevent infection and death. Post-exposure treatment for humans in the United States is nearly 100% effective.
The CDC recommends people at risk for rabies exposure, such as veterinary staff, be vaccinated against rabies. All cats and dogs should also be appropriately vaccinated for rabies, which is required by law in Pennsylvania.
How Can I Protect My Pet?
Vaccination of dogs and cats against rabies is recommended by the CDC, AAHA, AAFP, WHO, and AVMA. Vaccination is required by law in Pennsylvania.
Rabies vaccination can first be administered to dogs and cats 3 months of age, then is boosted every 1-3 years based on the vaccine product. Dogs receive killed vaccines, while cats should get non-adjuvanted recombinant rabies vaccines.
Rabies vaccination is effective. While no vaccine is 100% effective, the rabies vaccine has been shown over and over again to be highly effective. In a study looking at dogs diagnosed with rabies in the United States from 1997 to 2001, only 4.9% of the 264 rabid dogs and 2.6% of the 840 rabid cats had received a rabies vaccinations in their lifetime, and only 2 dogs (0.76%) and 3 cats (0.35%) were considered currently vaccinated.
Rabies vaccination is safe. A study published in 2023 looked into vaccine adverse event rates. The study included 4,654,187 dogs vaccinated at 1119 veterinary clinics over a 5 year period in the United States, which accounted for 5,094,558 doses of rabies vaccinations. They found 12,647 adverse events reported, which is 0.25%, and nearly all adverse events were classified as "mild."
Cats should get non-adjuvanted recombinant rabies vaccines, like the Purevax recombinant vaccine, which was specially designed for cats when adjuvanted rabies vaccines were found to be associated with injection site cancer in about 0.01% of inoculations. An older study from 2007 looked at adjuvanted killed vaccines (recombinant vaccines for cats did not exist yet) found an adverse event rate of about 0.51% (also nearly all “mild”), which is likely a much higher rate than for non-adjuvanted recombinant vaccines.
What Does This Mean For You?
All pet dogs and cats should be vaccinated against Rabies between 12-16 weeks of age and boosted appropriately. Rabies vaccination is extremely effective and safe.
Do not engage with wild animals, even dogs and cats, especially if they seem abnormal, including abnormally friendly. In the United States, on average about 93% of diagnosed rabid animals are wildlife, while 7% are domestic animals.
Any bite wounds, especially of unknown origin (ie possibly from wildlife) could be a source of Rabies. Contact your doctor or seek urgent/emergency care for any possible exposure, or contact the Philadelphia Department of Health (215-685-6748). Bites on pets should be discussed with a veterinarian.
If you see sick, injured, or deceased wildlife or pets in Philadelphia, contact ACCT Philly.
In December 2024, a California teacher died from being unknowingly bitten by a rabid bat. Many exposures from bat bites may not be easily noticed, especially on children, because their fangs are sharp and tiny. If a bat is found inside the living space of your home, contact ACCT Philly at 267-385-3800. If the bat may have been in a room where someone was asleep or where children were present, contact the Philadelphia Department of Public Health Division of Disease Control at 215-685-6748.
The CDC has a comprehensive website that covers many topics about rabies.