Rabies and other lyssaviruses (including Australian bat lyssavirus)

Key points for clinicians People may be exposed to rabies and other lyssaviruses through animal scratches or bites, or by direct contact of mucosal surfaces with infected saliva. Patients may require rabies vaccine and immunoglobulin for post-exposure prophylaxis if they are bitten or scratched by a bat anywhere in the world (including in Australia) or by a land-dwelling mammal overseas Use of rabies vaccine and immunoglobulin for post-exposure prophylaxis, including cache stock held at select WA hospitals and primary care clinics, requires approval by Public health prior to administration. For advice or to access post-exposure prophylaxis for patients with a potential rabies or Australian bat lyssavirus exposure, clinicians must contact their local public health unit during business hours, or call 1800 434 122 and follow the prompts if after hours. Read Rabies vaccine and HRIG administration advice (PDF 244KB) before administering rabies vaccine or immunoglobulin. Further details are available from the Australian Immunisation Handbook – Rabies and other lyssaviruses (external site). Also see the April 2024 clinician alert Rabies risk expanded to island of Timor for further information.

Statutory notification

• Rabies and other lyssavirus infections are urgently notifiable infectious diseases in Western Australia.
• Alert: Suspected or confirmed cases must be reported urgently by telephone to the local public health unit within a few hours of first suspicion of diagnosis.
• Case definition: See Australian bat lyssavirus infection (external site), Rabies (external site) and Lyssavirus infection (not elsewhere classified) (external site) national surveillance case definitions.
• Notification: Notify using the communicable disease notification form for metropolitan residents (PDF 209KB) or regional residents (PDF 208KB). For notification of regional residents see contact details of public health units.
• See also description of statutory medical notifications in Western Australia.

Public health summary

• Infectious agents: Rabies virus, Australian bat lyssavirus (ABLV), and other lyssaviruses such as European bat lyssavirus (EBLV) 1 and EBLV 2.
• Transmission: People are usually infected following a bite or scratch from an animal infected with the virus.
• Incubation period: Usually 3 to 8 weeks, rarely as short as a few days or as long as several years, depending on features of the wound. The incubation period for ABLV and other lyssavirus infections is less certain but is assumed to be similar to rabies virus.
• Infectious period: The infectious period for rabies virus infection has been described reliably only in dogs, cats and ferrets, in which communicability usually commences 3 to 7 days before onset of clinical signs and persists throughout the course of the illness. The period of communicability of ABLV and other lyssaviruses is not known.
• Case exclusion: Case should be isolated for duration of the illness.
• Contact exclusion: Do not exclude.
• Treatment: Post-exposure management is recommended for anyone with a potential exposure. There is no known effective treatment for people with rabies once symptoms have appeared.
• Immunisation: Pre-exposure prophylaxis with rabies vaccine is recommended for people whose occupation (including volunteer work) or recreational activities place them at increased risk of being bitten or scratched by bats, and, following a risk assessment, those who work in or travel to rabies-enzootic countries. See Australian Immunisation Handbook – Rabies and other lyssaviruses (external site) for further information.
• Case follow-up: Conducted by the local public health unit.