Can cows get rabies?
January 24, 2025
The answer is “yes” and we had a case documented in the state of TN during 2024. Our state also had a case of rabies in a horse and a case in a bison. The most common type of rabies documented in TN in 2024 was bat rabies with skunk rabies close behind. Skunk rabies typically is our most common reservoir for rabies in TN. There was also one case of cat rabies and one dog rabies. (TN map attached)
A recent summary article1 on the surveillance of rabies in the United States in 2022 noted that 50 dogs tested positive (50% of these were in Puerto Rico and TX). There were 222 cats that tested positive (50% of the positives were from PA, VA, NJ, and GA). Of note, 42 cattle tested positive, 18 horses, 8 goats, 4 sheep, and 1 llama. Good news is that there were no human cases reported in the United States in 2022.
An article in Lancet ID from 2023 reviewed published cases of fatal human rabies despite post-exposure prophylaxis.2 Most of the cases were from dog bites and over half involved high risk areas like the head, face, and neck, which can have a shorter incubation time. Learning points from this article include the importance of following guidelines on the care of exposed patients. Of these cases, quite a few described errors related to administration of the rabies immune globulin which provides passive immunity for these exposed patients.
TN Department of Health published an on-line manual3 on rabies that discusses epidemiology, guidelines for post exposure prophylaxis, and a list of hospitals that stock post exposure prophylaxis. Vanderbilt University Hospital and Monroe Carell Jr Hospital at Vanderbilt are not on the list even though our hospitals do carry the rabies immune globulin and vaccine.
1. Ma X, Boutelle C, Bonapart S, et al. Rabies surveillance in the United States during 2022. JAVMA 2024;262:1518-25.
2. Whitehouse ER, Mandra A, Bonwitt J, et al. Human rabies despite post-exposure prophylaxis: a systematic review of fatal breakthrough infections after zoonotic exposures. Lancet Infect Dis 2023;23:e167-74. 3. https://www.tn.gov/content/dam/tn/health/documents/reportable-diseases/… accessed January 17th, 2025.
Saralyn R. Williams, MD, Professor of Emergency Medicine, Medicine, and Pediatrics