The Rabies Laboratory at the NCSLPH is the sole source for diagnostic rabies testing in North Carolina. This service is available to all health care providers within the state. Only animals that have potentially exposed a person, household pet, or livestock to rabies should be submitted. Exposure is defined as a bite or contamination of scratches, abrasions, open wounds, or mucous membranes with infectious saliva. Individuals wishing to submit small rodents, rabbits, or surveillance animals must receive prior approval from either the Laboratory or the State Public Health Veterinarian/epidemiologist on-call. Submission of specimens for rabies testing must meet the established testing criteria. Specimens submitted for testing that fail to meet the testing policy will be rejected and destroyed.
Testing resources are reserved for situations where the testing outcome will influence patient management decisions. Terrestrial animal submissions are limited to significant rabies vector species that expose humans, livestock, or unvaccinated pets. Exposure is defined as a bite that breaks the skin or contact of mucus membranes or broken skin with either animal saliva or nervous tissue. Significant rabies vector terrestrial species include raccoons, skunks, foxes, most other carnivores, and woodchucks. Domestic animals exhibiting signs of rabies and wild animals that have potentially exposed a person, unvaccinated pet, or livestock to rabies should be submitted for testing without delay.
Dogs, cats and ferrets that do not exhibit signs of rabies and which bite people, pets or livestock should not be euthanized and instead should be confined and observed for 10 days, unless circumstances demand otherwise. If a dog or cat shows no clinical signs of rabies after ten days of observations, one can be assured that the animal was not shedding virus at the time of the exposure. Dogs, cats and ferrets that survive the 10-day quarantine period should not be submitted to the rabies laboratory for testing. Conversely, if the dog, cat or ferret does not survive the 10-day quarantine period, the specimen should be submitted to the rabies laboratory for testing.
Wild animals (unlike dogs, cats, and ferrets) should not be held for observation following an exposure, but rather should be caught, euthanized immediately, and the head submitted for rabies virus detection. Bats that have interaction with humans should be submitted for testing only if the contact involves:
If one or more bats escape capture, do not submit the remaining bats since recommendations regarding post-exposure prophlyaxis will not be altered by testing only some of the bats. The State Public Health Veterinarian/epidemiologist on-call should be consulted at 919-733-3419 in cases where there has been potential exposure to multiple bats.
Surveillance animals will be tested only with prior approval. Low risk animals (i.e., rabbits, squirrels, and small rodents) rarely require testing and should not be submitted without prior approval from either our laboratory or the State Public Health Veterinarian at (919) 733-3419.
Animals should be euthanized in a manner that will not destroy the brain tissue which is examined in the diagnosis of rabies. Thus, only the animal’s head should be submitted for diagnostic purposes. The animal’s neck should be severed at the midpoint between the base of the skull and the shoulders. Treat any specimens with fleas, ticks, maggots, ants, etc. prior to packing. Small animals no larger than a squirrel may be submitted whole. For bats, the whole dead animal must be submitted and should be secured in a clear container such as a zip-lock bag or equivalent. DO NOT SUBMIT LIVE BATS – PLEASE ENSURE THAT THE BAT HAS BEEN EFFECTIVELY EUTHANIZED BEFORE PLACING IN THE BAG.
Place each animal specimen for rabies diagnosis in a separate leak-proof container (i.e., can, double plastic bag, etc.) and securely seal. Place this container in a sturdy shipping carton (use sturdy styrofoam if possible) and enclose refrigerants to keep the specimen cold. Specimens should be kept cold but NOT FROZEN. DO NOT USE LOOSE WET ICE OR DRY ICE. Specimens inadvertently frozen are still suitable for testing; however, testing may be delayed due to thawing. Submit specimens to the rabies laboratory at the N.C. State Laboratory of Public Health as soon as possible. If shipment will be delayed, refrigerate specimens prior to shipment.
Large animal heads such as cows, horses, deer, large dogs, etc. should be submitted to our rabies laboratory via the Dept. of Agriculture’s Rollins Animal Disease Diagnostics Laboratory in Raleigh (919) 733-3986 or one of their satellite laboratories throughout the state:
These laboratories will remove the brain tissue and forward the tissue to the SLPH rabies laboratory for testing. Contact the agriculture labs directly for specimen submission information. The anatomical tissues that the SLPH requires for a satisfactory rabies test include either hippocampus or cerebellum and a complete cross section of the brain stem. Specimens fixed in formalin cannot be tested and will be reported as unsatisfactory.
Shipment via State Courier Service is usually the most rapid mode of transit. Personal conveyance or FedEx shipment for overnight delivery may be used when courier service is unsuitable. The laboratory should be informed in advance of the manner of shipment to be used for samples that have been approved for weekend testing. In addition, the outside of the box should be clearly labeled “Approved for Weekend (or Holiday) Testing” if the sample is to be tested on Saturday or a holiday. Address all shipping containers using the special label (white with red lettering) available from the SLPH mai room. The label instructs the transporting service to call the SLPH upon arrival and will assure proper handling of the specimen.
If you do not have the special mailing label, the following information should be clearly visible on the exterior of the mailing container containing the animal head:
TO: State Laboratory of Public Health
4312 District Dr.
Raleigh, NC 27607
"This package contains an animal head suspected of having rabies."
Routine testing is available Monday through Friday (7:30 a.m. to 4:00 p.m.). Weekend/holiday testing will be handled via a duty cell phone on-call system and restricted to emergency situations only. The circumstances constituting an emergency situation for human exposure to suspected rabies must satisfy one of the following criteria:
Rabies laboratory staff can be reached at (919) 733-7544 during regular hours of operation or by telephoning the on-call staff duty cell phone at (919) 280-8915 between 4:30 p.m. Friday and noon on Saturday. Specimens received after noon on Saturday without prior approval will be tested on the following routine work day, i.e. usually Monday.
Test results for any animal positive for rabies or any unsatisfactory test result will be telephoned automatically by laboratory staff to the appropriate parties at the numbers provided. IT IS THE RESPONSIBILITY OF THE SUBMITTER, NOT THE LABORATORY, TO NOTIFY THE PERSON EXPOSED.
All test results will be sent via U.S. Mail or the State Courier System to the submitter and county health department director in the county where the animal specimen was obtained. It should be noted that although the fluorescent antibody test is very reliable, a negative test does not completely exclude the possibility of the animal being rabid.
All Rabies results are also available on-line. Go to “login” on the home page. If you are a new user, follow the link at the bottom of the page to request a new account.
All suspected cases of rabies in humans are handled on a case-by-case basis. Contact the laboratory at (919) 733-7544 for special instructions on specimen collection criteria and shipping directions.
Hospital infection control consultation should be obtained Monday-Friday, 8:00 a.m. - 5:00 p.m., from the Public Health Veterinarians at (919) 733-3419. Consultation services are available after work hours and during weekends or holidays by leaving a message in the voice mail box at (919) 733-3419 which will automatically activate a beeper for the on-call individual.
Rabies virus antibody testing is available through commercial laboratories. Testing of specimens should be arranged directly with those laboratories. The following laboratory is known to offer the Rapid Fluorescent Focus Inhibition Test for rabies virus antibody:
Rapid Fluorescent Focus Inhibition Test
Department of Veterinary Diagnosis
Veterinary Medical Center
Kansas State University
Manhattan, Kansas 66506
Web: Kansas State University Rabies Serology/Diagnostics
Consultation prior to post-exposure prophylaxis should be obtained Monday-Friday, 8:00 a.m. - 5:00 p.m., from one of the Public Health Veterinarians/epidemiologists on-call at (919) 733-3419.
Consultation services are available after work hours and during weekends or holidays by leaving a message in the voice mail box at (919) 733-3419 which will automatically activate a beeper for the on-call individual.
When the decision has been made to administer post-exposure prophylaxis, the Public Health Veterinarian/epidemiologist on call will arrange for the ordering and purchase of Rabies Immune Globulin and the Rabies Vaccine from the State Laboratory. After purchase, these products cannot be returned to the Laboratory for refund or credit. During non-working hours, one of the above named individuals can arrange with the Laboratory for shipment of these products.
The purpose of the presentation is to assist in training people packaging and shipping rabies specimens to the NCSLPH for rabies testing. Following the instructions should result in optimal integrity of the sample, ensure the safety of all staff handling the specimen, expedite test results, and ensure compliance with the Department of Transportation (DOT) regulations. The presentation may be viewed for guidance or continuing education. To receive 1.0 contact hours of continuing education, the quiz at the end of the presentation must be completed and passed. A certificate will be issued.