Exposure to the Virus
People usually get rabies from the bite of a rabid animal. It is also possible, but quite rare, that people may get rabies if infectious material from a rabid animal, such as saliva, gets directly into their eyes, nose, mouth, or a wound.
Scratches, abrasions, open wounds, or mucous membranes contaminated with saliva or other potentially infectious material (such as brain tissue) from a rabid animal constitute non-bite exposures. Occasionally reports of non-bite exposure are such that postexposure prophylaxis is given.
Inhalation of aerosolized rabies virus is also a potential non-bite route of exposure, but except for laboratory workers, most people won't encounter an aerosol of rabies virus.
Other contact, such as petting a rabid animal or contact with the blood, urine or feces of a rabid animal, does not constitute an exposure.
The only well-documented cases of rabies caused by human-to-human transmission occurred among eight recipients of transplanted corneas, and recently among three recipients of solid organs. Guidelines for acceptance of suitable cornea and organ donations, as well as the rarity of human rabies in the United States, reduce this risk.
In addition to transmission from cornea and organ transplants, bite and non-bite exposures inflicted by infected humans could theoretically transmit rabies, but no such cases have been documented. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, feces) does not constitute an exposure and does not require postexposure prophylaxis. In addition, contact with someone who is receiving rabies vaccination does not constitute rabies exposure and does not require postexposure prophylaxis.
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