Snohomish Health District Communicable Disease Program investigates over 50 reported diseases. Our goal is to
find the source of the disease or outbreak in order to stop any ongoing spread of illness. For certain
diseases, like pertussis (whooping cough), we identify close contacts and determine if any treatment or
preventive medicines are recommended. The Communicable Disease Program also provides information and
resources about many different communicable diseases and conditions, including MRSA, and information about
animals and rabies.
Communicable Disease Fact Sheets
List of fact sheets available from the Snohomish Health District:
Fact Sheets in English
Fact Sheets in Spanish
Notifiable Conditions are diseases and conditions
that are reportable to local public health authorities in Washington in accordance with
Communicable Disease Outreach Program (for child cares)
Illnesses can spread quickly in child care environments. Snohomish Health District
staff is available to assist child care providers and related organizations with disease
prevention and control issues through consultation, investigation, and education.
The Communicable Disease Outreach program is staffed with a public health nurse and an
environmental health specialist. If you have questions or concerns about illnesses in a
child care, please call 425.339.5278. For services available to child care programs through
the Communicable Disease Outreach program and the Child Care Health and Nutrition consultant,
Rabies Prevention and Information
Because rabies is a fatal disease, the goal of public health is, first, to prevent human
exposure to rabies by education and second, to prevent the disease by vaccination
treatment if exposure occurs (called post-exposure prophylaxis or PEP).
The Snohomish Health District is responsible for determining the risk of rabies related
to animal bites and other exposures. If there is any concern of potential rabies
exposure, then we will help coordinate follow-up treatment for the exposed person. More
information about animal bites and rabies risk is included here.
Rabies, although rare in humans, is a severe viral illness that affects the central
nervous system of humans and other mammals and is nearly 100% fatal. Since 1990, the
number of reported cases in the United States has ranged from 1 to 6 cases annually.
People get rabies from contact with the infected saliva or brain/nervous tissue,
usually from the bite of an animal with rabies.
If you have been bitten by any animal, or may have come into contact with a
bat (bite, scratch or sleep exposure), you should be seen by a healthcare provider
for wound treatment and for an assessment to determine if you will need rabies
postexposure prophylaxis (PEP), or rabies shots. The decision to start PEP is based
on many different factors, including:
- Type of animal (domestic, imported, wild)
- Surveillance information for the area where the animal exposure happened
- Type of exposure (provoked, unprovoked)
- Whether lab testing of the animal can be done
Rabies in Washington State and Other Areas
Different states or regions have different animals known to carry rabies. In Washington,
bats are the only wild animal known to carry rabies. About 1% of bats in the wild are
infected with the rabies virus. In other states, along with bats, the animals most often
infected with rabies are raccoons, skunks, foxes and coyotes. In many developing
countries around the world, dogs are a major source of rabies and therefore dog bites
in those countries should be treated as a likely exposure to rabies.
Small rodents (i.e., squirrels, hamsters, chipmunks, rats and mice) and lagomorphs (i.e.,
rabbits and hares) are almost never found to be infected with rabies and have not been
known to transmit rabies to humans. The possibility of rabies in a domestic animal (i.e.,
dog, cat, or ferret or in a wild animal in WA State is very unlikely. However, if a
bite is unprovoked or if the animal (wild or domestic) was acting unusual or appeared
ill, contact your health care provider and the Communicable Disease program for
How to reduce your risk for exposure:
- Make sure your home is bat proofed. Bats give birth in the summer and
the offspring do not fly until almost full-grown, usually by August in Washington.
The best time to bat proof is in the fall or winter, when they are hibernating. To
avoid trapping bats inside a building, do not attempt bat proofing from May through
- Vaccinate all pets (especially dogs, cats and ferrets) against rabies.
- Avoid any direct contact with bats and other wild or unfamiliar animals, especially
sick, injured or dead ones. Teach your children this rule as well.
If you have been bitten or scratched by a domestic dog, cat or ferret:
- Immediately wash the wound thoroughly with soap and water.
- Seek medical attention for wound treatment Make sure you have had a tetanus
vaccination within the last 10 years. If you are due for a tetanus vaccination,
consider getting Tdap, which also provides protection against pertussis . Tdap
vaccination is recommended for adolescents and adults who have not yet received
- Dogs, cats or ferrets who bite humans should be confined in the home or a shelter
for 10 days to observe for signs of rabies. If the animal is alive and healthy after the
10 day confinement, the animal did not have rabies at the time of the bite and the
exposed person is not at risk for rabies. If the animal develops any symptoms
suspicious for rabies or dies during the confinement, then testing for rabies
should be done. Contact Snohomish Health District at 425-339-5278 to facilitate
testing. DO NOT euthanize the animal during its 10 day confinement period.
If you find a bat in your home or if you have been bitten or scratched by a bat or other wild animal:
- Immediately clean the wound thoroughly with soap and water. Seek medical attention.
Make sure you have had a tetanus vaccination (or Tdap) within the last 10 years.
- If you have been bitten or scratched, or if there is any chance that someone could
have unknowingly been bitten or scratched by a bat (i.e., bat found in a room where
children are sleeping), try to safely capture the bat when possible (see below) and
save it until after talking to the Snohomish Health District. If you have been bitten or
scratched by a wild animal other than a bat, and the animal is available for possible
testing, please save it until after talking to the Snohomish Health District (keep the
dead animal cold but not frozen-either in a refrigerator or on ice).
- Contact the Snohomish Health District Communicable Disease Program at 425.339.5278.
Staff will decide whether an exposure has occurred and if testing of the animal is appropriate.
If you need urgent assistance after business hours, please seek medical attention.
How to safely capture a bat in the home
If there is any chance that a person has been bitten, scratched or come into contact
with a bat (i.e., bat found in a room where children are sleeping), DO NOT let the
bat go free
. To safely catch the bat, you can either call for professional help
from a pest control or nuisance wildlife company or catch the bat yourself,
List of Resources:
MRSA (Methicillin Resistant Staphylococcus Aureus)
MRSA is NOT reported to the Snohomish Health District. If you or someone you know has
been diagnosed with MRSA, you should follow-up with your healthcare provider.
If you have general questions about MRSA or need help finding more information, you may
call the Communicable Disease Program at 425.339.5278. Included here is information
about MRSA, along with many different resources.
What is MRSA?
Staphylococcus aureus, often referred to simply as "staph," are bacteria commonly found
on the skin or in the nose of healthy people. Staph bacteria are one of the most common
causes of skin infections in the United States. Some staph bacteria are resistant to
certain antibiotics. This means that antibiotics commonly used to treat these infections
no longer kill the bacteria. MRSA (methicillin-resistant Staphylococcus aureus) is
a type of staph that is resistant to many, but not all antibiotics, including penicillin
and amoxicillin. About 25% to 30% of people are colonized in the nose with staph bacteria
but only about 1% are colonized with MRSA. Colonization means the bacteria live in the
body but do not cause infection.
What are the symptoms of MRSA?
Staph bacteria, including MRSA, usually cause skin infections that may look like a pimple
or boil (sometimes mistaken for a spider bite) and can be red, swollen, painful, or
have pus or other drainage. More serious infections may cause pneumonia, bloodstream
infections, or surgical wound infections.
How is MRSA diagnosed and treated?
In general, a culture should be obtained from the infection site. If Staph aureus is
found, the bacteria should be tested to determine which antibiotics will be effective
for treating the infection. Staph skin infections, such as boils or abscesses, often
may be treated only by incision and drainage, depending on the severity. If you are
given an antibiotic, be sure to finish all of the medication unless your doctor tells
you to stop. Do not share your antibiotics with others or save them for later. This
helps prevent bacteria from becoming resistant to more antibiotics.
How is MRSA spread?
MRSA is usually spread by direct skin to skin contact or contact with shared items or
surfaces that have been contaminated by someone who has an infection (i.e., towels,
clothing,). Poor hygiene and crowded living conditions can also make it easier to
get MRSA infections.
How do I prevent spreading or getting MRSA?
- Wash your hands frequently with warm water and soap.
- See your health care provider if you have any infected skin wounds.
- Keep all cuts, scrapes and draining wounds clean, dry and covered with
bandages. If you have an infected wound that cannot be kept covered, avoid
physical contact with others until the wound is healed. Generally, students
do not need to be excluded from school when they have MRSA.
- Do not share items such as bars of soap, towels, clothing, or other objects
that have come into contact with an open or draining wound.
- Clean and disinfect any object, equipment, or surface that has come into
contact with an open or draining wound. Use detergent-based cleaners,
EPA-registered disinfectants, or freshly made diluted bleach solution
(1 tablespoon household bleach in 1 quart cool water).
List of Resources:
Office Hours: Monday - Friday 8:00 am to 5:00 pm