Public health agency for Snohomish County
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Communicable Disease Information ( For the Public )
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
Campylobacteriosis * (13.1.3)
Chickenpox (varicella) (13.1.3)
Chlamydia trachomatis * (13.1.3)
Cryptosporidiosis (13.1.3)
Giardia * (13.1.3)
Gonorrhea * (13.1.3)
Hepatitis A * (13.1.3)
Hepatitis B * (13.1.3)
Hepatitis C (13.1.3)
Herpes, genital (HSV) * (13.1.3)
HIV/AIDS * (13.1.3)
Influenza (13.1.3)
Lice (13.1.3)
Measles (Rubeola) * (13.1.3)
Meningococcal * (13.1.3)
Mumps * (13.1.3)
Pelvic Inflammatory Disease (PID) (13.1.3)
Pertussis * (13.1.3)
Rubella * (13.1.3)
Salmonellosis * (13.1.3)
Shigellosis * (13.1.3)
Shingles (for child cares) (13.1.3)
STD (13.1.3)
Syphilis * (13.1.3)
Trichomoniasis (13.1.3)
Fact Sheets in Spanish
Notifiable Condition

* Notifiable Conditions are diseases and conditions that are reportable to local public health authorities in Washington in accordance with WAC 246-101
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, click here.
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 recommendations.
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 August.

  • 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 a Tdap.

  • 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:
  1. Bats and Rabies (CDC)  web
    Information about Bats and Rabies
  2. Rabies Basics (CDC)  web
    Information about Rabies
  3. Rabies, Human (WA DOH)  web
    Information about Rabies
  4. Washington State Rabies Activity (WA DOH)  web
    Information about Rabies Activity in Washington
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?
  1. Wash your hands frequently with warm water and soap.

  2. See your health care provider if you have any infected skin wounds.

  3. 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.

  4. 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.

  5. 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:
  1. For Schools: CDC - Q & A about MRSA in schools  web
    CDC - Q & A about MRSA in schools
  2. For Schools: Tacoma-Pierce County toolkits - For elementary schools  web
    Tacoma-Pierce County toolkits - For elementary schools
  3. For Schools: Tacoma-Pierce County toolkits - For middle and high schools  web
    Tacoma-Pierce County toolkits - For middle and high schools
  4. For the Public: CDC Healthcare-associated MRSA  web
    CDC information on healthcare-associated MRSA
  5. For the Public: King County - Stop Germs! Stay Healthy!  web
    Information about stopping the spread of germs
  6. For the Public: Tacoma-Pierce County - “Living with MRSA” in English  web
    “Living with MRSA” booklet English version
  7. For the Public: Tacoma-Pierce County - “Living with MRSA” in Spanish  web
    “Living with MRSA” booklet Spanish version
  8. For the workplace: National Institute for Occupational Safety and Health  web
    MRSA and the Workplace
  9. For the workplace: Tacoma-Pierce County workplace handout  web
    Tacoma-Pierce County workplace handout
Contact Info
Phone: 425.339.5278
Office Hours: Monday - Friday 8:00 am to 5:00 pm

Last Reviewed and updated 7/19/2010