Risk factors for human exposure to raccoon rabies during an epizootic in Connecticut

The emergence of rabies among terrestrial wildlife poses increasing but poorly defined risks to people. In particular, events leading to human exposure to rabies virus via mammalian reservoirs remain elusive. Thus, we determined those risk factors associated with human exposure to rabies-positive animals during a raccoon rabies epizootic in Connecticut. Existing passive surveillance data on animal rabies tests in Connecticut from 1991 through 1994 were evaluated for demographic, ecological, and behavioral characteristics of human exposure. Of 2,525 rabies-positive terrestrial animals identified, human contact was reported on 556 occasions (22%) and involved at least 939 individuals. The annual incidence of exposure rose from none during 1985-1990 to 66 in 1991 and then averaged 291 during 1992-1994. Exposure was most often indirect in nature, involved a rabies-positive raccoon, was mediated through a domestic animal, and occurred most frequently either near or inside the home. These results suggest that human exposure to rabid animals represents a significant, reemerging public health concern in the United States. Analysis of the epizootiology of rabies infection and of individual exposure risks could reduce inappropriate administration of rabies postexposure prophylaxis, as well as inform other proposed interventions.