What transmission means touching or contact with the patients blood or saliva?

Rabies virus is transmitted through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with saliva or brain/nervous system tissue from an infected animal.

People usually get rabies from the bite of a rabid animal. It is also possible, but rare, for people to get rabies from non-bite exposures, which can include scratches, abrasions, or open wounds that are exposed to saliva or other potentially infectious material from a rabid animal. Other types of contact, such as petting a rabid animal or contact with the blood, urine or feces of a rabid animal, are not associated with risk for infection and are not considered to be exposures of concern for rabies.

Other modes of transmission—aside from bites and scratches—are uncommon. Inhalation of aerosolized rabies virus is one potential non-bite route of exposure, but except for laboratory workers, most people won’t encounter an aerosol of rabies virus. Rabies transmission through corneal and solid organ transplants have been recorded, but they are also very rare. There have only been two known solid organ donor with rabies in the United States since 2008. Many organ procurement organizations have added a screening question about rabies exposure to their procedures for evaluating the suitability of each donor.

Bite and non-bite exposures from an infected person 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), is not associated with risk for infection. Contact with someone who is receiving rabies vaccination does not constitute rabies exposure, does not pose a risk for infection, and does not require postexposure prophylaxis.

Rabies virus becomes noninfectious when it dries out and when it is exposed to sunlight. Different environmental conditions affect the rate at which the virus becomes inactive, but in general, if the material containing the virus is dry, the virus can be considered noninfectious.

Footnote

1. A qualified health care professional is any health care provider who can provide counseling and perform all medical evaluations and procedures in accordance with the most current recommendations of the U.S. Public Health Service, including providing postexposure chemotherapeutic prophylaxis when indicated.

References

CDC. Basic Expectations for Safe Care Training Module 5 – Sharps Safety. Available at: https://www.cdc.gov/oralhealth/infectioncontrol/safe-care-modules.htm. Accessed May 8, 2018.

CDC. CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR 2013:62(No.RR-10). Available at: https://www.cdc.gov/mmwr/PDF/rr/rr6210.pdf pdf icon[PDF-712K].

CDC. Exposure to Blood: What healthcare personnel need to know. Updated July 2003. https://www.cdc.gov/HAI/pdfs/bbp/Exp_to_Blood.pdf pdf icon[PDF-329K].

CDC. National Institute for Occupational Safety and Health. NIOSH Alert: Preventing needlestick injuries in health care settings. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, CDC, National Institute for Occupational Safety and Health, 1999.

CDC. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR 2001;50(No.RR-11). Available at: https://www.cdc.gov/mmwr/PDF/rr/rr5011.pdf pdf icon[PDF-333K].

CDC. Workbook for designing, implementing, and evaluating a sharps injury prevention program. Available at: https://www.cdc.gov/sharpssafety/.

Cleveland JL, Cardo DM. Occupational exposures to human immunodeficiency virus, hepatitis B virus, and hepatitis C virus: risk, prevention, and management. Dental Clinics of North America 2003;47(4):681-96.

Kuhar DT, Henderson DK, Struble KA, Heneine W, Thomas V, Cheever LW, Gomaa A, Panlilio AL; US Public Health Service Working Group. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis. Infect Control Hosp Epidemiol. 2013;34(9):875–892.

US Department of Labor, Occupational Safety and Health Administration. 29 CFR Part 1910.1030. Occupational Exposure to Bloodborne Pathogens: Needlestick and Other Sharps Injuries: Final Rule. Federal Register 2001;66:5317–5325. Updated from and including 29 CFR Part 1910.1030. Occupational exposure to bloodborne pathogens; final rule. Federal Register December 6, 1991;56:64003–64182. Available at: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051external icon.

Some infections can be passed on in blood or in body fluids (such as saliva) that can become mixed with blood. These are known as blood-borne viruses (BBVs).

The risk of an infection being passed on in this way largely depends on the type of infection and how you come into contact with the infected blood.

Which infections can be passed on?

The most common blood-borne viruses in the UK are:

These viruses can also be found in body fluids other than blood, such as semen, vaginal secretions and breast milk. Other body fluids such as urine, saliva and sweat only carry a very small risk of infection, unless they contain blood.

However, the presence of blood is not always obvious, and it is possible for someone to have one of these infections without realising it.

Routes of transmission

The chance of an infection being passed on from someone else's blood also depends on how you come into contact with the infected blood. This is known as the route of transmission. The risks associated with different routes of transmission are outlined below.

Higher risk of infection

The risk of an infection being passed on is highest if your skin is broken or punctured as you come into contact with the infected blood.

For example, if:

• you puncture your skin with a used needle or other sharp object that has infected blood on it
• someone with blood in their saliva bites you and breaks your skin

Lower risk of infection

The risk of an infection being passed on from someone else's blood is lower if the blood only comes into contact with your eyes, mouth, nose, or skin that's already broken.

For example, if someone spits in your face, they may have blood in their saliva and it may get in your eyes, mouth or nose. The infected saliva may also get into an existing cut, graze or scratch.

There is also a lower risk of infection if infected blood comes into contact with skin that is already broken due to a health condition like

.

Very low risk of infection

The risk of infection is very low if infected blood comes into contact with unbroken skin.

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Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.

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