After the bite: A descriptive analysis of animal exposure incidents resulting in a human rabies post-exposure prophylaxis recommendation in Ontario, Canada, 2014–2024

Background: For all potential rabies exposure incidents in Ontario, Canada where rabies post-exposure prophylaxis (RPEP) is recommended, demographic and exposure information is reported to Public Health Ontario to support provincial surveillance of such incidents and to inform provincial planning, including vaccine procurement.Objective: To describe demographic and species-specific trends for potential rabies exposures of Ontario residents, either locally or overseas, that resulted in a recommendation to receive RPEP.Findings can inform public education and public health risk assessments.Methods: Demographic and exposure information for Ontario residents who were recommended to receive RPEP from 2014 to 2024 were extracted from the provincial surveillance database.Publicly available animal rabies testing data from the Canadian Food Inspection Agency were obtained for the same period.Data were analyzed to identify demographic or species-specific trends.Results: Reported potential rabies exposure incidents more than doubled over the study period.Most incidents involved a dog (37%), bat (22%) or a cat (17%), with bat exposures consistently peaking during the month of August.Implicated animal species was associated with both client age and gender.Sixteen percent of incidents involving international travel were associated with a primate, several with a macaque.Conclusion: Increasing awareness among pet owners about the importance of rabies vaccination for domestic cats and dogs, and the need to share such information in the event of a potential exposure incident, could mitigate the need for RPEP in some situations.Risk assessment for returning travellers who report an exposure incident involving a primate should consider other zoonotic exposure risks, particularly herpes B virus.