Recognizing the Role of Skunks in Human and Animal Rabies Exposures in the Southwest.

Rabies is arguably the most important viral zoonotic disease worldwide with an estimated 55,000 human deaths each year. Globally, dogs are the primary animals affected. In the United States, especially on the East Coast, raccoons and bats are the primary reservoir. However, in the southwestern United States, skunk and bat rabies play a large role. We describe the epidemiology and environmental risk factors associated with rabies in the US Southwest using exposure data for 2004-2012 from one Arizona county as a case study. Unlike other parts of the country, here bats and skunks are the most commonly collected positive animals (62% and 32%, respectively). Even though most of the positive animals were bats, human and domestic animal exposures were primarily a result of skunk interactions (58% and 50%, respectively). Consequently, the majority of exposures occur early in the year, January and February, when the majority of skunk pickups also occur. Using public health surveillance data, our study highlights the importance of recognizing the role of skunks in human and animal exposures in the southwestern United States. Consistent with a "One Health" approach, our data show how wildlife and domestic animal and human exposures are associated and informative to one another.