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Rabies
When bitten by an
animal, you should always care for the wound immediately by washing it out with
soap, water, and some sort of commercial antiseptic iodine solution, if
available. This will help kill the common bacterial germs that may be passed by
the bite but also has been shown to decrease the likelihood of transmission of
the rabies virus, should the animal be rabid.
- If the animal is a
pet, get the owner's name, address, and phone number, if possible. This
information will aid the local public health authorities as they monitor the
animal.
- If the animal is a
wild animal, or stray dog or cat, contact the local animal control authorities
(your local humane society or city or county public health office)
immediately. They will attempt to safely capture the animal for examination.
The victim or other bystanders should not attempt to capture or subdue the
animal. This might lead to further bites or exposures.
- If the animal is a
bat, and the exposure occurred in a building, the doors and windows should be
shut in the room containing the bat after all other people are evacuated. If
this cannot be done without risk of repeat exposure to the bat, then the most
important thing is to minimize the chance of contact between that bat and
other people. Once again, call local animal control authorities, and they
will capture the bat.
- Bat exposures are
different from any other animal. There does not necessarily have to be a
detectable bat bite to constitute a significant exposure.
- If a bat bite or
direct contact cannot be ruled out, then there may have been a significant
exposure, such as in the following circumstances:
- A sleeping person
awakens to find a bat in the room.
- An adult sees a
bat in the room of a previously unattended child, mentally disabled
person, or intoxicated person.
Medical Treatment
- Treatment to prevent
rabies has 3 essential components if a high probability of disease exists.
Depending on the likelihood the animal has rabies and, in some cases, the
availability of the animal for observation, your doctor may not initiate the
latter 2 steps involving shots against the rabies virus.
- Wound care
involving soap and a virus-killing cleanser (this should always be done)
- Injection of rabies
immune globulin around the wound. This is a substance that provides rapid,
short-term protection against rabies
- Injection of the
first of a series of vaccine doses to provide protection against rabies
after an exposure.
- The decision to treat
for rabies: The likelihood of an animal having rabies depends heavily on the
species of the animal, its behavior, and where you were exposed to the
animal. For example, in some areas of the country, such as the Texas-Mexico
border, stray dogs have an extremely high likelihood of being rabid. In other
areas, stray dogs may have little chance of being rabid.
- Domestic dogs,
cats, and ferrets have a well-defined incubation period for the rabies
virus. If you have been bitten by 1 of these 3 animals, and the animal does
not appear overtly ill at the time, then the animal will be observed by
local health authorities for 10 days. If the animal remains well during
that period, you will not need rabies shots.
- If the animal has
the potential for rabies and is available for sacrifice and immediate
examination by the local health department, then treatment may be withheld
pending the results of that test. This would include animals such as any
wild animal, or an unwanted stray dog or cat, if you know where the animal
is (dead or alive).
- If the animal has
the potential for rabies and is unavailable for sacrifice and examination,
then you will be given rabies shots in the emergency department.
- Special situations
- Rabies vaccination
and pregnancy: Both human rabies immune globulin (HRIG) and the various
rabies vaccines are safe in pregnancy.
- Immune suppression:
If you are taking medicines (such as prednisone or steroids) or have a
disease that interferes with the body's response to the rabies vaccine,
discuss these situations with your doctor. The doctor will then determine
if you will need additional blood tests to ensure that an adequate response
to the vaccine has occurred and that protection against rabies is
developing.
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