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Rabies

Rabies is a disease caused by a virus that, with very rare exceptions, is always fatal. The rabies virus is present in the saliva of the infected animal and is spread when the saliva gets into a bite or scratch. It is spread through bites or scratches from infected, fur-bearing animals. The virus infects the brain, causing the animal to exhibit unusual, often aggressive, behavior. The risk of getting rabies is greater if a person is bitten multiple times or if the bites are close to or on the head.

In developing countries, 90 percent or more of rabies cases in humans are caused by dog bites. In the United States, rabies in dogs has been largely eliminated as a result of animal vaccination. Wild bats now pose the greatest risk of rabies. Other animals that can spread rabies include: Raccoon, Skunks, Foxes and Coyotes.

What are the symptoms of Rabies?

Symptoms of Rabies are Flu like symptoms such as: Fever, sore throat, HA, N/V, weakness in arms or legs.

Rabies vaccine and immune globulin

A series of injections, including rabies vaccine and human rabies immune globulin (RIG) can prevent rabies, even if the virus enters the body. RIG provides immediate antibody protection against rabies infection while the rabies vaccine provides protection within approximately two weeks. You cannot acquire rabies from either medicine and are safe to treat children and pregnant women.

Side effects of rabies vaccine and RIG can include discomfort at the injection site (similar to a flu shot), low-grade fever, and muscle aches.

POST-BITE RABIES PREVENTION

Rabies infection can be prevented, even after a bite or a scratch from an infected animal occurs.

How to treat a wound.

Wounds should be washed with soap and lots of water and may be rinsed with an antiseptic. This will reduce the risk of the rabies virus entering the body.

When is rabies prophylaxis needed?

A person with a high risk exposure to an animal that is or may be infected with rabies should be given immediate post-exposure prophylaxis with rabies vaccine and RIG.

Post-exposure prophylaxis may also be recommended immediately if a bite from a high-risk animal involves the head or neck. If the animal can be observed and is not infected with rabies, the regimen can be discontinued.

If the animal is not available for observation or testing, most experts recommend post-bite rabies prophylaxis because of the risk of fatal illness caused by infection with the rabies virus.

What is the schedule for treatment?

One dose of RIG is given on day zero. As much of this as possible is injected into and around the wound(s).

If post-exposure prophylaxis is needed, the rabies vaccine should be given as soon as possible (considered day zero for the immunization schedule). The rabies vaccine is given into a muscle, usually in the upper arm. The vaccine for rabies is given on day 0, 3 7 and 14.

Some persons have received rabies prophylaxis before exposure (eg, veterinarians). These persons only require two doses of rabies vaccine on days zero and three. No RIG is necessary for people who have previously received the rabies vaccine.

What information is required for prophylaxis treatment?
  • Whether the person was bitten and the location of the bite.
  • The type of animal involved
  • Whether the exposure was provoked or unprovoked (animals infected with rabies are more likely to attack, even when not provoked)
  • Whether the animal was previously vaccinated against rabies
  • The presence of rabies in that animal species in the region
  • The availability of the animal for testing or observation
What if we have the animal?

If the animal is a healthy pet, such as a dog, cat, or ferret, and the animal is available for observation, rabies prophylaxis can be delayed while the animal is observed [in a secure facility, such as a veterinary clinic], for 10 days.

if the animal develops signs of rabies, post – bite prophylaxis should be started immediately.

If the animal remains healthy during the 10 day observation period, the bite victim does not need vaccine or immune globulin.

Montgomery County Animal Control Phone Number.

What if I am traveling?

Rabies is still quite common in many developing countries. When traveling to countries where rabies is more common, you should avoid touching all wild and domestic animals. If you are bitten or scratched, you should wash the area immediately and seek expert advice about the need for post-exposure prophylaxis.

In developing countries, the availability and type of rabies vaccine and immune globulin varies considerably. If a person has high risk exposure to rabies, he or she should consult with a reliable health care provider.

Pre-exposure rabies vaccination may be recommended if you are traveling to a developing country and might be living in conditions where exposure to rabid and potentially rabid animals is likely.

It is important to know that having pre-exposure rabies vaccination does not eliminate the need for future vaccination if you are bitten. If you have had the rabies vaccine previously and are bitten or scratched by a rabid animal, you need two doses of rabies vaccine, on days 0 and 3 . No rabies immune globulin is needed.

ADVICE REGARDING SPECIFIC ANIMALS AND RABIES

contact with wild and unfamiliar domestic animals should always be avoided. Wild animals should not be kept as pets and should never be handled by people who are not properly trained and vaccinated.

Domestic animals

In the United States, dogs, cats or ferrets that have received rabies vaccination are unlikely to be infected with rabies. The number of rabies cases among domestic animals, such as dogs and cats, declined markedly in the United States in the 1930s due to rabies vaccination.

While vaccinated animals present little risk, domestic animals must be up-to-date on rabies booster vaccination to assure their protection. Rabies booster vaccines are given every one to four years, depending on the blood tests.

The likelihood of rabies in domestic animals is small and varies by region. In the United States, rabies is most often in dogs along the US – Mexico border and in cats in areas of rabid raccoon activity. However, sporadic cases of rabies develop in domestic animals outside of these areas.

Wild animals

Bites from wild animals are considered to carry a risk of rabies unless proven otherwise by testing. Post exposure prophylaxis should be given immediately to anyone who is bitten or scratched unless the animal is caught and tested promptly. In the United States, raccoons, skunks, foxes, bats, and coyotes are the most commonly infected species.

Small rodents, such as squirrels, chipmunks, rats, hamsters, gerbils, guinea pigs, mice, and lagomorphs, such as rabbits, are almost never found to be rabid. There has never been a reported case of rabies transmission to a human from one of these animals. These animals are capable of developing rabies; although this is unlikely because small animals are usually killed or severely injured during an attack by a rabid animal.

Pet rabbits and rodents that are caged outdoors are at risk of exposure to rabid wild animals.

Livestock

Among all types of domestic livestock, rabies is most likely to occur in cows. Horses, goats and other livestock species are rarely affected. Anyone who is bitten by livestock should be managed individually, in consultation with local public health authorities.

Bats

Among 40 reported cases of human rabies in the US between 1990 and 2006, 37 cases (93 percent) were caused by a bat strain of rabies.

Anyone who is bitten or scratched by a bat should receive post-exposure prophylaxis, unless the bat can be collected and tests negative for rabies. However, under certain circumstances, bats can bite and transmit rabies without the victim being aware of the bite. As a result, the following precautions are recommended:

  • Post-exposure prophylaxis is recommended if a person has direct contact with a bat, unless the exposed individual is certain that there was no bite or scratch or the bat was tested and found not to be rabid.
  • Bats should never be kept as pets and should not be picked up or handled by anyone, except those who are trained and have received rabies vaccination. If a bat is found in a home, avoid touching it. If possible, the bat should be allowed to escape outdoors. If it is not possible to allow the bat to escape, advice about safely capturing the bat is available at www.cdc.gov/rabies/qanda/general.html#b3 . Contact your health department with questions about potential rabies exposures and about testing captured bats for rabies.
  • Sleeping. If you find a bet in your room after waking up, it is possible that you were bitten while sleeping and is recommended to receive post exposure prophylaxis.