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Rabies

Intro

If you think an exposure to a rabid animal has occurred, call your doctor immediately.

  • The doctor should discuss both the animal's risk for having rabies and the risk of the exposure for transmission of the virus.
  • The doctor also should know if you have previously received vaccination against rabies, either because you're in a high-risk profession (for example, a veterinarian or zoo worker) or you have been exposed to a potentially rabid animal before. If you have been vaccinated previously, it will change the treatment that will follow after a new potential exposure.
  • Because rabies is such a rare disease, the doctor may be unfamiliar with the need for treatment or may not have the vaccine in the office for prompt administration. The local public health department is a good source of information in these cases, and a hospital's emergency department is a good place to seek medical  care.

Any serious animal bite should be cared for as soon as possible in a hospital's emergency department.

In addition to the potential for transmission of rabies, other medical  issues need to be checked:

  • Transmission of regular bacterial germs from the mouth of the biting animal
  • Need for an injection to maintain protection, or immunity, against tetanus   (another type of infection that can be transmitted by bites or to open wounds)
  • Issues of wound repair

Even the most trivial bite can transmit rabies. Any bite or scratch by a rabid animal warrants the administration of rabies shots. Whether or not that animal is at risk for rabies depends somewhat on the region of the country and on the species of the animal. Any exposure to a bat where a bite cannot be ruled out is a significant exposure.

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Self-Care at Home

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.

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Follow-up

If you have been exposed to rabies, maintain contact with the local health authorities and stick to the schedule of prescribed rabies vaccine shots. Contact your doctor after treatment in the emergency department. Your doctor may refer you for the additional doses of the vaccine if the doctor does not have them on hand.

Local discomfort at the site of the injection is expected. You may apply warm compresses and take over-the-counter pain remedies. Any reactions differing from this should be discussed with your doctor.

Prevention

Prevention of rabies depends on decreasing the disease in the animal kingdom. Avoid contact with wild animals and strays. Have your pets vaccinated against rabies. Keep pets under control and away from wild animals and strays.

Outlook

If you get timely, appropriate wound care and rabies shots, you will be virtually 100% protected against rabies.

To date, there have been no failures of this treatment in the United States.
Failures overseas, however, have occurred despite seeking medical  care after exposure because doctors either failed to give wound care, did not inject the immune  globulin around the bite or wound site, or did not give the vaccine in the correct spot (for example, vaccine was given in the buttocks).

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