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.
Under special situationso 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.
