This page provides rabies information useful to health care
providers, including veterinarians.
Rabies Overview
Rabies is a viral disease affecting the central
nervous system. Rabies is spread through contact with the saliva
and nervous tissue from a rabid animal through a bite, scratch, or
contact with mucous membranes, such as of the eyes, nose, or mouth.
The early signs of rabies can be fever or headache,
but this changes quickly to central nervous system symptoms, such as
confusion, sleepiness or agitation. Once these symptoms are exhibited in
a person infected with rabies, death usually occurs in a matter of
weeks. Fortunately, human rabies cases in the United States are rare.
There is effective treatment to prevent rabies as
long as the treatment is given soon after exposure. Contact
DOH-Sarasota for assistance with animal testing and
medical advice.
Animal Testing Sarasota – (941) 861-6133
Medical Advice Sarasota – (941) 861-2784
North Port – (941) 861-3864
Diagnosing rabies
Some important factors to consider before treatment:
Was the bite from an animal species that is at
high risk for having rabies? Wild animal bites, especially from
bats, raccoons, skunks, or foxes are often suspect.
If a domestic animal was involved, was it acting
strangely? Was the animal vaccinated against rabies? If the
exposure was from a lick, was it near an open scratch, wound, or
mucous membrane, such as the mouth, nose, or eyes?
If the animal is dead, you should save the
carcass for examination (remember to wear gloves if handling an
animal carcass).
People working in high-risk professions such as animal control
and veterinary personnel, laboratory workers, and those working with
wildlife should receive pre-exposure prophylaxis.
Pre-exposure vaccination also should be considered for other
persons whose activities bring them into frequent contact with
rabies virus or potentially rabid bats, raccoons, skunks, cats,
dogs, or other species at risk for having rabies.
The pre-exposure series consists of three doses of rabies
vaccine administered on days 0, 7 and 21 or 28.
Human Rabies Immune Globulin (HRIG) should be given:
Only to those who have not been previously vaccinated against
rabies
As soon as possible after the exposure
As an infiltrate in and around the wound whenever possible
When necessary, it can be given even months later, in
conjunction with the rabies vaccine (or up to 7 days after the first
dose)
Refer the patient to the DOH-Sarasota for
post-exposure prophylaxis (PEP) follow-up.
Post exposure prophylaxis (PEP) is indicated for persons
possibly exposed to a rabid animal (or human).
Possible exposures include animal bites, scratches or mucous
membrane contamination with infectious tissue or fluids such as
saliva. Blood, feces and urine do not carry the virus and are not
infectious.
PEP should begin as soon as possible after an exposure.
Administration of rabies PEP is a medical urgency, not a medical
emergency. There have been no vaccine failures in the United States
(i.e., someone developed rabies) when PEP was given promptly and
appropriately after an exposure.
Physicians should evaluate each possible exposure to rabies and
as necessary consult with the DOH-Sarasota
regarding the need for rabies PEP.
In the US, post exposure prophylaxis for non-immunocompromised,
previously unvaccinated persons consists of rabies immune globulin
and four doses of rabies vaccine over a 14-day period.
The immune globulin and the first dose of vaccine should be
given as soon as possible after exposure.
Additional doses of rabies vaccine should be given on days 3, 7,
and 14 after the first vaccination.
Persons who are immunocompromised require rabies immune globulin
and vaccine as soon as possible plus four additional doses
administered on days 3, 7, 14 and 28
