If a human is exposed to the rabies virus post-exposure prophylaxis (PEP) can be administered. In the United States, PEP consists of a regimen of one dose of immune globulin and five doses of rabies vaccine over a 28-day period. Modern day prophylaxis has proven nearly 100% successful in preventing the virus from completing its natural course. Successful PEP can only occur if administered before the virus penetrates too far into the nervous system (generally before symptoms appear). PEP should be given as soon as possible after an exposure.
Pre-exposure prophylaxis, usually given to people at high risk for rabies, may aid in the prevention of rabies, but PEP also must be administered after an exposure in order to be highly successful. A person who was vaccinated before an exposure will generally be able to exclude the immune globulin treatment and have a decrease in the number of vaccine doses.
Currently there is no proven successful treatment of rabies in unvaccinated animals. Currently vaccinated animals can prevent the disease through their pretreatment and/or re-administration of the vaccine.
Rabies treatment after the onset of symptoms
There currently is no treatment for rabies after symptoms of the disease appear in humans or animals. Once the virus has reached the brain death is almost always inevitable. There there have been a few documented cases of people who have survived after exhibiting symptoms, but none have made a full recovery. Due to the extremely large number of people worldwide who have died from the disease, these rare cases have no significant impact on the survival rate. Also, the majority of those people who survived were given some kind of pre-exposure treatment (i.e. vaccination) prior to exposure.
There have been no documented animal survival cases of rabies after the onset of symptoms. With the medical and science community focusing their efforts on human rabies treatment, successful animal treatment is unlikely in the near future.
What should I do after a possible exposure?
If you are bitten or scratched by a potentially rabid animal, wash the wound thoroughly with soap and water. This will aid in preventing the virus from setting into your nervous system. Medical attention should be immediately sought and your local health department should be contacted to help assess the situation. Medical treatment may be avoided if the animal can be proven not to have rabies. Laboratory testing of wild animals can rule out that the animals had rabies. Quarantine of domestic pets (dogs, cats & ferrets) can show that the animal was not in the infectious phase of the disease and rule out the need for PEP.
Guidelines for exposure to potentially rabid animals
-
Treat all animal exposures as a potential for rabies transmission. Any break in the skin caused by a bite or scratch is a potential exposure.
-
Immediately wash exposed wounds with soap and water.
-
Seek medical attention immediately and contact your local health department.
-
If the animal is wild or a stray try to contain it in a safe manner. Damage to the head should be avoided because this may make laboratory testing unsuccessful. Have your local animal control or police department take the animal to the proper authorities so it can be tested.
-
If the animal is a pet, obtain the owner's contact information and contact your local police department or animal control. Most states have rabies control laws that will require the animal to be quarantined to determine if the animal was in the infectious phase of the disease.
-
If the animal cannot be captured immediately, seek medical attention and contact your local health department to determine if PEP is necessary.
What can I do to help prevent the spread of Rabies?
Be a responsible pet owner:
-
Keep vaccinations up-to-date for all dogs, cats and ferrets. This requirement is important not only to keep your pets from getting rabies, but also to provide a barrier of protection to you, if your animal is bitten by a rabid wild animal.
-
Keep your pets under direct supervision so they do not come in contact with wild animals. If your pet is bitten by a wild animal, seek veterinary assistance immediately.
-
Call your local animal control agency to remove any stray animals. They may be unvaccinated and could be infected by the disease.
-
Spay or neuter your pets to help reduce the number of unwanted pets that may not be properly cared for or regularly vaccinated.
Avoid direct contact with unfamiliar animals:
-
Enjoy wild animals (raccoons, skunks, foxes) from afar. Do not handle, feed, or unintentionally attract wild animals with open garbage cans or litter.
-
Never adopt wild animals or bring them into your home. Do not try to nurse sick animals to health. Call animal control or an animal rescue agency for assistance.
-
Teach children never to handle unfamiliar animals, wild or domestic, even if they appear friendly. "Love your own, leave other animals alone" is a good principle for children to learn.
-
Prevent bats from entering living quarters or occupied spaces in homes, churches, schools, and other similar areas, where they might come in contact with people and pets.
-
When traveling abroad, avoid direct contact with wild animals and be especially careful around dogs in developing countries. Rabies is common in developing countries in Asia, Africa, and Latin America where dogs are the major reservoir of rabies. Tens of thousands of people die of rabies each year in these countries. Before traveling abroad, consult with a health care provider, travel clinic, or your health department about the risk of exposure to rabies, pre-exposure prophylaxis, and how you should handle an exposure, should it arise.
