Rabies - Dr. M. Zeller

​​Why is rabies important?  Rabies has the highest case fatality rate of any infectious disease, and it is entirely preventable.  Although it is rare in the United States, it is very common in the developing world and is the cause of over 20,000 deaths per year in India alone.

What is an infectious exposure?  The direct exposure of saliva, CSF fluid, or CNS material to exposed wound or mucosa places an individual at risk of infection

What is not an infectious exposure?  The direct exposure to urine, feces, or blood or exposure of saliva to intact skin does not place an individual at risk of infection.

How do we treat an exposure?  Post exposure prophylaxis (PEP) includes a combination of local wound care, a one-time dose of human rabies immunoglobulin, and a total of four doses of rabies vaccine (on day 0, 3, 7, 14).

When do we treat an animal bite?  PEP is indicated in bites caused by bats, raccoons, foxes, skunks, possums, and large rodents (beaver and woodchuck) when the animal cannot be tested within 72 hours after the exposure.  PEP is also indicated in bites caused by dogs, cats, or ferrets that cannot be observed for a 10 day period by the local health department.

When do we not treat an animal bite?  PEP is not indicated in bites caused by dogs, cats, or ferrets that can be observed for a 10 day period by the local health department, herbivores, or small rodents (rats, squirrels, etc.)

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