Rabies

Provide local wound care and consider antibiotics and possible surgical consultation for infected wounds. Consult local health departments for guidance

Give rabies vaccine concurrently with rabies immunoglobulin (RIG), with RIG given only with first dose of vaccine

Consider the need for tetanus prophylaxis

Bite

• What type of animal bit the patient?
• Is the animal available for testing?
• Has the human or animal who bit the patient been vaccinated for rabies previously and was the vaccine received over 90 days prior?
  • If yes, no vaccine necessary

Non-bite: vaccinate only if wet saliva introduced into fresh wound

• Finding a bat in a room where someone was sleeping is considered a possible bite.

Bats

• Available for testing: do not administer rabies vaccine
  • Animal should be submitted to local health department for testing
• Not available for testing - administer vaccine
  • Including if unsure of bite (e.g., child sleeping in room with a bat)

Wild terrestrial carnivores (e.g., raccoons, skunks, foxes)

• Available for testing: do not administer rabies vaccine
  • Animal should be submitted to local health department for testing
  • Can still administer vaccine if either:
    • High clinical suspicion based on behavior
    • No testing of animals through the health department
• Not available for testing: administer rabies vaccine

Other wild animals

• Small rodents (squirrels, rats, chipmunks): do not administer (not reservoirs)
• Lagomorphs (rabbits/hares): do not administer (no known transmission)
• Other wild animals: consult local health department

Human bite

• do not administer rabies vaccine No documented human-to-human exposure outside of organ transplant

Domesticated animals (e.g., dog, cat, ferret)

• Available for quarantine: do not administer rabies vaccine
  • Unless animal suspicious for infection: administer rabies vaccine
  • Observe the animal for 10 days
• Not available for quarantine
  • Consult local health department for guidance on local epidemiology