Rabies: Managing Suspected Exposure

By May 30, 2017Uncategorized

Rabies is generally known as a rare and dangerous disease. Thankfully, a prompt visit to the hospital or your family doctor is highly effective. Every health care provider in Ontario follows the same flow of procedures, which we will go through step-by-step in this blog so you know what to expect should you ever become infected.

Step 1: Cleaning the Wound

When you are initially bitten by a dog, cat, or ferret, the first step is to thoroughly clean the wound with soap and water, flushing it for fifteen minutes afterwards. Applying a solution of iodine or alcohol is also recommended to slow down and neutralize the spread of infection. This should happen as soon as possible, before heading to the hospital, and can be the most effective procedure in the prevention of rabies.

Step 2: Visit Your Health Care Provider/Contact the Public Health Office

These steps are grouped together because, preferably, they would happen simultaneously. A visit to your health care provider will inevitably complete both of them. The first thing your doctor will do is mindfully listen to the description of your events. If there is even the slightest chance that you might have rabies, the doctor must report it to the Public Health Office so that they can work towards a decision together. If you are unable to visit a health care provider right away, contact the Public Health Office yourself—even after hours!

Step 3: The Public Health Office Responsibilities

After being notified of a potential human exposure to rabies, the Public Health Office has a list of responsibilities to accomplish before determining whether or not the patient should receive the Rabies Post-Exposure Prophylaxis (rPEP), which is a highly successful vaccine administered after exposure:

-Collect information from you about yourself, the animal, its owner, and the exposure incident
-Track the prevalence of rabies in the community
-If the animal in question is available, arrange for it to be brought in
-If it is not available, assist in locating it
-Test the animal
-Provide rPEP medication

Step 4: Determining rPEP Administration

If the animal is readily available, the Public Health Office will observe it for 10 days after the bite, which is the maximum amount of time it takes for rabies to be detected in an animal. If the animal is completely fine following this period, the patient does not need rPEP. If rabies is detected, however, the patient should be administered rPEP. The only exception to this is if the patient has been bitten close to the neck or head, then rPEP will usually be given immediately.

If the animal is not available for observation whatsoever, the Public Health Office will use the information they’ve collected to put together a risk assessment regarding the need for rPEP. Some facts about the incident are critical to making the decision, such as:

-How common are cases of rabies in the area?
-Did the animal in question have an owner, or was it a stray?
-Was the bite provoked or did the animal approach you?
-What is the type of exposure and where did the potential infection enter the body?

Following the decision made by the Public Health Office, a patient must administer the rPEP as instructed. The flowchart for other types of animals, such as bats, rodents, and livestock can be found here at the Public Health Ontario website.