HealthLink BC File #07, May 2009

Rabies

• What is rabies?
• What are the symptoms of rabies in animals?
• What should I do if I have been exposed to rabies?
• What is the treatment for rabies exposure?
• Possible Reactions after Treatment
• Who should not get the immune globulin and rabies vaccine?
• How can rabies be prevented?
• Mature Minor Consent

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What is rabies?

Rabies is a very serious and usually fatal disease caused by the rabies virus, which infects the brain and nervous system. Rabies is fatal if the disease is not prevented with shots given soon after exposure.

Symptoms include headache, fever, increasing difficulty in swallowing, excessive drooling, muscle spasm or weakness, and strange behavior.

Any mammal can carry the rabies virus. Currently in B.C., only bats are known to carry rabies and other animals have rarely been found to be rabid. In other parts of Canada, the rabies virus is found in wild animals such as bats, raccoons, skunks, foxes and coyotes. In some developing countries, dogs and other animals often have rabies.

What are the symptoms of rabies in animals?

Animals with rabies often act very strangely. Some animals may become aggressive. Wild animals often show a lack of fear of humans, and they may attack humans for no reason.

Symptoms of rabies in animals include paralysis, especially of the hind limbs and throat muscles. Rabid bats may appear normal except for a gradual weakness and loss of flying ability. Rabid bats may also come out in the daytime, which is unusual bat behaviour.

What should I do if I have been exposed to rabies?

If you are bitten or scratched by an animal that may have rabies or seems sick and behaves strangely, you should:

1. Wash the wound well with soap and warm water under moderate pressure for at least five minutes and then flush thoroughly with water. This greatly reduces the chance of infection.
2. Seek medical care from your doctor or local public health unit right away.

It is crucial to begin prevention treatment for possible rabies as soon as possible. It typically takes from 3 to 8 weeks before rabies symptoms start. If you wait until the symptoms appear, it is usually too late to start effective medical treatment. If there is any chance that you may have been exposed to the rabies virus, contact your local public health unit or family doctor. They will be able to decide if you need rabies prevention.

What is the treatment for rabies exposure?

Prevention treatment is only successful if started before symptoms appear. It involves getting both rabies immune globulin and rabies vaccine.

Rabies Immune Globulin:

• Rabies Immune Globulin (RabIg) is rabies antibodies taken from donated human blood. It is given once, usually at the same time as the first dose of rabies vaccine. RabIg is given by needle into the area(s) of the bite or scratch and in a different place on your body than the vaccine.

Rabies Vaccine:

• If you have never received rabies vaccine before, you will get 5 doses or shots in the upper arm over a 28-day period. The vaccine makes your immune system produce antibodies against the rabies virus. Antibodies are proteins that help to fight infection.
• If you have received a full series of rabies vaccine in the past, you will get 2 shots of rabies vaccine over a 3-day period. These will boost your antibodies against rabies.

Possible Reactions after Treatment

Common reactions to RabIg may include soreness or stiffness where the shot was given. Fever, headache, feeling unwell, rash, or chills may also occur.

Common reactions to the vaccine may include soreness, redness, swelling and itching where the shot was given. Fever, nausea, headache, muscle aches, fatigue and dizziness may also occur.

Report serious or unexpected reactions to your public health nurse or doctor.

Who should not get the immune globulin and rabies vaccine?

Anyone who has been exposed to the rabies virus will receive the vaccine and immune globulin. Speak with a public health nurse or doctor if you have had a life-threatening reaction to eggs or egg products.

How can rabies be prevented?

• Vaccinate your cat, dog, or ferret against rabies and keep its immunization up-to-date.
• If your pet has contact with a bat, consult your public health unit and veterinarian.
• If you find a dead bat, do not touch it. The rabies virus could enter broken skin.
• If you have come into physical contact with a live bat which can be captured, you can do the following:
1. Contact a wildlife professional or pest control company to have someone capture it; your local public health unit may be able to suggest someone to help.
2. If no one is available to capture the bat, try to capture the bat without touching it so it can be tested for rabies.
• If the bat is inside, close all doors and windows in the area. Put on a hat, leather gloves, a long-sleeved jacket, and pants.
• Use a blanket, net, broom or towel to catch the bat without touching it and protect any exposed area such as your face. Use tongs to put the bat in a sealable container. Clean the tongs with boiling water. Place the container in a cool, safe place away from human or pet contact, or put it into the freezer so the bat will go into hibernation. Do not kill the bat.
• Call your local public health unit.
• The bat will be tested for rabies. If it does not have rabies, no prevention will be necessary.


• If bats are in your attic, contact your nearest Ministry of Environment office for advice, or visit the website at www.env.gov.bc.ca/epd/ipmp/publications/brochures/bats.htm. If you are travelling for a month or more to a developing country where rabies is often found in different animals, consider being vaccinated for rabies before you leave. Get advice at a travel clinic.
• If you are attacked or bitten by any animal outside of B.C., you should get medical advice about rabies prevention treatment, no matter how long since you were bitten.
• If you receive shots for rabies exposure in another country, you should get information about the products used, including copies of the immune globulin and vaccines labels. Show them to your B.C. health care provider to make sure they are adequate. Consider returning home to Canada for medical attention.

Mature Minor Consent

Efforts are made to seek parental or guardian consent prior to immunization. Children under the age of 19 who are able to understand the risks and benefits may consent to or refuse immunizations, regardless of the parents' or guardian's wishes. It is recommended that parents/guardians and their minor children discuss immunizations beforehand, and ask the nurse or doctor any questions.

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