HealthLinkBC File #07, August 2013
- What is rabies?
- What are the symptoms of rabies in people?
- 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?
- What are possible reactions after treatment?
- Who should not get the rabies immune globulin and rabies vaccine?
- How can rabies be prevented?
- Mature Minor Consent
What is rabies?
Rabies is a very serious and usually fatal disease caused by one of a number of rabies viruses. The virus infects the brain and nervous system of mammals and is fatal in humans if the disease is not prevented by immunization soon after exposure.
Any mammal can be infected by the virus. In B.C., only bats carry the rabies virus and other animals are rarely infected. In other parts of Canada and North America, rabies can be carried by other species such as raccoons, skunks, foxes and coyotes. Worldwide, unimmunized dogs are the most common carrier of rabies virus.
What are the symptoms of rabies in people?
Symptoms of the disease include:
- increasing difficulty in swallowing;
- excessive drooling;
- muscle spasm or weakness; and
- strange behavior.
The majority of people with rabies die of the disease.
What are the symptoms of rabies in animals?
Animals with rabies may act very strange. Two types of behavior seen in animals with rabies are 'furious' and 'dumb'. The furious form causes some animals to show aggression, while the dumb form results in animals being sick and lethargic.
Another symptom of rabies in animals includes paralysis, or loss of muscle function, especially of the hind limbs and throat muscles. In addition, infected bats may act strangely. Normally, bats are usually only seen at night, but infected bats may be seen during the day. They may also appear weak and lose their ability to fly.
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 do the following:
- Wash the wound well with soap and warm water under moderate pressure for at least 15 minutes. This greatly reduces the chance of infection.
- Seek medical care from your health care provider or local public health unit right away.
It is crucial to begin prevention treatment for rabies as soon as possible. It typically takes from 3 to 8 weeks before rabies symptoms start but can be much longer. 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 health care provider, no matter how long since you were exposed. They will be able to decide if you need rabies prevention treatment.
What is the treatment for rabies exposure?
Prevention treatment only works if it is started before symptoms appear. It involves getting both rabies immune globulin and the rabies vaccine.
Rabies Immune Globulin:
- Rabies Immune Globulin (RabIg) contains rabies antibodies taken from donated human blood. It is given once, usually at the same time as the first dose of the 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.
- If you have never received the rabies vaccine before, you will get 4 doses in your upper arm over the course of 2 weeks. If you have a weakened immune system because of disease or medications or are taking chloroquine (a drug to fight malaria) you will get 5 doses. 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 doses of rabies vaccine over 3 days. These will boost your antibodies against rabies.
What are possible reactions after treatment?
Common reactions to rabies immune globulin may include soreness, redness and hardening of the skin where the injection was given. You may also have a fever and headache.
Common reactions to the rabies vaccine may include soreness, redness, swelling and itching where the vaccine was given. You may also experience fever, nausea, headache, muscle aches, fatigue, and dizziness.
It is important to always report serious or unexpected reactions to your health care provider.
Who should not get the rabies immune globulin and rabies vaccine?
Anyone who has been exposed to the rabies virus will receive the rabies vaccine and immune globulin. Speak with a health care provider if you have had a life-threatening reaction to eggs or egg products.
How can rabies be prevented?
- Immunize 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:
- 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.
- If no one is available to capture the bat, you may 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.
- Without touching the bat, use a shoebox, coffee can, cooking pot or similar container to cover the bat.
- Slide a piece of cardboard underneath to cover the opening.
- Place the covered container in a cool place away from human or pet contact.
- Do not kill the bat.
- Contact the public health unit for further instructions.
- Clean the container with boiling water.
- Close the door and open the windows to let the bat fly out on its own. Leave the room until the bat escapes.
- If this is not possible, contact a wildlife professional or pest control company to have someone capture it.
Mature Minor Consent
It is recommended that parents or guardians and their children discuss consent for immunization. Efforts are first made to seek parental/guardian or representative consent prior to immunization. However, children under the age of 19, who are able to understand the benefits and possible reactions for each vaccine and the risk of not getting immunized, can legally consent to or refuse immunizations.
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