Most puppies that bite are exploring the world using their mouths and will interact with people in a playful way, which includes nipping and biting, and do not have rabies. However, all bites from unvaccinated animals living in regions where rabies is endemic should be investigated by a medical expert.
If the puppy has been restricted indoors, walked only on a leash outdoors, and the owner is confident that the puppy has not interacted with any wildlife or other dogs, then it is extremely unlikely that the puppy is infected with the rabies virus. A person bitten by an unvaccinated puppy that has been roaming outdoors or exposed to other animals may be at risk for the rabies virus and should seek medical advice. Even puppies that have been contained in a fenced-in backyard, may still have been exposed to high risk wildlife such as skunks, coyotes, fox, raccoons and bats, and a bite from an unvaccinated puppy is a considered a risk for contracting the disease if the puppy has not been in a restricted environment.
Yes. It is possible, though very rare, to develop clinical rabies after an incubation period of several years. Typically, the incubation period for the rabies virus is between one and three months; however, the length of the time to onset of disease symptoms can be as short as a few days to as long as several years. As long as there are no symptoms of rabies after an exposure, PEP can still prevent clinical rabies from developing. If there is a suspicion of exposure, even as long as several years ago, victims can still benefit from PEP, and should immediately consult a medical expert to determine if it is necessary.
If there is potential that there was exposure to the rabies virus, then PEP is recommended.
Yes, you will need a booster series of rabies vaccinations, to make sure that your immune system is prepared to fight off the virus. You do not need to have rabies immunoglobulin (RIG) if you have been pre-vaccinated.
If you suffered a rabies exposure but have received a complete series of rabies vaccinations within the last three months, you do not need vaccine or RIG. Thorough wound cleansing is still recommended.
Immediately after any exposure to the virus, medical attention should be sought. It is critical to remember that the bite wound must be cleaned with soap and water for 15 minutes, and anti-rabies vaccine will be needed and, often, anti-rabies immunoglobulins too. Once the clinical onset of rabies is evident, there is no cure available and death is inevitable. It is therefore extremely important to get prompt medical treatment.
Full PEP consists of thorough washing of the wound, followed by immunoglobulin injections (antibodies against the rabies virus) into the wound and a series of rabies vaccinations that are administered after an exposure occurs, to prevent disease progression. If the bite victim has never been immunized for rabies, they should always receive the vaccination and the immunoglobulin treatment. For victims who were vaccinated with a modern rabies vaccine prior to exposure, you will still need booster doses of vaccine. You will not need immunoglobulin injections.
No, you will not need to start over again if you deviate from the vaccine dosage schedule, but you should contact your doctor if a PEP injection is missed. The next dose will be given as soon as possible. Tell your doctor if you know in advance that you will miss one or more doses of PEP. In order to be protected against the disease, the full series of vaccines needs to be administered, and all doses, particularly at the start of the course, should be given at the recommended intervals wherever possible.
Pre-Exposure Prophylaxis (PrEP) is a preventative series of rabies vaccinations, before anyone is exposed to rabies. They are usually given to people considered to be at a high risk of exposure. People who are likely to come into contact with rabid animals or the rabies virus should consider rabies pre-exposure vaccinations. Veterinarians, those who work with rabies in laboratory settings, animal control workers and wildlife officers should consider pre-exposure rabies vaccination.
If you are travelling to a country where rabies is widespread, and you are likely to interact with animals far from medical help if you were bitten, you should consult your doctor about receiving pre-exposure vaccination against rabies.
If you have PrEP and are exposed to rabies you still need post-exposure prophylaxis (PEP). But, in this case, the PEP number of doses is reduced.
Routine boosters are only recommended for workers at high risk of rabies exposure, such as lab workers and veterinarians. No booster doses following a primary series of pre-exposure vaccinations or post-exposure treatment are required for individuals living in, or travelling to, high-risk areas.
The recommended booster schedule depends upon the potential risk of exposure.People at high risk of exposure should have a blood test to evaluate the presence of rabies neutralizing antibodies. The time interval between blood tests is determined by the degree of risk. Directors of rabies laboratories should have specific requirements in place to monitor the presence of rabies neutralizing antibodies in the workers. In the event that the serological titre of someone working in a rabies laboratory falls below 0.5 IU/mL, they should receive one routine booster injection.
Travelers and residents of areas of high rabies incidence can be vaccinated against rabies prior to exposure.
In areas where rabies is known to occur, people are advised to reduce their exposure to wild animals and dogs.
To prevent potential transmission to humans, household pets such as dogs, cats and ferrets should be vaccinated against rabies and have their vaccinations updated regularly.
Abnormally-behaving wildlife may be infected with the rabies virus and should be avoided. Efforts should be made to keep bats out of residences and public buildings due to the potential for unseen transmission.