With a virtual guarantee of death, rabies is a terrifying disease that is 99% fatal once symptoms develop. Fortunately, post-exposure prophylaxis (PEP) – when given shortly after exposure, before symptoms appear – is almost 100% effective. PEP is a combination of human rabies immunoglobulin and rabies vaccine administered according to the guidelines of the Advisory Committee on Immunization Practices (ACIP).[1,2]
In the United States, rabies exposures largely come from bites from animals, especially wild animals, such as bats, skunks, raccoons, and foxes. Transmission of the rabies virus, a type of lyssavirus, by companion cats and dogs is relatively rare due to the widespread immunization of these animals. However, all mammals, including domestic animals, can contract rabies from wild animals and transmit the infection to humans. A recently released MMWR report highlights important steps for rabies control and underscores the need for a campaign to educate the public about the risk of rabies.
Challenge yourself with these cases, developed by the U.S. Centers for Disease Control and Prevention (CDC), which illustrate key rabies prevention and treatment situations. Would you know what to do?
Case 1: A bat in the bedroom
The mother of a 3-year-old boy reports that she found a bat flying in the boy’s room yesterday morning. The mother, conceding that she is “quite panicked”, wants her son to be treated by PEP. She knows that bats can carry rabies and that it is deadly. The child has no apparent bite marks. Unfortunately, the boy’s father captured and released the bat, so it is not available for testing.