Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Treatment to prevent rabies has three essential
components if a high probability of viral transmission exists. Depending on the likelihood the animal has rabies and, in some cases, the availability of the animal for observation, your doctor may not initiate the latter
two steps involving shots against the rabies virus.
Wound care involving soap and a virus-killing cleanser (this should always be done for any animal bite)
A onetime injection of human rabies immune globulin (or HRIG), which is a substance that provides rapid, short-term protection against rabies
Injection of the first of a series of vaccine doses to provide protection against rabies after an exposure
The decision to treat for rabies: The likelihood of an animal having rabies depends heavily on the species of the animal, its behavior, and where you were exposed to the animal. For example, in some areas of the country, such as the Texas-Mexico border, stray dogs have an extremely high likelihood of being rabid. In other areas, stray dogs may have little chance of being rabid.
Domestic dogs, cats, and ferrets have a well-defined incubation period for the rabies virus. If you have been bitten by
one of these three animals, and the animal does not appear overtly ill at the time, then the animal will be observed by local health authorities for 10 days. If the animal remains well during that period, you will not need rabies shots.
If the animal has the potential for rabies and is available for sacrifice and immediate examination by the local health department, then treatment may be withheld pending the results of that test. This would include animals such as any wild animal, or an unwanted stray dog or cat, if you know where the animal is (dead or alive).
If the animal has the potential for rabies and is unavailable for sacrifice and examination, then you will be given rabies shots in the emergency department.
Rabies vaccination and pregnancy: Both
human rabies immune globulin (HRIG) and the various rabies vaccines are safe
Immune suppression: If you are taking medicines (such as prednisone or steroids) or have a disease that interferes with the body's
immune response to the rabies vaccine, discuss these situations with your doctor. The doctor will then determine if you will need additional blood tests to ensure that an adequate response to the vaccine has occurred and that protection against rabies is developing.