Animal Bites: Assessing Risk for Rabies and Providing Treatment

Abstract

1. Mark Rapoport, MD, MPH* 1. 2. *Medical Director Medicaid Programs Oxford Health Plan New York, NY 1. Rabies Virus . Fishbein DB, Bernard KW. In: Mandell C, Bennett J, Dolin R, eds. Principles and Practices of Infectious Diseases . 1995:527-543 Churchill Livingstone New York, NY 2. Rabies Prevention—United States, 1991 . Centers for Disease Control. MMWR . 1991;40:RR-3 [OpenUrl][1] 3. Human Rabies—New York, 1993 . Centers for Disease Control. MMWR . 1993;4241:799-805 [OpenUrl][2][PubMed][3] 4. Beneson A. Control of Communicable Disease Manual . 1995:382-390 Washington, DC.: APHA Rabies kills relatively few persons in the United States, but more than 30,000 people worldwide die each year from the disease. Three facts govern our approach to rabies: 1) It is a disease uniformly fatal once symptoms appear; 2) We have a low-toxicity, virtually 100% effective vaccine; and 3) We lack a definitive test for actual exposure (except when the biting animal is available for testing). Rabies virus can infect any mammalian species. A given strain may infect one species predominantly, but can be passed into and by any other species. Periods of communicability and incubation are defined only for domestic dogs and cats and for some farm animals. For all other animals suspected of having rabies after biting, euthanasia and subsequent testing are required to rule out risk of human disease. In addition to the human vaccine, there are vaccines available for dogs, cats, and some other domestic species. A raccoon-associated rabies epidemic is present in much of the eastern part of the United States. Outbreaks associated with foxes, coyotes, and dogs exist elsewhere. Rabies spread by bats is present across most of the country. Although most bites in which rabies exposure … [1]: {openurl}?query=rft.jtitle%253DMMWR.%26rft.volume%253D40%26rft.spage%253DRR%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: {openurl}?query=rft.jtitle%253DMMWR.%2B%2BMorbidity%2Band%2Bmortality%2Bweekly%2Breport%26rft.stitle%253DMMWR%2BMorb%2BMortal%2BWkly%2BRep%26rft.volume%253D42%26rft.issue%253D41%26rft.spage%253D799%26rft.epage%253D%2B806%26rft.atitle%253DHuman%2Brabies--New%2BYork%252C%2B1993.%26rft_id%253Dinfo%253Apmid%252F8413167%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [3]: /lookup/external-ref?access_num=8413167&link_type=MED&atom=%2Fpedsinreview%2F18%2F4%2F142.atom