With the summer months upon us and an uptick in animal bites in the community, Jefferson County Public Health would like to share some up-to-date information on rabies.
When determining the risk of rabies in your patient, the number one factor to consider is the type of animal the patient was exposed to. Bats are the primary carrier of rabies in Washington State. Domesticated animals only very rarely carry rabies here, with only 2 cats and no dogs testing positive since 1988.
If you are assessing a patient who has been bitten by an animal other than a bat, the primary question to determine rabies risk is if the bite was provoked. Unprovoked exposures are rare and typically require an animal to cross neutral space and attack. Ask your patient to describe the scenario in which the bite occurred – do not simply ask if the bite was provoked.
Provoked exposures may include:
- Attempting to feed an animal
- Having contact with an injured animal
- Entering an animal’s territory
- Handling an animal
- Breaking up a fight between animals
- Walking, running, or riding a bicycle past an animal
Rabies evaluations are high stakes, high stress, and uncommon, so we’ve built a flowsheet to help with risk assessment and determining the need for Post-Exposure Prophylaxis (PEP).
Rabies PEP can be lifesaving, but it is also in limited supply and incredibly expensive to patients, so it is important to be judicious in its administration. The initial dose of rabies PEP (vaccine and immunoglobulin) is only available through the ER. Need for subsequent dosing will be determined and scheduled from there, with Public Health consultation available.
Jefferson County Public Health staff are always happy to help in determining the need for rabies PEP and facilitating animal testing if needed. Please call us at (360) 385 9400, if you suspect your patient has been exposed to rabies. This number will be answered after hours.
