Rabies Virus

Once the virus reaches the brain there is no treatment available and the disease is inevitably fatal. However if a person is bitten by an animal and there is a chance of having been exposed to rabies, there are steps that will help combat the risk of contracting the disease. The process of accomplishing this is termed “post exposure treatment”. The recommendations given here are sourced from the public health agency of Canada’s website and are not meant as a replacement for those guidelines, which can be found at:

http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-rabi-rage-eng.php#epi

 

Post exposure prophylaxis is undertaken following the evaluation of the probability the animal had rabies (vaccination status, behavioral signs, detection of rabies in the brain) and the susceptibility of the patient (vaccination status, type of exposure, severity of wound, age, immune status).

 

If someone is bitten by a potentially rabid animal they ought to follow these procedures;

1. Clean the wound using warm water and soap to remove the virus from the injury. This is a crucial step in decreasing the numbers of the potential virus in the host.

2. If directed by their health care professional, post exposure prophylaxis should be initiated. 

   • In the immune-competent (otherwise healthy) patient 4 rabies vaccines will be given on days 0,3,7 and 14 following exposure.  In addition to this, rabies immunoglobulin (a neutralizing antibody) will be administered. If the patient has not been previously vaccinated and is immune-compromised a 5th vaccine would be administered on day 28.

   • If the patient has previously been vaccinated for rabies post exposure prophylaxis 2 more vaccines on days 0 and 3 will be undertaken for treatment. It is crucial that rabies immunoglobulin (the neutralizing antibody) should not be provided to these patients.

Post exposure prophylaxis is provided in order to increase the levels of circulating antibodies in order to combat the virus propensity to enter the CNS. Exposure within this tissue is fatal to its host.