Rabies Symptoms, Causes, Treatment - Can rabies be prevented? on MedicineNet

Rabies (cont.)

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Medical Author:

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Mary D. Nettleman, MD, MS, MACP

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.

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Medical Editor:

Melissa Conrad Stöppler, MD

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.

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Can rabies be prevented?

Yes. There are several ways to prevent rabies. The best way to prevent animals from getting rabies and completing the rabies life cycle is by large-scale vaccination programs. Most developed countries have programs to vaccinate pets and many have additional programs to reduce or eliminate rabies in many wild animals. The few incidences per year in most developed countries are good indications of how successful these programs have been at preventing rabies. England was successful in eliminating rabies from the country until it was recently found again in a bat population. Preexposure vaccination is recommended by the CDC in certain circumstances (outlined as follows):

Rabies preexposure prophylaxis guide (by CDC)
Risk category	Nature of risk	Typical population	Preexposure recommendations
Continuous	Virus present continuously, often in high concentrations. Specific exposures likely to go unrecognized. Bite, non-bite, or aerosol exposure.	Rabies research laboratory workers; rabies biologics production workers.	Primary course. Serologic testing every six months; booster vaccination if antibody titer is below acceptable level.
Frequent	Exposure usually episodic, with source recognized, but exposure also might be unrecognized. Bite, non-bite, or aerosol exposure.	Rabies diagnostic lab workers, spelunkers, veterinarians and staff, and animal-control and wildlife workers in rabies-enzootic areas. All people who frequently handle bats.	Primary course. Serologic testing every two years; booster vaccination if antibody titer is below acceptable level.
Infrequent	Exposure nearly always episodic with source recognized. Bite or non-bite exposure.	Veterinarians and terrestrial animal-control workers in areas where rabies is uncommon to rare. Veterinary students. Travelers visiting areas where rabies is enzootic and immediate access to appropriate medical care including biologics is limited.	Primary course. No serologic testing or booster vaccination.
Rare (population at large)	Exposure always episodic with source recognized. Bite or non-bite exposure.	U.S. population at large, including people in rabies-epizootic areas.	No vaccination necessary.

This article is not designed to cover every aspect of rabies in animals, but in this section, a short presentation of how dogs can be vaccinated is an example of how prevention can be easy and effective seems appropriate:

Puppies get vaccinated at age 9-16 weeks (some suggest to wait until age 12 weeks).
Adult dogs can get a yearly vaccination; some states only require a vaccination every three years.
Consult a veterinarian for local laws on rabies vaccination; get a vaccine certificate and keep it.
A dog without a vaccine certificate that bites a human (in the U.S.) is at risk for being impounded or euthanized; its owner may be subjected to fines and lawsuits.
Costs are relatively low; about $20-$30 per year for dog vaccine and tag (vaccine certificate included).

Another way to reduce or eliminate rabies is to vaccinate wild animals. Although it may be difficult to eliminate the disease, ongoing attempts reduce the chance a wild animal will develop the disease. For example, in 2011 in Texas, health officials announced that the oral vaccine for wild animals, Raboral V-RG vaccine, would be placed in bait for coyotes and foxes. The vaccine-treated bait is safe, even if ingested by domestic animals, but is not approved for use in domestic animals.

Finally, people should avoid any animal that is behaving oddly (see rabies transmission section above) and call authorities to handle the animal. Exposure to bat guano carries a small risk of rabies; filter masks that can stop two micron-sized particles may offer some protection against aerosolized guano. These actions should reduce the chances an individual will be exposed to rabies virus.

Reviewed by Mary D. Nettleman, MD, MS, MACP on 4/18/2012

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