By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HAVING PROMPT RABIES SHOTS MAY HAVE SAVED READER’S LIFE

Question: My cat brought home an almost dead bat the other day. Without thinking, I reached down to get the bat away from the cat, and I got scratched by the bat. I went to the ER and was treated with a couple of different rabies vaccines. Can you tell me more about rabies and treatment for exposures? By the way, the cat is fine.

Answer: Rabies is a viral infection of the nervous system in humans and mammals. By far the most common way a human gets rabies is when he or she bitten by an infected animal. Rarely, rabies has been transmitted to a person through contact with an animal’s saliva or other body fluid without the history of a bite. Once the symptoms of rabies appear, the disease is nearly always fatal. That’s why public health officials usually err on the side of caution when deciding whether or not to administer the life-saving rabies vaccine.

Any mammal can get rabies. Rabies is most common in wild animals such as raccoons, skunks, foxes, coyotes and bats. Domestic animals, such as cows and cattle can also get rabies. Due to aggressive vaccination programs in the United States, most cases of rabies in the dog and cat population have been eliminated.

Usually, as in your case, rabies vaccine is given promptly after the exposure. There are exceptions, however. People who are at high risk for contact with rabid animals -- like veterinarians, animal handlers and people who frequent caves -- are often given rabies vaccine even if they haven’t been bitten. This is called a “prophylactic” or preventive vaccination. In other parts of the world, rabies among dogs is still quite prevalent, so some international travelers also get pre-exposure rabies vaccine.

It appears that you managed your exposure well. I assume the wound was cleaned with antiseptic solution. One of the shots you got was the rabies immune globulin. This contains some “ready to go” antibodies to rabies. This was then followed by the rabies vaccine, which stimulates your own body’s rabies antibodies. The rabies vaccine is a series of five shots that are given at specific intervals. While we have all heard the stories about having to get shots “in your stomach,” the modern vaccine is given in your arm -- like a flu shot -- and is usually just as painless. In your case, having this shot may easily have saved your life.

Rabies prevention is always preferable to treatment. Keeping your animals, such as dogs, cats, and ferrets vaccinated protects not only your pet but also you and your whole family. That is, if they are bitten by a rabid animal they won’t develop the disease and be able to pass it on to anyone else.

Other good preventive steps are basically common sense. Stay away from wild animals, especially raccoons, skunks and foxes. Don’t handle or feed wild animals. Never adopt wild animals or nurse sick animals in your home. The illness they have may be rabies. Bat-proof your house by plugging small holes and repairing torn screens.

And, if you’re traveling abroad, avoid wild animals, and stay away from dogs. In other parts of the world, human rabies claims thousands of lives annually.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.