Rabies PEP Can Often Be Avoided with Testing or Observation

November 27, 2018

Rabies post-exposure prophylaxis (PEP), an expensive and time-consuming series of treatments, can often be avoided in situations where the animal is available for testing or observation. Rabies PEP is a medical urgency, not an emergency. PEP does not need to be started in most cases* after an exposure, allowing time to determine if PEP is necessary based on the animal’s rabies status. Rabies testing can only be performed on the brain tissue of deceased animals.

*Some instances, such as a bite/scratch from a rabid-acting animal or contact with a bat on the head or neck, may require PEP immediately prior to test results becoming available. When in doubt, contact public health for consultation.

Bats

If a person presents for medical care with confirmed or suspected exposure to a bat, the person should be asked if the bat is available. If the bat is alive, it should be captured safely, stored out of reach, and public health should be contacted immediately (509.324.1560 x 7 during business hours, 509.869.3133 after hours) for further instruction. The person will then be asked to bring the bat safely to the SRHD contracted veterinarian to send the bat for testing. The Washington State Department of Health Public Health Laboratories (WA PHL) will test the bat’s brain for rabies, and results will be reported to SRHD and the exposed individual.

If the bat is dead, it may still be testable. Leather gloves should be worn to transfer the bat to a hard plastic container. The bat should be stored in a cool place like the refrigerator or a cooler (it should not be frozen). Public health should also be contacted for further instruction as outlined above. If the brain has been destroyed or if it is dried out (i.e., the bat has been dead for some time or has decayed), the bat will not be testable and post-exposure prophylaxis will likely be recommended to exposed individuals.

Bats should never be killed by blunt force, freezing, gases, or other inhumane ways.

If the bat is unavailable for testing, SRHD will generally recommend PEP to exposed individuals.

Dogs & Cats

When provoked* bites and scratches from dogs and cats with normal appearance and behavior should be confined and observed for ten days. Stray dogs and cats can be captured and quarantined by Spokane County Regional Animal Protection Services (SCRAPS). If signs of rabies develop during observation, SRHD should be called immediately for further instruction.

If a bite or scratch occurs from a dog or cat that has been euthanized due to chronic illness or injuries, the animal should be tested if feral or stray. The animal should also be tested if the bite or scratch was unprovoked* or if the animal had a known exposure to a bat or wild animal. If the bite/scratch was provoked*, the victim can waive testing.

If unable to observe or test the animal, contact SRHD as outlined above for advice and recommendations.

*Provoked exposures may include invasion of an animal’s territory, assisting an injured animal, startling or trying to capture an animal, coming between an animal and its young, taking away food from an animal, acting aggressively toward an animal, breaking up an animal fight, etc. Provocation must always be considered from the animal’s perspective. An exposure is considered unprovoked if these behaviors are absent.