Rabies Information for Health Professionals
Rabies Disease is caused by a virus and produces acute encephalitis and is always fatal in humans. Once symptoms onset the disease is irreversible. The virus, thought to be infectious to most mammals (including bats), is spread through the bite of the rabid animal. In some cases one could be exposed if the saliva from an infected animal gets directly into a scratch, abrasion, open wound, or mucous membrane.
To learn more about animal and human rabies disease epidemiology, disease reporting and case investigation, and controlling further spread please visit the following link to the IDPH surveillance, investigation, and reporting guide (EPI Manual).
Rabies Exposure Evaluation and Treatment in Scott County
If a person has been bitten by an animal, the Health Department encourages them to immediately wash the wound with soap and water and then proceed to report the bite to animal control and contact their health care provider for further investigation regarding possible rabies exposure.
The majority of human rabies cases are caused by bats carrying the virus. Bats are a special concern because their bite can sometimes leave marks not easily seen. As a precaution this may lead to situations where people should seek medical advice even in the absence of a bite wound. For example SCHD advises individuals to seek medical advice and have the bat tested if they awaken to find a bat in their room, see a bat in the room of an unattended child, or see a bat near a mentally impaired or intoxicated person.
Following are IDPH tools physicians may use when assessing possible rabies exposures.
- Rabies Exposure Management for Bat-Related Incidents
- Iowa Rabies Exposure Assessment Tree http://www.idph.state.ia.us/adper/common/pdf/cade/rabies_exposure_all_animals.pdf
Assessing Rabies Exposure and Care Coordination
While we encourage exposure victims to contact their physician, we also encourage physicians to coordinate with Scott County Health Department. Because of the lethality of human rabies, the expense of post-exposure prophylaxis, and our evolving understanding of its epidemiology, the Scott County Health Department wants to coordinate the decision making on the evaluation and treatment of possible exposures.
We are asking that when contacted by patients regarding mammalian exposures (including bats), you have the responsible individual in the involved household call the Scott County Health Department to provide details of the potential exposure. The Health Department will ask for:
- A description of the exposure
- Demographic details about the person(s) exposed
- Identification of primary health care provider
We will then apply principles in the Iowa Department of Public Health EPI Manual and the most recent information from the Centers for Disease Control and Prevention to decide about the need for post-exposure prophylaxis as well as requirements for abatement of any material threat of ongoing exposure. Consultation with the Iowa Department of Public Health experts will be made on an as needed basis. When recommendations have been formulated, both you and your patient will be contacted with the details by Scott County Health Department.
The Scott County Health Department does not administer the post-exposure prophylaxis for victims of animal bites nor does the Health Department supply the medication. When a victim has been recommended for post-exposure prophylaxis, the Health Department staff person directs the individual back to their personal health care provider for administration of treatment. To view CDC treatment recommendations please visit the following link
- Human Rabies Prevention-United States, 2008
- ACIP Rabies Vaccine Recommendations for the Prevention of Human Rabies
Current rabies post-exposure prophylaxis regimens using rabies immune globulin and vaccine are generally very well tolerated and compatible with administration in the office setting. We ask that you make every effort to provide these services in an office setting, to avoid the expense associated with administration in the hospital outpatient setting.
The Health Department Medical Director does not advocate the use of emergency room resources for the administration of the treatment.
Obtaining Rabies Treatment Regimen
Rabies vaccine and rabies immune globulin is available through the Mississippi Valley Regional Blood Center.
It may be ordered:
- directly from the Mississippi Valley Regional Blood Center (by calling 563-359-5401 and asking for finance)
- through a hospital pharmacy.
Indigent Patient Programs for Rabies Post Exposure Treatment
Often there are questions regarding options for individuals who have had a rabies exposure who are uninsured, not covered by Medicare or Medicaid, and do not have the financial means to pay for the rabies post exposure treatment. Patient support programs for rabies post exposure treatment are available, however, the patient’s healthcare provider is responsible for application and inquiry regarding patients who may be eligible. Inquiries may be made to the following rabies treatment manufacturers.
- Sanofi-Pasteur manufactures the human rabies immune globulin and their patient support program representatives are available at 877-798-8716.
- Chiron manufactures the rabies vaccine (Rabavert), and their patient support program is managed through Rx Hope at 866-972-2437 (http://www.rxhope.com)
IMOVAX rabies vaccine (human diploid cell vaccine) is available again. For the past two years, Chiron was the only company producing rabies vaccine. During the summer and fall there is tremendous demand throughout the U.S. for the rabies post-exposure prophylaxis biologics. IMOVAX rabies vaccine is now available through Sanofi Pasteur, Inc. For more information, contact Sanofi Pasteur at 1-800-822-2463 (1-800-VACCINE) or visit http://www.sanofipasteur.us
Patient support phone number as listed above is 877-798-8716
Iowa Department of Public Health Annual Rabies Summaries
- 2010 Rabies Map
- 2009 Rabies Map
- 2008 Iowa Rabies Summary
- 2007 Iowa Rabies Summary
- 2006 Iowa Rabies Summary
- 2005 Iowa Rabies Summary
- Summary Rabies Statistics 2001-2006
For more information regarding rabies visit:
- The Centers for Disease Control
- Iowa Department of Public Health Rabies Fact Sheet