I read some posts about rabies here on AH, and there was some less than accurate information being shared. So I thought I would clarify the current prevention and treatment of rabies here.
Here are my street creds: I dabble in a lot of things, but primarily I am an emergency medicine physician with a fellowship in wilderness medicine. I am a prior military physician who has lived and travelled overseas around the world. I deal with rabies prevention and post-exposure treatment on a regular basis.
There are three aspects of rabies in humans we need to consider:
1. Active Rabies
2. Post-Exposure Prophylaxis
3. Rabies Prevention
1. ACTIVE RABIES
Once you have symptoms of rabies, you are pretty much out of luck. It is basically 100% fatal. We have a protocol to try and save an infected person's life, but it has a VERY low survival rate. Bottom line: you don't want rabies. Fortunately, getting rabies is not very common, but hunting overseas puts you in a higher-risk category than someone who doesn’t travel or doesn’t hunt.
2. POST-EXPOSURE PROPHYLAXIS
If you are exposed to an animal with rabies or exposed to an animal that MIGHT have rabies, then we initiate the Post-Exposure Rabies Prophylaxis treatment protocol.
Ideally, this is started as soon as possible after exposure (less than 24 hours is ideal, but under 72 hours is best).
Post-Exposure Rabies Prophylaxis treatment protocol has 2 parts:
A. Rabies Vaccine
B. Rabies Immunoglobulin (RIG)
A. The Post Exposure Rabies Vaccine series is a FOUR shot series given on day 0, day 3, day 7, and day 14.
This is given in the deltoid muscle. It used to be given in the abdominal wall muscles. We don't do that anymore.
This is given as soon as possible after exposure.
This is not very expensive (compared to RIG) in the U.S. averaging $50-$100 per shot.
This is used to build a very rapid immunity to rabies.
If used ALONE, this MAY stop a rabies infection even if you are bitten by a rabies-infected animal.
It is not 100% effective in preventing an infection though which is why they developed RIG
B. The Rabies Immunoglobulin (RIG) binds any circulating rabies virus, so that it cannot infect the person.
It is given as soon as possible after exposure.
It is typically injected at the site of exposure (like a bite or wound).
It is weight based, so the larger the person, the higher the dose. If the wound is smaller than can accept the full dosing of medicine (like on a finger tip), then the rest of the medicine is given in the deltoid or gluteus muscles.
RIG is VERY expensive in the US (ranging from $3,500-$25,00!)
When both Rabies Vaccine and Rabies Immunoglobulin (RIG) are used together, it is VERY effective in preventing rabies in people even if they are severely bitten by a rabies-infected animal.
3. RABIES PREVENTION (AKA PRE-EXPOSURE PROPHYLAXIS)
Rabies prevention is attained with TWO shots of the Rabies Vaccine.
Given on day 0 and day 7.
Rabies vaccines last a few years (yes, this is vague, because immunity duration is different in everyone). If you want to be really sure, you can test titers, or you can just get a booster at 1 year and then every 2-3 years.
DO I NEED A RABIES VACCINE?
Definitely, talk to your physician about this, ideally one with overseas travel experience.
The CDC has country specific recommendations for rabies pre-exposure vaccination.
https://wwwnc.cdc.gov/travel/destinations/list
Generally speaking, if you are traveling to a country with rabies AND you are “performing occupational or recreational activities that increase risk for exposure to potentially rabid animals” AND you “might have difficulty getting prompt access to safe post-exposure prophylaxis”, then it is recommended that you get the Rabies Pre-Exposure Prophylaxis vaccinations.
My take: Many places we hunt overseas are going to have rabies and we are going to be exposed to animals and we are going to be fairly remote. I would strongly consider getting the vaccines, but everyone gets to make their own choices.
Happy hunting!
Here are my street creds: I dabble in a lot of things, but primarily I am an emergency medicine physician with a fellowship in wilderness medicine. I am a prior military physician who has lived and travelled overseas around the world. I deal with rabies prevention and post-exposure treatment on a regular basis.
There are three aspects of rabies in humans we need to consider:
1. Active Rabies
2. Post-Exposure Prophylaxis
3. Rabies Prevention
1. ACTIVE RABIES
Once you have symptoms of rabies, you are pretty much out of luck. It is basically 100% fatal. We have a protocol to try and save an infected person's life, but it has a VERY low survival rate. Bottom line: you don't want rabies. Fortunately, getting rabies is not very common, but hunting overseas puts you in a higher-risk category than someone who doesn’t travel or doesn’t hunt.
2. POST-EXPOSURE PROPHYLAXIS
If you are exposed to an animal with rabies or exposed to an animal that MIGHT have rabies, then we initiate the Post-Exposure Rabies Prophylaxis treatment protocol.
Ideally, this is started as soon as possible after exposure (less than 24 hours is ideal, but under 72 hours is best).
Post-Exposure Rabies Prophylaxis treatment protocol has 2 parts:
A. Rabies Vaccine
B. Rabies Immunoglobulin (RIG)
A. The Post Exposure Rabies Vaccine series is a FOUR shot series given on day 0, day 3, day 7, and day 14.
This is given in the deltoid muscle. It used to be given in the abdominal wall muscles. We don't do that anymore.
This is given as soon as possible after exposure.
This is not very expensive (compared to RIG) in the U.S. averaging $50-$100 per shot.
This is used to build a very rapid immunity to rabies.
If used ALONE, this MAY stop a rabies infection even if you are bitten by a rabies-infected animal.
It is not 100% effective in preventing an infection though which is why they developed RIG
B. The Rabies Immunoglobulin (RIG) binds any circulating rabies virus, so that it cannot infect the person.
It is given as soon as possible after exposure.
It is typically injected at the site of exposure (like a bite or wound).
It is weight based, so the larger the person, the higher the dose. If the wound is smaller than can accept the full dosing of medicine (like on a finger tip), then the rest of the medicine is given in the deltoid or gluteus muscles.
RIG is VERY expensive in the US (ranging from $3,500-$25,00!)
When both Rabies Vaccine and Rabies Immunoglobulin (RIG) are used together, it is VERY effective in preventing rabies in people even if they are severely bitten by a rabies-infected animal.
3. RABIES PREVENTION (AKA PRE-EXPOSURE PROPHYLAXIS)
Rabies prevention is attained with TWO shots of the Rabies Vaccine.
Given on day 0 and day 7.
Rabies vaccines last a few years (yes, this is vague, because immunity duration is different in everyone). If you want to be really sure, you can test titers, or you can just get a booster at 1 year and then every 2-3 years.
DO I NEED A RABIES VACCINE?
Definitely, talk to your physician about this, ideally one with overseas travel experience.
The CDC has country specific recommendations for rabies pre-exposure vaccination.
https://wwwnc.cdc.gov/travel/destinations/list
Generally speaking, if you are traveling to a country with rabies AND you are “performing occupational or recreational activities that increase risk for exposure to potentially rabid animals” AND you “might have difficulty getting prompt access to safe post-exposure prophylaxis”, then it is recommended that you get the Rabies Pre-Exposure Prophylaxis vaccinations.
My take: Many places we hunt overseas are going to have rabies and we are going to be exposed to animals and we are going to be fairly remote. I would strongly consider getting the vaccines, but everyone gets to make their own choices.
Happy hunting!
