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Rabies Prevention - Vaccinating Animals and Post-Exposure Prophylaxis

across the world there are about 60,000

deaths per year from rabies but there's

only one to three per year in the US now

why is that well in many developing

countries like India which has 25,000 to

30,000 reported cases a year dogs are

not routinely vaccinated and rabid dogs

bite people and that's where you get the

most cases in the u.s. we vaccinate dogs

against rabies and that knocks out a

huge source of infection it's the most

effective method of prevention that we

know of but there are other ways to get

infected in the u.s. mainly bats as well

as raccoons skunks foxes so the second

most important prevention method is to

avoid all of those but failing that

there's something else that's really

important to know about remember how

rabies has that long incubation period

well it turns out that if we intervene

during the incubation period we can

actually prevent the disease so if we

think someone has been exposed and might

be incubating we begin an intensive

protocol which we call post exposure

prophylaxis and I'll tell you exactly

what that protocol is but first what

exactly qualifies as an exposure there's

no easy answer to that it depends on a

lot of factors including your location

what animal you were exposed to whether

you were bitten etc but to give you an

idea any time you've been around a bat

and you don't know 100% for sure that

you haven't been bitten because bat

bites can actually be really small and

hard to notice that counts as an

exposure if you're bitten by a

vaccinated dog in Manhattan and it's a

provoked bite that's not an exposure if

you're bitten by a feral dog in India

that is an exposure now note that if you

have an exposure like I described to a

bat or any other potentially rabid

animal you can still avoid getting post

exposure prophylaxis if you're able to

somehow collect the animal and get it

tested or observe it and show that it

doesn't have rabies

but barring that you need post exposure

prophylaxis so what is it well it's the

following first wound cleansing where

the wound is the bite second four doses

of

rabies vaccine the first one immediately

and the next ones in the following days

although you need fewer if the person's

been previously vaccinated and the idea

here is to give a big boost to the

person's immune system while the rabies

virus is incubating and third you're

gonna give rabies immune globulin

administered around the wound and also

intramuscularly now if you don't know

where the bite is you still give the

immune globulin but make sure you don't

give it in the same spot as the vaccine

because you want to avoid all of the

immunoglobulin binding to and

deactivating the vaccine locally now you

can skip this whole step if the person

has previously been vaccinated against

rabies now this is pretty complex but

rabies is so serious that most places

have 24-hour rabies hotlines that you

can call to guide you through this whole

process

so that's post exposure prophylaxis and

it's very effective almost a hundred

percent so that's the really good news

about rabies now you might have gotten a

little confused when I said rabies

vaccine because you might be wondering

why don't we just give everybody the

rabies vaccine since rabies is so deadly

and the answer is we don't because one

it's expensive to it requires a lot of

shots and the logistics are difficult

and three since only one to three people

get it in the u.s. each year it's not

worth it we only recommend the vaccine

for vets and other professions with a

high chance of exposure