What is rabies?
- Rabies is a dangerous viral infection that humans can get from infected animals; it attacks the nervous system. Rabies is found worldwide, but it is rare in Canada.
- Early symptoms of the disease usually show up from 3 to 8 weeks after exposure, and include numbness near the bite, fever, headache and feeling unwell, leading eventually to delirium and paralysis and death. Once symptoms appear, rabies is nearly always fatal.
- It is spread through close contact with the saliva (fluid from the mouth) of infected animals, most often from a bite or scratch, but occasionally from licks on broken skin or mucous membranes (the skin lining the mouth, nose or eyelids).
- Skunks, bats, raccoons and foxes are the most common wildlife carriers of rabies in Canada, and they can transmit to people, dogs, cats and livestock.
- It is difficult to feel or see the mark of a bat’s bite, so if you are directly exposed to a bat, you should seek medical help immediately; you will likely need the post-exposure vaccine.
- Rabies is more common in developing countries where stray animals, especially infected dogs, live close to humans;it is best to avoid touching stray or wild animals.
Who needs the rabies vaccine?
- The rabies vaccine helps to protect individuals from developing rabies after they have been bitten, licked or scratched by an animal with rabies. The vaccine may be given either:
- Pre-exposure, to protect certain people at high risk, e.g. some travellers, just in case they ever come into contact with a rabid animal. It involves 3 doses of rabies vaccine—one injection per day on days 0, 7, and 21 or 28 OR
- Post-exposure, as a precaution / treatment, after an incident with a proven or suspected rabid animal. It involves both rabies vaccine and rabies immune globulin—RabIg—which is a sterilized blood product containing concentrated amounts of rabies antibodies:
- 4 doses of rabies vaccine to help you make your own antibodies, with one injection per day on days 0, 3, 7 and 14 (plus a fifth dose of vaccine on day 28 if you have immune system problems or you are taking anti-malarial medication).
- several injections of RabIg at the same time, preferably on the first day of treatment (day 0), but it may be given up to and including day 7.
Who should get the rabies pre-exposure vaccine?
- Any individual at high risk of exposure to rabid animals
- veterinarians and veterinary staff, animal control and wildlife workers.
- certain laboratory workers exposed to live rabies virus.
- spelunkers (cave explorers).
- hunters and trappers in high-risk areas, such as the Far North.
- workers / travellers to developing countries, if high risk of rabies and limited access to post-exposure treatment (e.g. children who touch stray animals).
Who should get the publicly funded (free) rabies post-exposure treatment?
- Anyone who has had direct contact with the infected saliva of a proven or suspected rabid animal should immediately receive rabies vaccine and rabies immune globulin.
Who should not get the rabies vaccine?
Pre-Exposure
- Anyone who has had a serious allergic reaction to this vaccine in the past, or to any component of the vaccine
- RabAvert® – rabies antigen, polygeline (bovine gelatin), human serum albumin, neomycin, chlortetracycline, amphotericin B, chick protein – ovalbumin, potassium glutamate, sodium EDTA. Does not contain latex.
- Imovax Rabies® – rabies antigen, human albumin, MRC-5 human diploid cells, beta propiolactone, neomycin, phenol red. Does not contain latex.
- Anyone with a high fever or moderate to severe illness should wait until they feel well to get the pre-exposure vaccine.
- Anyone who is pregnant or lactating should delay pre-exposure vaccination unless high risk of exposure and it is clearly necessary.
Post-exposure
- There are no contraindications to post-exposure treatment if there is a significant exposure to a proven rabid animal.
What are the common side effects of the rabies vaccine?
- Some people may feel sore, swollen or itchy for a few days where the needle was given and have general muscle aches, headaches, dizziness, and / or feel unwell for a day or two.
- Tylenol® or ibuprofen may be taken afterwards, as directed, to reduce discomfort or fever.
- Children under 19 years of age must NOT be given ASA, Aspirin® or salicylates.
What else do I need to know?
- Avoid animals acting in a highly unusual way, e.g. aggressive, disoriented or too tame.
- If an animal attacks for no reason, it is more likely to be rabid.
- If bitten, scratched or licked on broken skin or mucous membrane by a possibly rabid animal, immediately wash and flush the affected area for at least 15 minutes with soap and water and disinfectant.
- You should also receive a tetanus booster (Td or Tdap, which includes the one recommended adult dose of pertussis) if you have not had a booster in the past 10 years.
- A rabies booster may be given every 2 to 5 years, for frequent high-risk exposure.
When should I seek medical attention after immunization?
- If you or your child experiences any unusual side effects, seek medical attention and notify public health.
- Go to Emergency at a hospital right away or call 911 if you or your child has any of the following after immunization:
- swelling of the face and neck
- problems breathing
- hives and itchy, reddened skin
Your Record of Protection
After you receive any immunization, make sure your health care provider updates your personal immunization record. Keep it in a safe place. Please inform us of any immunizations not received from Public Health.
