Rabies Risk Assessment: Test Your Knowledge

Erin R. Whitehouse, PhD, MPH, RN

Disclosures

August 08, 2019

Editorial Collaboration

Medscape &

With a virtual guarantee of death, rabies is a terrifying illness that is 99% fatal once symptoms develop. Fortunately, postexposure prophylaxis (PEP)—when administered soon after exposure, before the onset of symptoms—is nearly 100% effective. PEP involves a combination of human rabies immunoglobulin and rabies vaccine given according to guidelines by the Advisory Committee on Immunization Practices (ACIP).[1,2]

In the United States, exposures to rabies are largely from animal bites—particularly wildlife, such as bats, skunks, raccoons, and foxes. Transmission of rabies virus, a type of lyssavirus, by pet cats and dogs is relatively uncommon because of widespread immunization of these animals. However, all mammals, including pets, can contract rabies from wildlife and transmit the infection to people. A recently released MMWR report highlights important milestones for rabies control and underscores the need for a campaign to raise public awareness about rabies risk.[3]

Challenge yourself with these cases, developed by the US Centers for Disease Control and Prevention (CDC), that illustrate key rabies prevention and treatment situations. Would you know what to do?

Case 1: A Bat in the Bedroom

The mother of a 3-year-old boy reports that she found a bat flying in the boy's bedroom yesterday morning. The mother, conceding that she is "pretty freaked out," wants her son to be treated with PEP. She knows that bats could carry rabies and that it's fatal. The child has no apparent bite marks. Unfortunately, the boy's father captured and released the bat, so it is unavailable for testing.

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