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Treatment of Rabies

If an animal that is possibly infected with rabies bites you, you must be treated promptly. Rabies is fatal once symptoms develop. Medical advice should be sought for any animal bite, and a tetanus injection given.

Symptoms can usually be prevented from developing if proper treatment is started immediately after being bitten. Early treatment is especially important following bites on the face. Immediately after being bitten, you should:

  • Wash the wound thoroughly with soap and water under a running tap.
  • Use antiseptic or alcohol to clean the wound, if available.
  • Apply ethanol, tincture or aqueous solution of iodine, if available.
  • Leave the wound open. Do not attempt to stitch it.
  • Go to the nearest doctor or hospital and explain you have been bitten.

If you have not been vaccinated before you were bitten, human rabies immunoglobulin (HRIG), also known as ‘passive immunisation’, will be injected around the bite to neutralise the virus before it gets into the body. This substance binds to the virus so that the immune system can destroy it. In addition, a longer-lasting rabies vaccine (active immunisation) should be given in 5-6 doses over 30 days. The vaccine is given into the arm and is relatively painless, with minimal side effects that may include headaches, fever, nausea, muscle aches, and dizziness.

If you have already been vaccinated before being bitten (the pre-exposure vaccine), two doses of the rabies vaccine will be given: one at the time of the bite, and one 3-7 days later. The body should respond to treatment quickly. The immunoglobulin is not generally needed in this instance.

  • Although human-to-human contact is not known to have happened, anyone who has had intimate contact with an infected person should also be treated with the vaccine.
  • Where possible, the suspect animal should be captured and observed for 5-10 days (see ‘diagnosis’).
  • Inform the police and relevant authorities.
  • If you are abroad, seek medical advice on your return to the UK.

If the infected person is not treated and symptoms have developed (see ‘symptoms’), rabies is said to be ‘established’. In this situation, nothing can be done, except keep them comfortable. They should be nursed in a darkened room and their symptoms kept under control with equipment and medication. Death is now almost inevitable.

A very small number of patients with established rabies have been successfully treated, using heavy sedation and intensive care facilities to maintain the action of the heart and the respiratory system, but those who have survived have suffered long term disability.