Rabies FAQ : Prevention, Part 2

by CDC

(Page 5 of 7)

I have been told I don't need rabies treatment, but I would like to receive it anyway - is this possible?

Transmission of rabies from an infected person is exceedingly rare. Rabies can be transmitted only under a few types of situations and cannot be spread through casual contact (for example, by shaking hands) or by standing close to someone. If you have been evaluated by the health department and have been advised you are not at risk for rabies, you should feel reassured that you do not need treatment. We do not recommend that the vaccine be given to persons who do not need it because there is a risk, albeit low, of side effects, including a severe allergic reaction, and it is necessary to ensure that there is enough vaccine available for persons who have had a true exposure.

I am receiving rabies PEP due to exposure to a patient with rabies - can I give rabies to other people?

Persons cannot give rabies to other people unless they themselves develop clinical signs of rabies. The treatment you are receiving will protect you from developing rabies, and therefore you pose no rabies-related risk to other people. You should continue to go to work and participate in other normal activities.

I have had contact with a person who is undergoing rabies PEP - could this person give me rabies, and should I receive PEP?

A healthy person undergoing PEP after a potential exposure does not pose a rabies risk to their contacts. A person receives rabies PEP to prevent them from developing rabies due to their exposure. PEP is not recommended for the contacts of such persons because the treated individual does not have rabies.

If a pregnant or breastfeeding woman is receiving rabies PEP, can the vaccine or human rabies immune globulin harm her unborn or nursing child?

Rabies vaccine is not known to cause birth defects or harm to unborn children. It is safe to continue breastfeeding during your treatment.

I've heard that rabies patients are infectious before they show signs of illness. What is the amount of time that they are infectious before becoming ill?

The answer for this is not fully known. Some assumptions can be made on the infectious period based on what we know in domestic animals, such as cats and dogs. These animals have rabies virus present in their saliva for only a few days before the onset of clinical signs; other animals may have virus in their saliva longer. Because the infectious period is not fully known for humans, public health officials are recommending that anyone with nonintact-skin or mucous-membrane contact with saliva from the donor or transplant recipient within 14 days before and anytime after the patient's onset of illness receive PEP.

Who should I contact if I have more questions about my specific situation?

A:You should contact your state or local health department for more information about your specific situation.

I visited or received care at a hospital where a rabies patient was treated - am I at risk for rabies?

No, in such circumstances you would not have been exposed to rabies.

Prevention: Healthcare Settings

I am a healthcare worker who handled rabies-infected organs as part of the procurement or transplant procedure - am I at risk for rabies?

Healthcare workers who may have handled an organ to be transplanted are at low risk for exposure because the virus is contained within the nerve tissue of the organ. Organ manipulations that might generate sprays or splashes containing nerve tissue theoretically pose a risk for exposure to the rabies virus. The use of Standard Precautions (i.e., gowns, gloves, and mask with goggles or face shield when indicated) would prevent such exposure; rabies PEP would be recommended in this situation only if Standard Precautions were not used and an exposure occurred.

I am a healthcare worker who took care of a rabies patient after or shortly before they developed clinical signs of rabies - am I at risk for rabies?

There are no known cases of rabies transmission to healthcare workers caring for patients with rabies. According to the 1999 ACIP human rabies prevention and control recommendations, any bite from a human rabies patient is an obvious exposure to rabies. The contamination of open wounds, abrasions, or mucous membranes with saliva or other potentially infectious material (such as neural tissue and other innervated tissue) from a rabid human also constitutes a non-bite exposure. Other contact by itself, such as touching a rabid human and contact with blood, urine, cerebrospinal fluid or feces of a rabid human, does not constitute an exposure and is not an indication for prophylaxis. Routine delivery of health care to a patient with rabies is not an indication for post-exposure prophylaxis unless an accident with sharp instruments or needles occurred (i.e., a penetrating wound from a contaminated sharp instrument) or lack of personal protective equipment allowing contamination of mucous membrane or non-intact skin with potentially infectious material (i.e., droplet splashes to the eyes, nose or mouth). Adherence to standard precautions as outlined by the Hospital Infection Control Practices Advisory Committee will minimize the risk of exposure.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.