The determination of whether to administer vaccine and anti-rabies
serum should be made only after examination of the patient, examination of the animal
(if possible), and careful evaluation of the circumstances.
The surgeon of each major command is responsible for establishing
a rabies advisory board within his area of medical technical supervision.
-- This board, composed of carefully selected physicians and a
veterinarian, must be readily available for consultation to all facilities administering
specific anti-rabies prophylaxis.
-- The World Health Organization (WHO) recommends similar
boards for civilian communities and facilities.
(2) Local treatment of the bite wound. Treating the bite wound as soon as
possible after the bite is probably the most important single procedure in preventing
First aid treatment consists in immediately washing and flushing the
wound with soap and water, detergent, or water alone. This procedure is recommended
in all bite wounds, including those unrelated to possible rabies exposure.
Following first aid treatment, specific post-exposure treatment should
be administered by or under the direction of a physician. This treatment consists of:
-- Adequate cleansing of the wound.
-- Then, thorough treatment of the wound with 20 percent soap
solution and/or application of a quaternary ammonium compound or other substance of
proven lethal effect on the rabies virus.
-- Topical application and infiltration around the wound of anti-rabies
-- Administration, where indicated, of anti-tetanus procedures and/or
antibiotics to control infections other than rabies.
Section IV. ZOONOSES: LEPTOSPIROSIS
Leptospirosis is actually a collective term for a group of acute infections caused by
many serotypes of the genus Leptospira (a spirochete). The disease is also known as
Well's disease, infectious jaundice, and Fort Bragg fever.