c. Coordination of the Bite Case. The bite should be reported to the local
authorities. The animal bite report should be completed in the emergency room on the
initial treatment and copies of the report sent to the Rabies Advisory Board, the post
veterinarian, and to the provost marshal. The report should provide a description of the
circumstances surrounding the bite, the species of the offending animal (very
important), and if the bite resulted from a provoked or nonprovoked attack. It must be
established if the animal was disturbed while eating, or if the bite occurred during
actions that an animal might interpret as threatening. It is important to know if the bite
occurred while there was involvement with the animal's offspring, while attempting to
capture a wild animal, or in a case where the animal was defending its territory.
d. The Biting Animal. If the bite resulted from a domestic animal (dog or cat),
the animal should be captured, confined, and observed by a veterinarian for a 10-day
quarantine. The vaccination status of the animal must be verified. Much depends upon
the location of the wound, the length of time before first aid was given, and the quality of
the first aid. In the case of wild animal bites, attempts should be made to capture the
animal, sacrifice it, and ship the head (iced) to the nearest laboratory that is qualified to
make a determination if the animal was rabid. If the animal cannot be examined, it
should be presumed to be rabid.
e. Treatment. Based on the recommendations of the US Public Health
Service Advisory Committee and upon study of the circumstances of the bite, the
physician decides the best course of treatment to follow.
f. Prevention and Control of Rabies. Public education is necessary to inform
the population about this very severe illness that has an almost universal fatal outcome.
Once the symptoms appear, death inevitably occurs after 2-3 days either from cardiac
or respiratory failure or generalized paralysis. Owners should ensure that their pets are
vaccinated on a timely basis and pets should be confined or walked on a leash. Some
states have very heavy fines for pets unleashed while others are very lax and leave this
requirement up to the owner. It is not wise to pick up loose pets and strays because
they could be rabid, but appear to be in good shape for the time being. For high-risk
individuals (veterinarians, animal handlers), pre-exposure prophylaxis with vaccine must
be considered. The contact potential between wildlife and domestic animals should be
reduced.
MD0589
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