It is very important to report animal bites to Public Health so a case investigation can start. Public Health can help determine if the person that was bitten is in need of Post-Exposure Rabies Vaccine.
In the event that you are bitten by a dog or cat that you can identify, please monitor the animal for 10 days and call Public Health at 406-665-8720. In the event that the animal is unknown, please call Public Health to determine if you need Rabies Vaccine. Rabies can come from dogs, cats, bats, racoons etc.
Rabies virus causes an acute encephalitis in all warm-blooded hosts and the outcome is almost always fatal. The first symptoms of rabies may be nonspecific and include lethargy, fever, vomiting, and anorexia. Signs progress within days to cerebral dysfunction, cranial nerve dysfunction, ataxia, weakness, paralysis, seizures, difficulty breathing, difficulty swallowing, excessive salivation, abnormal behavior, aggression, and/or self-mutilation1.
***The only way to test for rabies in an animal is to send off for testing.
People are usually infected following a deep bite or scratch from an animal with rabies, which is, in 99% of the cases, a dog. Transmission can also occur if saliva of infected animals comes into direct contact with mucosa (e.g. eyes or mouth) or fresh skin wounds.
In the Americas, hematophagous bats are now the major source of human rabies deaths as dog-mediated transmission has been largely interrupted in this region. Bat-mediated rabies is also an emerging public health threat in Australia and western Europe.
Human deaths following exposure to foxes, raccoons, skunks, jackals, mongooses and other wild carnivore host species are very rare, and bites from rodents are not known to transmit rabies.
Contraction of rabies through inhalation of virus-containing aerosols or through transplantation of infected organs has been described, but is extremely rare. Human-to-human transmission through bites or saliva is theoretically possible but has never been confirmed. The same applies to the transmission to humans via consumption of raw meat or milk of infected animals.
Post-exposure prophylaxis (PEP)
Post-exposure prophylaxis (PEP) is the emergency response to a rabies exposure. This prevents the virus from entering the central nervous system, which would invariably result in death. PEP consists of:
- extensive washing with water and soap for at least 15 minutes and local treatment of the wound as soon as possible after a suspected exposure;
- a course of potent and effective rabies vaccine that meets WHO standards; and
- the administration of rabies immunoglobulin or monoclonal antibodies into the wound, if indicated.
Exposure risk and indications for PEP
Depending on the severity of the contact with the suspected rabid animal, administration of a full PEP course is recommended as follows:
|Categories of contact with suspect rabid animal
|Post-exposure prophylaxis measures
|Category I – touching or feeding animals, animal licks on intact skin (no exposure)
|Washing of exposed skin surfaces, no PEP
|Category II – nibbling of uncovered skin, minor scratches or abrasions without bleeding (exposure)
|Wound washing and immediate vaccination
|Category III – single or multiple transdermal bites or scratches, contamination of mucous membrane or broken skin with saliva from animal licks, exposures due to direct contact with bats (severe exposure)
|Wound washing, immediate vaccination and administration of rabies immunoglobulin/monoclonal antibodies
Category II and III exposures require PEP. WHO recommends administering rabies vaccines intradermally, as this reduces the amount of necessary vaccine and therefore the cost by 60–80% without compromising any safety or efficacy.