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Protecting Yourself from Rabies

The CDC recommends receiving a titer check every two years

The CDC recommends receiving a titer check every two years

If you work hands-on with animals in an area where rabies is known to exist, you should receive the pre-exposure rabies vaccination series and then have your antibody levels checked every two years, according to the Centers for Disease Control and Prevention.

The pre-exposure series involves three shots injected either intradermally or directly into the muscle. These inoculations may help protect animal care and control professionals who are exposed unknowingly or who are unable to obtain immediate treatment after possible exposure. Just as importantly, the vaccinations will also spare infected individuals from having to undergo the full post-exposure series.

Rabies Vaccine Recalled

Three lots of rabies pre-exposure vaccine are being recalled, after manufacturer Aventis Pasteur discovered the IMOVAX® vaccine had lost some of its potency.

The recall affects rabies pre-exposures administered intradermally (under the skin), not those that are injected directly into the muscle. Recalled lots include P0313-3, P0030-2, and N1204-2.

According to the Centers for Disease Control and Prevention, those who were vaccinated using serum from the recalled lots should undergo a titer test to measure the presence of antibodies in their blood. If antibody levels are too low, Aventis Pasteur recommends that patients receive one dose of IMOVAX rabies vaccine for intramuscular use. Ideally, people who are re-vaccinated should then receive another titer test to ensure immunity.

Call Aventis Pasteur at 800-752-9340 for medical inquiries about the recall. Local health departments can also assist with inquiries regarding rabies vaccinations and titer tests.

Pre-exposure vaccination, however, does not preclude additional treatments after a possible infection. Even if a titer check shows that your antibody levels are sufficiently high, you still must receive post-exposure therapy if you've had potential contact with rabies. The therapy will be minimal if you've already been vaccinated: Whereas full treatment would require an injection of human rabies immune globulin as well as five other shots over a 28-day period, pre-exposed individuals need only receive two 1-milliliter intramuscular doses of vaccine—one immediately following the exposure and one three days later.

As always, the likelihood of contracting rabies after possible contact with a rabid animal is greatly decreased through immediate and thorough washing of all bite wounds and scratches; soap, water, and an application of a virucidal agent such as Betadine (a povidone-iodine solution) are recommended. Remember that rabies is transmitted only when the virus is introduced into bite wounds, into open cuts on the skin, or onto mucous membranes. Any penetration of the skin by teeth constitutes a bite exposure.

All bites, regardless of location, represent a potential risk of rabies transmission. Occasional reports of transmission by nonbite exposure suggest that the post-exposure series should be considered in these cases, although nonbite exposures rarely cause rabies. Exposures falling into the "nonbite"category involve contamination of open wounds, abrasions, mucous membranes, or scratches; contamination can only occur through contact with an animal's saliva or material such as neural tissue.

Petting a rabid animal—or contact with blood, urine, or feces of a rabid animal—does not constitute an exposure. In addition, if the material containing the virus is dry, the virus is noninfectious.

If you have received a rabies pre-exposure vaccine, you need only have a titer check every two years to make sure your antibody levels are sufficient. If they are too low, a booster is recommended.

For more information about rabies, visit the CDC Web site at www.cdc.gov/ncidod/dvrd/rabies.

 

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