From the Guidelines
If you've been bitten by a dog, immediately wash the wound thoroughly with soap and water for at least 5 minutes, then apply an antiseptic like povidone-iodine and seek medical attention promptly to assess your need for rabies post-exposure prophylaxis (PEP). The most recent and highest quality study 1 recommends a 4-dose vaccination regimen for rabies PEP in previously unvaccinated persons, which includes rabies immune globulin and a series of four rabies vaccine doses given on days 0,3,7, and 14 after exposure. Some key points to consider after a dog bite include:
- Washing the wound thoroughly with soap and water for at least 5 minutes
- Applying an antiseptic like povidone-iodine
- Seeking medical attention promptly to assess the need for PEP and other treatments
- The healthcare provider will determine if you need antibiotics like amoxicillin-clavulanate to prevent bacterial infection, and whether a tetanus booster is necessary if you haven't had one in the past 5-10 years
- Reporting the bite to local health authorities who can monitor the dog for signs of rabies, which may influence your treatment plan, as suggested by 1. It's crucial to note that rabies is nearly always fatal once symptoms appear, which is why immediate treatment is crucial, and the virus travels through nerve tissue to the brain, and PEP works by neutralizing the virus before it enters the nervous system.
From the FDA Drug Label
After severe bites about the face, neck, and arms, it may be as short as 10 days. All bites by such wildlife should be considered possible exposures to rabies virus Post-exposure prophylaxis should be initiated as soon as possible following suspected rabies virus exposure to such wildlife, unless the animal is available for diagnosis and public health authorities are facilitating expeditious laboratory testing, or if the brain tissue from the animal has already tested negative Domestic Dogs, Cats, and Ferrets The likelihood of rabies in a domestic animal varies regionally, and the need for post-exposure prophylaxis also varies on the basis of regional epidemiology
The essential components of rabies post-exposure prophylaxis for a dog bite are:
- Wound treatment: Thoroughly wash and flush all bite wounds and scratches immediately or as early as possible with soap or a cleansing agent and copious amounts of water.
- Administration of both human rabies immune globulin (RIG) and vaccine for previously unvaccinated persons. Post-exposure prophylaxis should be initiated as soon as possible following suspected rabies virus exposure to dogs, unless the animal is available for diagnosis and public health authorities are facilitating expeditious laboratory testing, or if the brain tissue from the animal has already tested negative 2.
From the Research
Dog Bite and Rabies
- Dog bites can transmit rabies, a deadly viral disease [(3,4)]
- Rabies vaccines are available for human use and have been developed to provide protection against the disease 3
- The purified chick embryo cell (PCEC) vaccine and the rabies human diploid cell vaccine (HDCV) are two types of vaccines that have been shown to be safe and effective [(3,4)]
- Human rabies immune globulin (HRIG) is also used in combination with vaccines to provide immediate protection after exposure [(4,5,6,7)]
- Studies have shown that HRIG and HDCV can be used together to induce high levels of neutralizing antibodies [(5,6,7)]
- The dosage of HRIG can affect the level of early antibody response, with higher doses resulting in higher antibody levels [(6,7)]