From the Guidelines
If you are bitten by a rat at a restaurant, you should seek immediate medical attention, but a rabies shot is not automatically required. While rats can potentially carry rabies, they are rarely infected in the United States and rarely transmit the virus to humans 1. However, the decision about rabies prophylaxis will be made by a healthcare provider based on several factors including the geographic location, the circumstances of the bite, whether the rat appeared sick, and if the rat can be captured for testing.
Key Considerations
- The reliability of information about the incident should be assessed for each case 1
- Clinicians should seek assistance from local or state public health officials for evaluating exposures or determining the need for postexposure management in situations that are not routine 1
- Even if rabies treatment isn't needed, you will likely need wound cleaning, possibly antibiotics like amoxicillin-clavulanate or doxycycline for 3-7 days, and a tetanus booster if you haven't had one in the last 5-10 years.
Public Health Concerns
- Rat bites can cause serious bacterial infections including rat-bite fever, which can lead to complications if untreated
- The restaurant should also be reported to local health authorities, as rats in food establishments represent a public health concern that requires investigation 1
From the Research
Rabies Transmission and Post-Exposure Prophylaxis
- Rabies is a zoonotic, fatal, and progressive neurological infection caused by the rabies virus, which can be transmitted through the bite of a rabid animal or the saliva of an infected host 2.
- The main reservoirs for rabies are wildlife such as raccoons, skunks, bats, and foxes, but the disease can affect all warm-blooded animals 2.
- Post-exposure prophylaxis (PEP) is essential in preventing rabies after a bite from a potentially infected animal, and it is recommended that PEP includes anti-rabies vaccination 3, 2.
Rat Bites and Rabies Risk
- Rats are not typically considered a primary reservoir for rabies, but they can still transmit other diseases such as rat-bite fever, leptospirosis, and tularemia through their bites 3, 4.
- The risk of rabies transmission from a rat bite is relatively low, but it is still important to evaluate the need for post-exposure prophylaxis, including anti-rabies vaccination, after a rat bite 3.
Antibiotic Prophylaxis and Rat Bites
- Antibiotic prophylaxis may be recommended for certain groups of patients after a rat bite to prevent infections such as rat-bite fever and leptospirosis 3, 5, 6.
- Doxycycline has been shown to be effective in preventing spirochetal infections, including leptospirosis, but its use as prophylaxis against rat-bite fever is still controversial 5, 6.