Rabies Transmission Risks and Vaccination Concerns

Transmission routes of rabies?

Hello Doctor, on April 1st, I went to Xitou with a friend.
On the way, I felt like something dripped on my hand, but I didn't think much of it at the time.
After about an hour, while having a meal, I remembered that this area might be a rabies-endemic zone.
I washed my hands with clean water, but afterward, I felt like there was a slight taste of saliva, which I’m not sure is just psychological.
I would like to ask you a few questions.

1.
Since I have a small superficial old wound about 0.1 cm on the finger that I felt was dripped on, is there a possibility of infection if that was saliva from a rabid animal?
2.
While eating, I didn’t think too much about it and used the same utensils to serve food to my friend.
Does my friend need to get vaccinated (especially if there are small wounds in their mouth)? This was about 1.5 hours after I felt the drip.
I read online that the virus is sensitive to UV light and dryness, but the weather that day was poor, with heavy fog and high humidity, and the sunlight was weak, which made me think about this issue.

3.
About 10 hours later, after taking a shower and thinking I should be clean, my girlfriend licked the old wound on that finger (she has a bleeding wound in her mouth).
I initially thought it would be fine, but later I found out that the virus can proliferate at the wound site.
Given these circumstances, does she need to get vaccinated? Is vaccination still effective after so many days?
I apologize if my questions seem foolish, but I am genuinely worried and hope you can alleviate my concerns.
Thank you.

Zeng Chenglin, 20~29 year old female. Ask Date: 2016/04/08

Dr. Liao Zhongxin reply Internal Medicine

Dear readers,
1.
First, refer to the explanation from the Centers for Disease Control: Transmission methods: (1) Animals infected with rabies have the virus in their saliva, which can enter the human body through bites or scratches (occasionally through skin wounds or mucous membranes).
Therefore, being scratched by an infected animal is also dangerous, as animals may lick their paws.
(2) Human saliva can also contain the virus, and theoretically, direct transmission between humans is possible, but there have been no reported cases to date.
There have been instances where patients who died from central nervous system diseases transmitted rabies to cornea recipients through corneal donation.
Bats in caves or laboratories may transmit the virus through the air.
In Latin America, vampire bats frequently transmit the virus to livestock.
Almost all mammals are susceptible to this disease, but susceptibility is related to the specific strain of the virus.
2.
Furthermore, since Taiwan has no indigenous rabies, it is considered a non-endemic area.
If bitten by a wild cat or dog, it is advisable to visit a nearby clinical medical facility to receive five doses of the rabies vaccine.
Thank you!

Reply Date: 2016/04/08

More Info

Rabies is a viral disease that poses a significant risk primarily through bites or scratches from infected animals, particularly dogs, bats, and other mammals. The rabies virus is present in the saliva of infected animals and can enter the human body through open wounds or mucous membranes. Your concerns about potential exposure to rabies are valid, especially given the circumstances you've described. Let’s address your questions one by one.

1. Infection Risk from a Small Wound: If you have a small, shallow wound on your finger and it came into contact with the saliva of a potentially rabid animal, there is a theoretical risk of rabies transmission. The rabies virus can enter the body through broken skin, and even a small wound can be a portal of entry. However, the risk is contingent upon several factors, including the type of animal involved and whether it was indeed rabid. If you suspect that the substance you touched was saliva from a rabid animal, it is advisable to seek medical attention promptly. The Centers for Disease Control and Prevention (CDC) recommends post-exposure prophylaxis (PEP) for anyone who has had potential exposure to rabies.

2. Friend’s Exposure: Regarding your friend who used the same utensils after you, the risk of rabies transmission through shared utensils is extremely low. The rabies virus does not survive long outside a host, especially in dry conditions. While it is theoretically possible for the virus to be present on a surface, the likelihood of transmission through indirect contact (like using the same utensils) is minimal. However, if your friend has an open wound in their mouth, it is prudent for them to consult a healthcare provider for advice, particularly if they have any concerns about exposure.

3. Girlfriend’s Contact with the Wound: The situation with your girlfriend licking your finger, especially if she has an open wound in her mouth, raises additional concerns. If the saliva from her mouth came into contact with your wound, there is a potential risk for transmission of infections, although rabies is less likely unless she had been exposed to a rabid animal herself. Rabies transmission typically requires direct contact with saliva from an infected animal. Given the complexity of your situation, it would be wise for both you and your girlfriend to consult a healthcare provider. They can assess the risk and determine if rabies vaccination is necessary.

In terms of timing, rabies vaccination is most effective when administered as soon as possible after exposure. The rabies virus has a long incubation period, but once symptoms appear, the disease is almost always fatal. Therefore, if there is any suspicion of exposure, it is crucial to act quickly. The rabies vaccine can be effective even if administered several days after exposure, but the sooner you receive it, the better.

In conclusion, while your concerns are understandable, the actual risk of rabies transmission in your described scenarios may be low, but it is not negligible. It is essential to consult a healthcare professional who can evaluate your specific circumstances and provide appropriate guidance, including the potential need for rabies vaccination. Remember, when it comes to rabies, it is always better to err on the side of caution.

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