Should You Get a Rabies Vaccine After Being Bitten by an Unvaccinated Puppy?

Q: Should You Get a Rabies Vaccine After Being Bitten by an Unvaccinated Puppy?

Dear Ms. V： 1. Rabies is an acute viral encephalomyelitis caused by the rabies virus; once symptoms appear, the mortality rate approaches 100%. Since 1959, there have been no human cases in our country. There were two imported cases from mainland China in 2002

Is there a concern for rabies if bitten by an unvaccinated puppy?

I was bitten by an unvaccinated puppy at home today around noon, and there was some bleeding.
The wound has since scabbed over, but there is pain around the area.
Should I receive a rabies vaccine? I have researched that the dog should be observed for 10 days, but I believe the vaccination should start on day 0, right? Will it still be effective if I get vaccinated a few days later? Thank you.

V, 20~29 year old female. Ask Date: 2021/06/06

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
V:
1.
Rabies is an acute viral encephalomyelitis caused by the rabies virus; once symptoms appear, the mortality rate approaches 100%.
Since 1959, there have been no human cases in our country.
There were two imported cases from mainland China in 2002 and 2012, and one imported case from the Philippines in 2013.
Since 1961, there have been no animal cases reported, but the Council of Agriculture confirmed rabies virus infections in domestic wildlife starting in July 2013.
Currently, the domestic outbreak is limited to wildlife such as ferrets and civets, primarily found in mountainous or suburban areas of Taitung, Hualien, Pingtung, Kaohsiung, Tainan, Chiayi, Yunlin, Nantou, and Taichung.
2.
Given your situation of being bitten by a puppy, the risk of contracting rabies is low; therefore, if you wish to receive the rabies vaccine, you may need to pay out of pocket, as health insurance or public funding is unlikely to cover it.
(The cost for four doses of the rabies vaccine is approximately several thousand New Taiwan dollars.)
3.
According to the Council of Agriculture's monitoring data on stray dogs and cats for rabies, all results have been negative.
Additionally, there is a continuous effort to vaccinate domestic dogs and cats against rabies, making the risk of rabies virus infection in domestic animals extremely low.
For "stray dog or cat bite victims," rabies vaccination is not currently recommended, unless the animal shows signs of rabies within 10 days of observation and is highly suspected by veterinary authorities.
4.
Since you were bitten by a dog, it is recommended to observe or confine the puppy for 10 days.
If the puppy dies or shows symptoms of illness, consideration should be given to administering the rabies vaccine.
5.
Theoretically, if bitten by a mammal such as a dog or cat, it is best to start the first dose of the vaccine on day 0 and complete all four doses as scheduled.
However, considering the economic burden, inconvenience, or potential side effects, in our country, it is acceptable to observe the animal for 10 days before making a decision, as it often takes more than 10 days for the rabies virus to travel from the bite wound to the spinal cord or brain to cause illness.
6.
Additionally, it is advisable for you to visit a surgical outpatient department at a regional hospital to manage the wound.
Besides the risk of rabies, animal bites are more commonly associated with aerobic or anaerobic bacterial infections, which may require antibiotic treatment.
If you have further questions, it is recommended to discuss them with your family physician.

Reply Date: 2021/06/06

More Info

If you have been bitten by an unvaccinated puppy, it is crucial to take the situation seriously due to the risk of rabies. Rabies is a viral disease that is almost always fatal once symptoms appear, and it is primarily transmitted through the saliva of infected animals. Here’s what you need to know and do in this situation.

Immediate Steps to Take
1. Wound Care: First and foremost, you should thoroughly clean the wound with soap and water for at least 15 minutes. This is a critical step in reducing the risk of infection and the potential transmission of rabies.

2. Seek Medical Attention: After cleaning the wound, you should seek medical attention as soon as possible. A healthcare professional will assess the wound and determine the appropriate course of action, which may include administering the rabies vaccine.

Rabies Vaccination Protocol
According to the Centers for Disease Control and Prevention (CDC) guidelines, if you are bitten by a potentially rabid animal (in this case, an unvaccinated puppy), you should receive post-exposure prophylaxis (PEP) as soon as possible. The rabies vaccination schedule typically consists of:
- Day 0: First dose of rabies vaccine
- Day 3: Second dose
- Day 7: Third dose
- Day 14: Fourth dose (if indicated, based on the risk assessment)
In your case, since the puppy is unvaccinated, it is advisable to start the rabies vaccination immediately, even if you are observing the puppy for signs of rabies for 10 days. The observation period is important, but it does not negate the need for vaccination if the animal is unvaccinated and has a potential risk of rabies.

Importance of Timeliness
The effectiveness of the rabies vaccine diminishes the longer you wait after exposure. Ideally, the rabies vaccine should be administered as soon as possible after the bite. Delaying the vaccination could lead to a higher risk of developing rabies if the puppy were to be rabid.

Monitoring the Puppy
While you should observe the puppy for 10 days for any signs of rabies (such as changes in behavior, difficulty swallowing, or excessive salivation), this should not delay your vaccination. If the puppy shows any signs of illness during this observation period, it is critical to inform your healthcare provider immediately.

Conclusion
In summary, yes, you should get the rabies vaccine after being bitten by an unvaccinated puppy, and you should start the vaccination process as soon as possible. Clean the wound thoroughly, seek medical attention, and follow the rabies vaccination schedule as recommended by your healthcare provider. Rabies is a preventable disease, and timely vaccination is key to ensuring your safety. Always err on the side of caution when it comes to potential rabies exposure, as the consequences of inaction can be severe.

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