| Rabies is a now uncommon infection, thanks to the routine vaccination of dogs in the United States. However, it is still present in wildlife throughout the United States, except for Hawaii, and in many other parts of the world that do not practice routine immunizations. The most common wild animals that may be infected with rabies include raccoons, skunks, foxes, coyotes and bats. Rabbits, hares, opossums, and small rodents, such as squirrels, hamsters, guinea pigs, gerbils, chipmunks, rats or mice are very rarely infected with rabies.
Rabies is a disease that is caused by a virus and causes rapidly progressive neurological symptoms, including anxiety, difficulty swallowing, seizures, paralysis and eventually death. Symptoms begin about 4 to 6 weeks after being exposed (but can range anywhere from 5 days to over a year), which is usually after a bite from an infected wild animal.
If your child is bitten by an animal or has any type of exposure to a bat (including finding a dead bat in his room without obvious signs of a bite), then you should contact your Pediatrician and/or local health department. In addition to bites, contamination of an abrasion of the skin or a child's mucous membranes by the saliva of an animal at risk of having rabies (such as by the animal licking an open wound on your child) can also put your child at risk and should be considered an exposure that may need treatment.
In general, for bites from dogs, cats and ferrets, if the animal is available, it should be observed for 10 days by a professional (call your local animal control department and health department) to see if it develops signs of rabies. If the animal is obviously rapid or suspected of being rapid or develops signs of rabies within the 10 day observation period, then your child should receive the rabies vaccine and prophylaxis with Rabies Immune Globulin (RIG). If the animal is not available for observation and did not obviously have rabies, then you should contact your local health department for advice on whether or not RIG is recommended.
All bites from raccoons, skunks, foxes, coyotes, bats, other carnivores and woodchucks are considered to put a child at risk of developing rabies, unless it is in an area that is known to be rabies free or if the animal is available for testing and found to be rabies free (by examination of brain tissue). Again, contact your local health department for advice. Most children with a bite from one of these types of animals should receive rabies vaccine and prophylaxis with RIG.
Keep in mind that unprovoked attacks by an animal make it more likely that the animal is rapid. It is less suspicious if your child was bitten while trying to handle the animal, but you should still report such a bite to the health department.
You should also contact your local health department after a bite from livestock, rodents, rabbits and hares, although this situation would rarely require antirabies treatment.
To prevent exposure to a rapid animal, you should instruct your child to not touch or try to capture a wild animal, or touch the dead carcass of any animal. You should also vaccinate all of your pets (especially dogs, cats and ferrets), secure garbage around the house so that you don't attract wild animals, and avoid touching dogs in parts of the world that still have a large number of cases of rabies in domestic animals. Also contact your local health department if one of your pets is exposed to a wild animal that may have rabies.
Treatment of bites should begin with local wound care. This includes thoroughly flushing the wound with water and then cleaning it with soap and water. You should then contact your Pediatrician or local health department for furthur instructions and to see if treatment with the rabies vaccine or RIG is recommended. You should also contact your local animal control department so that they can try and capture and contain the animal. You should avoid handling an animal that you suspect may be rapid.
For children that are thought to be at risk of developing rabies after an exposure, treatments should begin as soon as possible and ideally within 24 hours. Treatments include the rabies vaccine, which is given as a first dose and then repeated on day 3, 7, 14, and 28. Also, rabies immune globulin (RIG), a human formulation is used in the United States vs. the equine (horse) product previously used, is given as a shot into the wound (as much of the RIG as possible) and into a muscle.
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