Bite wounds should be immediately cleaned with antiseptic soap and water.
When rabies exposure is strongly suspected, it may be appropriate to begin treatment before testing confirms rabies in the animal. Read the CDC's "When should I seek medical attention?" for additional guidance.
In addition to wound cleaning and surgical care, treatment consists of:
- Rabies Immune Globulin (RIG) 0.06 milliliters per lb. body weight IM. Half of the dose should be infiltrated around the wound, and the remainder administered intramuscularly in the gluteal area. RIG should not be administered in the same syringe or in the same anatomical site as the rabies vaccine.
- Human Diploid Cell Rabies Vaccine (HDCV) 1 milliliter IM (deltoid) on days 0, 3, 7, 14, and 28. For previously immunized individuals, 2 doses of HDCV at days 0 and 3 are sufficient.
The Washington State Department of Health has guidelines on its website to help medical practitioners determine the appropriate course of treatment.
It is the policy of Clallam County that financial responsibility for rabies post-exposure treatment is a personal medical expense and not a publicly supported service. Billing of medical expenses for post-exposure treatment to private insurance vendors or managed care plans is appropriate. Staff will provide assistance in finding a medical practitioner who can provide the necessary evaluation and treatment services. In addition, should publicly-funded post-exposure treatment services become available in Washington State, eligible individuals will be offered assistance in applying for these benefits.