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Approach to management of suspected rabies exposures

What primary care physicians need to know

Correspondence: Dr Allan Grill, Markham Family Health Team, 377 Church St, Suite 101, Markham, ON L6B 1A1; telephone 905 471-9999; e-mailallan.grill{at}utoronto.ca

OBJECTIVE To review the role of primary care physicians, in conjunction with local public health units, in the management of suspected rabies exposures and to outline the current guidelines for the administration of rabies postexposure prophylaxis.

SOURCES OF INFORMATION Published guidelines on the topic of rabies were reviewed and additional articles were identified from key references. Various public health websites were also explored. Most evidence was level II or III.

MAIN MESSAGE Primary care physicians must always consider the risk of rabies when treating patients who have had animal-to-human exposures (eg, bite, scratch), and if indicated, postexposure prophylaxis must be administered as soon as possible because the infection is fatal once clinical symptoms develop.

CONCLUSION Human cases of rabies are almost entirely preventable if suspected exposures are identified and managed promptly and properly. Primary care physicians must continue to work together with local public health officials in order to minimize the threat of this deadly virus.

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