Rabid worrying?

July 18, 2012 9:49 PM

Dog bite. Am I in danger?

I was bitten by a chihuahua at work. I work with animals and normally we require rabies vax for any dog that comes in, but in this case, we allowed the dog in without one. The owners had recently adopted the chihuahua from a stranger outside a Wal-mart. She had obviously been a breeder dog and abused. The dog bit my hand and left a few abrasions and maybe a slight puncture. I was vaccinated for tetanus five years ago, but am slightly worried about rabies. Should I be?

posted by melangell to pets & animals (24 answers total)

A few years ago my son was bitten by a dog, and spent three days in the hospital on IV antibiotics fighting a bordatella-provoked infection. I don't know if rabies is an issue, but infections from puncture wounds can be devastating.
Good luck!
posted by msali at 9:56 PM on July 18, 2012 [3 favorites]

It is extremely unlikely that the chihuahua had rabies.
posted by erst at 10:09 PM on July 18, 2012 [1 favorite]

I personally wouldn't worry about rabies but rather infection, as msali said.
posted by bolognius maximus at 10:10 PM on July 18, 2012 [1 favorite]

Yep, quickly spreading infection is your biggest worry here. My wife and I have both been bitten by domestic animals and its been very, very bad - despite starting antibiotics within hours of the bite. Seemingly minor bites turned into huge issues - my wife's arm was in real danger for quite a while.
posted by blaneyphoto at 10:27 PM on July 18, 2012

When similar happened to our family member, the county animal control folks made the dog owner quarantine the dog and made the dog go through rabies testing. The dog was quarantined until the rabies test (and maybe some other tests, I can't quite remember) came back clean.

We also visited urgent care (I think--but if not that, some kind of 'real doctor') about the puncture wound and gave it whatever treatment the doctor recommended.

I would suggest calling your city or county animal control, see what they have to say. Dealing with exactly this kind of situation is exactly their job. And also visit an actual doctor about your wounds.
posted by flug at 10:49 PM on July 18, 2012

I agree that rabies seems extremely unlikely.

How long have you worked with animals? Have you asked any of your colleagues for advice? Did any of them witness the incident? They might have some insight.
posted by trip and a half at 10:59 PM on July 18, 2012

Does your city have a 311 line? I found it useful when I was bitten by a cat several years ago.

They recommended a visit to urgent care, animal control quarantined the animal (it hadn't been vaccinated), and took a report.

At the urgent care, They gave me a tetanus shot, and prescribed a round of antibiotics. I had no visible infection at all, but infections from animal bites are really difficult to get rid of, so at least go to urgent care.
posted by annsunny at 11:08 PM on July 18, 2012

Rabies is pretty much uniformly fatal if you get it. There is no effective treatment. The closest thing we've got involves a chemically induced coma and has worked in a handful of people. No matter how unlikely it is, I would absolutely not chance it. In the cost-benefit analysis for getting a few shots just in case, it seems like a no-brainer to just get the shots.
posted by cairdeas at 11:35 PM on July 18, 2012 [7 favorites]

the county animal control folks made the dog owner quarantine the dog and made the dog go through rabies testing. The dog was quarantined until the rabies test (and maybe some other tests, I can't quite remember) came back clean.

Right now, there is no test for rabies for live dogs. The only way to test for it is to look at brain tissue samples, which requires euthanizing the dog.

About the quarantine, it's generally believed that in dogs and cats, the time period between an rabies-infected animal becoming contagious, and dying, is 10 days. So, it's believed that if the animal is still alive 10 days after it bit you, then it wasn't contagious when it bit you.
posted by cairdeas at 11:37 PM on July 18, 2012 [1 favorite]

Follow the standard procedure.

My understanding is that standard procedure is prophylactic shots (because by the time any rabies could be detected, you're going to die). But since you have the dog, another option is to have it monitored for symptoms (because it will likely develop them before you), this is riskier, but given the rarity of rabies in most areas, may make sense as a good middle-ground solution.

(In fact, killing the animal for the brain test, to ensure your safety, is also quite a standard approach - unvaccinated animal bites are taken very seriously at reputable establishments)


What you should NOT do is decide based on factors like unspoken hopes of people around you that you'll let things slide and it'll all be ok. It's not ok for you take unnecessary risks with your health because doing otherwise feels like "making a fuss".
posted by -harlequin- at 11:53 PM on July 18, 2012 [6 favorites]

P.S. If you can't pay for the shots, the dog's owner's should, at minimum.
posted by cairdeas at 11:58 PM on July 18, 2012

I was bitten by an unvaccinated chihuahua. It had my hand in a jaw-lock for nearly a minute, leaving a precise and deep incisor puncture wound (blood spilled) and other abrasions. Everyone from the ambulance medics to the emergency triage nurses, and even web searches advised for rabies treatment. Consensus seemed to be, as Cairdeas commented above, 'No matter how unlikely it is, I would absolutely not chance it.'

So I made my way to the emergency room. After hours of wait, I was assured by two emergency MD's that rabies are extremely rare nowadays and rarely prescribe rabies treatments unless the biting animal is clearly ill. A nurse came in with soapy water and gauze to clean my affected hand, and I was discharged. (a $450 bill arrived later.) The chihuahua in question was checked in by an animal control officer after the required number of days of home quarantine and was found to be healthy.

Please report the incident to the animal control for your sake(to enforce and verify results of the quarantine) and for others too (to document potential repeat patterns of aggressive behaviors).
posted by hedonic.muse at 12:17 AM on July 19, 2012 [3 favorites]

Like others have said, rabies is probably unlikely, but the infection risk is nothing to blow off. My cousin's jack russell terrier bit him on the hand something like two years ago, and he's still working on regaining full use of it -- the infection was nasty and antibiotic-resistant, and apparently he could just as easily have lost the whole arm.
posted by hades at 1:14 AM on July 19, 2012

After hours of wait, I was assured by two emergency MD's that rabies are extremely rare nowadays and rarely prescribe rabies treatments unless the biting animal is clearly ill.

To some extent this is going to depend on the local prevalence of rabies. See for example, this map (from 2005). If you're in an area with no reported cases then the above strategy makes more sense than if you're in an area with significant numbers of reported cases.

It's really a call that a doctor needs to make.
posted by xchmp at 1:18 AM on July 19, 2012 [2 favorites]

Yeah, dog bites are notorious for getting infected. The tiny little puncture wounds, caused by a tooth covered in bacteria, are prone to it because the wound is so small the bad stuff has nowhere external to drain. If your hand turns red at all, a) draw an outline of the red area on your hand with a pen or marker (so you can more easily monitor the size and speed of the infection), and b) get yourself to urgent care at the very least, if not the ER. Good luck!
posted by emkelley at 4:26 AM on July 19, 2012 [1 favorite]

Also, for what it's worth, a modern rabies shot is pretty similar to the flu shot in terms of how it's administered and the level/potential of side-effects. You should get advice from a qualified medical professional, but there aren't many reasons to not play it safe and get the shots.

The old giant-needle-into-the-stomach shots are no longer used.
posted by schmod at 7:37 AM on July 19, 2012

As others have commented, the prevalence of rabies varies dramatically from place to place, so this is really a situation in which a local physician's advice would be useful. It is my (non-medical) understanding that the rabies injections are not pleasant, but unfortunately if treatment doesn't begin fairly quickly, the disease is 100% fatal. (There have been a few people who have survived with experimental treatment, i.e. induced coma, but it's a "last resort".)

You should be visiting with a doc anyway, as nasty infections are exceedingly common after animal puncture wounds & you'll probably want antibiotics sooner rather than later. (Urgent care physicians joke that the antibiotic augmentin should actually be called dogmentin.) Bites on extremeties (hands, feet) can be particularly problematic b/c of blood flow.

So regardless of what the internet advises, get thee to a doctor, stat.
posted by muirne81 at 7:42 AM on July 19, 2012

If this happened at work, any medical care should come under worker's compensation and your employer. If the employer wants to go after the customer, that's their decision. Animal control should be called and the dog quarantined. Infections besides rabies are the immediate concern; they can be nasty (despite the old wives tale that a dog's mouth is clean).

If you go to the ER, they will probably contact animal control and perhaps worker's comp on your behalf.
posted by Doohickie at 8:04 AM on July 19, 2012 [1 favorite]

(In fact, killing the animal for the brain test, to ensure your safety, is also quite a standard approach - unvaccinated animal bites are taken very seriously at reputable establishments)

The 10 day quarantine is the standard approach. No, they won't kill the animal, they will quarantine it.
posted by Doohickie at 8:08 AM on July 19, 2012

Another note about rabies: When my wife was bit, we were told that the way rabies works is a local infection will travel along the nerves up to the brain. Once it gets up to the brain, it is a fatal condition. In a small animal like a chihuahua, this will happen very quickly, much more quickly than in a human, where it could take months instead of days. That's why quarantine is the standard approach. The odds that the dog has rabies is extremely low. The odds that it passed rabies to you and will be okay in 10 days is effectively zero.
posted by Doohickie at 8:15 AM on July 19, 2012

Nthing the fear about infection beating rabies worries. Little dogs, especially one from such breeder/puppy mill situation can have horribly bad teeth seething in bacteria and puncture wounds are hard to clean properly.
posted by wwax at 10:26 AM on July 19, 2012

Multiple issues here:
1. Even without rabies, as others have said, the possibility for infection is great. As an EMT, if it was me, I would most probably just irrigate the crap out of it myself and be done with it, however my fiancee would probably convince me to go get a shot.
2. The dog needs to go in for observation. You're really lucky (the dog and owner are really lucky) that they're allowing observation on a dog w/o shots. Typically in my experience it's 10 days if they HAVE had shots, and insta-euthenize if it hasn't.
3. This happened at work, after your employer violated their own protocol. Your employer needs to pay. They COULD pass it on to workers comp, but in the ensuing investigation they would likely get dinged and possibly fined for not following protocol.

Good luck!
posted by TomMelee at 11:10 AM on July 19, 2012 [1 favorite]

I work with animals and normally we require rabies vax for any dog that comes in, but in this case, we allowed the dog in without one.
Don't do this ever again. Seriously. You put so many people and animals at risk. If you work with animals your employer should know better. If you're working anywhere other than a veterinary hospital or as an animal control officer there is zero reason for you, your staff, and the other animals in your care to risk this kind of exposure.

Here is an article from LSU School of Veterinary Medicine on dog and cat bites. They say, "Dog bites often do more outright damage, but only 3 to 18 percent become infected. In contrast, cat bites may appear more trivial, but up to 80 percent of cat bites may become infected if proper care is not taken."
posted by 3T at 2:44 PM on July 19, 2012

Thank you everyone for your answers. They were all very helpful. I think I know what to do now. Thank you again, Mefi friends!
posted by melangell at 6:28 PM on July 19, 2012