Management of Bites to Humans
Animal Bites and Rabies Risk:
A Guide for Health Professionals

On this page:
Consultations on animal bites and rabies risk
Evaluation of the patient following animal bites
Assessment of the need for rabies post-exposure prophylaxis
Factors to consider when determining need for PEP

Consultations on animal bites and rabies risk

• Available 24/7 at 651-201-5414 for healthcare providers, veterinarians, public health professionals, and law enforcement.
• Available to the public Monday-Friday, 8:30 a.m. to 4:30 p.m. at 651-201-5414.
• Please do not call the MDH Public Health Laboratory.
• For questions regarding animals that have been bitten by a suspect rabid animal in which there is no human exposure, please contact the Board of Animal Health (BAH) at 651-201-6808.
  

Evaluation of the patient following animal bites

• Wash the wound well with soap and running water.
• Assess the need for tetanus vaccination booster.
• Assess the need for antibiotics.
• Assess the need for rabies post-exposure prophylaxis (PEP).
  

Assessment of the need for rabies post-exposure prophylaxis

• Is this a species that we are concerned about?
  • Table 1: Human Rabies Risk Evaluation: Species of the Biting Animal (PDF)
• Was there a bite or saliva exposure to a mucous membrane? Is the animal available for 10 days of observation or testing?
  • Table 2: Guidelines for Managing Animal Bites and Bat Encounters in Humans (PDF)
  • Figure 1: Evaluation of Potential Rabies Exposures Flowchart (PDF)

Factors to consider when determining need for PEP

Type of exposure

• Bite exposures: Consultation with a healthcare provider is recommended anytime a bite wound breaks the skin. Considerations include wound cleaning, tetanus vaccination, the need for antibiotics, and whether or not rabies post-exposure prophylaxis (PEP) is indicated.
  
  
• Non-bite exposures: Non-bite exposures include saliva contact to mucous membranes, saliva contact to fresh, non-scabbed skin wounds, and scratches. In general, the risk of rabies is very low following non-bite exposures; however, there are rare reports of rabies transmission by these routes suggesting that they constitute sufficient risk to consider administration of PEP on a case-by-case basis.

Location and severity of the bite

• When a bite is to an extremity, there is adequate time and it is safe for the patient to wait for completion of a 10-day observation and confinement period of the animal, or for rabies test results on the animal to determine whether or not PEP is necessary.
• Bites to the face and head are more urgent, and consultation with MDH on these cases is recommended.
  • Table 2: Guidelines for Managing Animal Bites and Bat Encounters in Humans (PDF)
  • Figure 1: Evaluation of Potential Rabies Exposures Flowchart (PDF)
• Regardless of location, the deeper and more serious the bite wound(s), the greater the urgency for PEP.
• Normal laboratory turn-around time for rabies testing in Minnesota is 1 to 2 business days. In urgent situations, expedited rabies testing can be arranged by calling MDH at 651-201-5414.

Circumstances of the bite incident

• Factors surrounding the circumstances of the bite relevant to rabies risk include the species of the animal, whether the bite occurred in an urban or rural setting, if the animal runs loose/unmonitored when outdoors, if there was a history of a skunk on the premises within the past few months, whether the pet has a previous history of aggressive behavior, and whether the bite was provoked or unprovoked.

Vaccination status of the biting animal

In the United States, rabies vaccine is licensed for dogs, cats, ferrets, sheep, cattle and horses. An animal is currently vaccinated and can be considered immunized if the primary vaccination was given at least 28 days before the biting incident, or if the animal has received a primary vaccine and a booster vaccination within the timeframe recommended by the manufacturer.

• Typically, dogs and cats are vaccinated for rabies as puppies or kittens, and the vaccination is boosted at one year of age. After that, dogs are generally vaccinated for rabies every 3 years, and cats are generally vaccinated annually or every 3 years, depending on the vaccine used.
  
• Even though rabies rarely occurs among currently vaccinated animals, out of an abundance of caution, all dogs, cats and ferrets are confined and observed for 10 days, or euthanized and tested for rabies following a bite to a human.
• This is the law in Minnesota and it applies regardless of the animal’s vaccination status.

Species of the animal and requirements of the confinement and observation period

Dogs, cats, ferrets, and livestock such as horses, cattle, goats and sheep should be confined and observed for 10 days following a bite, to rule out rabies risk.

• There is no such option for wild animals that bite humans; these bites are handled on a case-by-case basis following consultation with MDH.
  • Table 2: Guidelines for Managing Animal Bites and Bat Encounters in Humans (PDF)
  • Figure 1: Evaluation of Potential Rabies Exposures Flowchart (PDF)
    
• Following a bite, a dog, cat, or ferret that is currently vaccinated for rabies may be confined in the home or as directed by local authorities.
  • A dog, cat, or ferret that is not currently vaccinated for rabies may be required by local authorities to be confined at a veterinary clinic or other secure location at the owner’s expense.
• Any illness in an animal under confinement must be reported to MDH.
• If, during the 10-day confinement period, an animal shows signs suggestive of rabies, or dies naturally or is euthanized, it must be tested for rabies.

Rationale for confinement and observation period

• Animals cannot transmit the rabies virus to humans until the virus is present in the animal’s salivary glands and saliva.
• Once the disease has progressed to this stage in domestic animals, they will begin to show obvious clinical signs of rabies.
• The time period between the onset of viral shedding and onset of clinical signs of rabies is known to be at maximum 3 to 4 days in dogs, cats and ferrets.
  • Thus, if a dog, cat or ferret had rabies virus in its saliva at the time of a bite (and could have transmitted the disease to the victim), it will be sick or dead within 3 to 4 days.
• The 10-day confinement period includes a safety factor.