Information for Providers
If a person was exposed to a potential transmission of the rabies virus, healthcare practitioners have several resources available for the management of a possible rabies exposure. Anyone having knowledge of an animal biting or scratching with a break to the skin is required by Texas State Law to report the incident to the local health authority. In San Antonio call Animal Care Services.
Administration of post-exposure prophylaxis (treatment) (PEP) is a medical urgency not a medical emergency. All bite wounds must first receive proper wound care and treatment in an acute care or primary care setting (ER or Primary Care Provider).
Only medical professionals licensed in Texas can administer anti-rabies biologicals to humans. “Prophylaxis should begin immediately after exposure, ideally within 24 hours. However, a delay of several days does not compromise effectiveness, and prophylaxis should be initiated if indicated, regardless of the interval between exposure and initiation of therapy.”—Red Book, 2006 Report of the Committee on Infectious Diseases, 27th Ed.
The initial treatment consists of Human Rabies Immune Globulin (HRIG) given according to weight, and the first dose of rabies vaccine (day 0). Subsequent doses of PEP are to be administered by the Primary Care Physician (PCP) or a physician who will monitor the client and complete the treatment on days 3, 7, and 14.
HRIG provides immediate protection to the patient against the virus that causes rabies while the patient’s immune system works to build long-lasting protection with the help of the rabies vaccine.
A vaccine depot such as Metro Health is not under authorization by the state of Texas to administer the rabies vaccine, but rather to have the anti-rabies biologicals accessible to health care providers. Patients may obtain rabies vaccine from Metro Health to be administered in the PCP’s office. *Please contact the rabies surveillance nurse prior to your visit to Metro Health. It will take approximately 24 hours for vaccine delivery. The release of anti-rabies biologicals and/or rabies immune globulin will require a written prescription from the treating physician, physician’s assistant, or nurse practitioner. Prescriptions from anyone other than those listed above are not accepted.
The State has the right to refuse to provide anti-rabies biologicals if the incident does not warrant rabies post-exposure prophylaxis. The Advisory Committee on Immunization Practices guidelines are used to determine a true rabies exposure. In the event that the incident does not warrant rabies PEP, the department will provide the medical professional information on purchasing anti-rabies biological.
For further instructions on the process of obtaining vaccine, call the Rabies Surveillance Nurse. This call may help to facilitate a better understanding for completion of the patient’s treatment.
Centers for Disease Prevention & Control Clinical Information Line, 877.554.4625, 24 hours a day, 7 days a week
Rabies Surveillance Nurse