About Rabies

What Is Rabies?

Rabies (ray-beez) is a deadly disease caused by a virus found in the saliva of a rabid animal and is transmitted by a bite or possibly by saliva contamination of an open cut or the eyes. The rabies virus infects the central nervous system and, if left untreated, ultimately causes disease in the brain and death.1

Only mammals, including people, can get rabies. Rabies occurs most often in wildlife, particularly raccoons, bats, skunks, groundhogs, and foxes. Wild animals account for 92% of rabies cases in the United States. Cats account for the vast majority of domestic animal rabies cases, but farm animals, dogs, and other domestic pets can also become infected. So take measures to keep wild animals from entering houses, barns, and garages. Small rodents such as rats, mice, chipmunks, and squirrels are rarely infected.1,2

Rabid animals are usually vicious and aggressive and may appear to have trouble walking. However, some animals may be rabid even though they appear to be acting normally. People should stay away from all wild and stray animals that are aggressive or appear to be sick to reduce the risk of exposure to rabies.1

How Is Rabies Diagnosed?

In animals, rabies is diagnosed using a test that looks for the presence of rabies virus in brain tissue. In humans, several tests are available to confirm rabies disease once a person becomes ill; however, there are no tests that can detect if rabies has been transmitted from exposure to a rabid animal before a person becomes ill.1

Myth or Fact?

Rabies is found in every state except Hawaii.

What Is Postexposure Prophylaxis?

Postexposure prophylaxis (PEP) is any preventive medical treatment started immediately after exposure to a pathogen such as rabies.1

Treatment for Rabies

Rabies vaccine and HyperRAB® (Rabies Immune Globulin [Human]) should be given to anyone suspected of exposure to rabies with one exception: people who have been previously immunized with rabies vaccine and have a laboratory test measuring the antibody amount in their blood, called a rabies antibody tither, should receive only vaccine. Unlike the vaccine, human rabies immune globulin (RIG) works immediately to neutralize the rabies virus. By injecting antibodies directly at the site of infection, RIG provides an immediate suppression of the rabies virus. Vaccines can take weeks to build efficacy but can protect for years. RIGs contain high concentrations of rabies antibodies for postexposure prevention and are recommended by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) to be administered at the same time as the rabies vaccine in previously unvaccinated persons immediately following a bite or scratch by an animal suspected of being rabid.1,3

Visit Hypermunes.com to learn more about HyperRAB®.

Is Nonbite Exposure Possible?

Rabies can be transmitted if open skin comes in contact with animal saliva. An animal does not need to bite for the virus to be transmitted, though nonbite exposure is rare.1

Indication and Usage

HYPERRAB® (rabies immune globulin [human]) is indicated for postexposure prophylaxis, along with rabies vaccine, for all persons suspected of exposure to rabies.

Limitations of Use 

Persons who have been previously immunized with rabies vaccine and have a confirmed adequate rabies antibody titer should receive only vaccine.

For unvaccinated persons, the combination of HYPERRAB and vaccine is recommended for both bite and nonbite exposures regardless of the time interval between exposure and initiation of postexposure prophylaxis.

Beyond 7 days (after the first vaccine dose), HYPERRAB is not indicated since an antibody response to vaccine is presumed to have occurred.

Important Safety Information

For infiltration and intramuscular use only.

Severe hypersensitivity reactions may occur with HYPERRAB. Patients with a history of prior systemic allergic reactions to human immunoglobulin preparations are at a greater risk of developing severe hypersensitivity and anaphylactic reactions. Have epinephrine available for treatment of acute allergic symptoms, should they occur.

HYPERRAB is made from human blood and may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

The most common adverse reactions in >5% of subjects during clinical trials were injection-site pain, headache, injection-site nodule, abdominal pain, diarrhea, flatulence, nasal congestion, and oropharyngeal pain.

Do not administer repeated doses of HYPERRAB once vaccine treatment has been initiated as this could prevent the full expression of active immunity expected from the rabies vaccine.

Other antibodies in the HYPERRAB preparation may interfere with the response to live vaccines such as measles, mumps, polio, or rubella. Defer immunization with live vaccines for 4 months after HYPERRAB administration.  

Please see full Prescribing Information for HyperRAB.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

HyperTET® S/D (tetanus immune globulin [human]) is indicated for prophylaxis against tetanus following injury in patients whose immunization is incomplete or uncertain.

HyperTET S/D should be given with caution to patients with a history of prior systemic allergic reactions following the administration of human immunoglobulin preparations.

In patients who have severe thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections, HyperTET S/D should be given only if the expected benefits outweigh the risks.

Slight soreness at the site of injection and slight temperature elevation may be noted at times. Sensitization to repeated injections of human immunoglobulin is extremely rare. In the course of routine injections of large numbers of persons with immunoglobulin, there have been a few isolated occurrences of angioneurotic edema, nephrotic syndrome, and anaphylactic shock after injection. Administration of live virus vaccines (eg, MMR) should be deferred for approximately 3 months after tetanus immune globulin (human) administration.

HyperTET S/D is made from human plasma. Products made from human plasma may contain infectious agents, such as viruses and theoretically, the Creutzfeldt-Jakob disease (CJD) agent that can cause disease. There is also the possibility that unknown infectious agents may be present in such products.

Please see HyperTET S/D full Prescribing Information for complete prescribing details.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.


References:

  1. Centers for Disease Control and Prevention website. http://www.cdc.gov/rabies/transmission/. Updated January 20, 2016. Accessed March 25, 2016.
  2. Dyer JL, Yager P, Orciari L, et al. Rabies surveillance in the United States during 2013. J Am Vet Med Assoc. 2014;245(10):1111-1123.
  3. World Health Organization. Guide for post-exposure prophylaxis. World Health Organization website. http://www.who.int/rabies/human/postexp/en/#. Updated 2016. Accessed April 11, 2016.