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    Follow These Rabies Rules for Safety


    The treatment is easy -- and relatively painless. "It's a series of seven injections over a month's time," says Mille Vitale, RN, rabies nurse for Pinellas County, Fla. "You will have five visits to the doctor, on days zero, three, seven, 14, and 28 -- and that schedule has to be kept. You will be getting the vaccinations in the upper arm, on alternate arms."

    "Most people still think you get them in the stomach -- and you absolutely don't," says Slote. But you can get the RIG injected in unusual places -- depending on where the bites are. "Nina had three places where the fox bit or scratched her and she had to have some RIG injected into each of those spots."

    The HDCV/RIG regimen is a huge advance from what might be called the Dark Ages of rabies treatment, Vitale says, when the vaccinations were so numerous they had to be given in places such as the abdomen -- and even then, didn't always work.

    "It's much easier to treat patients and much easier to recommend treatment," says Alfred DeMaria, MD, director of communicable disease control at the Massachusetts Department of Public Health. "Now the risk of treatment is virtually nil."

    Which is not to suggest anyone who comes in contact with a rabid animal necessarily needs treatment. It really depends on how "contact" is defined. Public health experts say the greatest danger lies in getting the saliva of a rabid animal, or its brain or nervous system tissue, into an open cut. That could happen through a bite, of course, or indirectly.

    That was the case with Roland Vaillancourt, a paramedic from Greenville, N.H. One day eight years ago he noticed an odd sight: a raccoon wandering around a neighborhood in daylight. "So something was wrong," he says. "It was acting very unusual -- slow [breathing], unsteady gait. We just decided to put it down at that point."

    He used a bow and arrow, and accidentally cut himself on the arrowhead, which was tainted with the raccoon's nervous system tissue. But Vaillancourt underwent PEP and didn't have any problem.

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