It is expected that a new rabies vaccine program will be developed in the coming months, following consultations with … Discontinue the vaccine if rabies testing of the involved animal is negative. Preventing and managing rabies exposure 5. Low-Cost Clinics . How prevalent is rabies in the involved species in the geographic area? Refer to Contraindications, Precautions and Concerns in Part 2 for additional information. Pre-exposure immunization: three 1.0 mL intramuscular (IM) or 0.1 mL intradermal (ID) doses of rabies vaccine given on days 0, 7 and any time between days 21 to 28. Canadian Immunization Guide Part 4: Active Vaccine: Rabies Vaccine -Public Health Agency of Canada Rabies in Ontario -Ministry of Agriculture, Food and Rural Affairs Management of Potential Rabies Exposures Guideline -Ministry of Health Management of Potential Rabies Exposures Guideline -Ministry of Health and Long-Term Care At first indication of rabies in the animal, arrange to have the animal tested for rabies. Your doctor can tell you how much it will cost. Infiltration of wounds with RabIg in some anatomical sites (finger tips) must be carried out with care to avoid increased pressure in the tissue compartment. No human cases of rabies associated with bat strains have been known to be transmitted from exposure to other animals. skunks, foxes and raccoons), bats, cattle and stray dogs and cats. The first is Wednesday from 4 p.m. to 7 p.m. In consultation with public health officials, post-exposure prophylaxis may be discontinued if the animal tests negative for rabies. In 2004, the US Centers for Disease Control and Prevention confirmed the first reported case of rabies following solid organ transplantation. Rabies is mainly a disease of animals. The person responsible for observation of the animal should be advised to notify public health officials if the animal becomes ill or escapes during the observation period. Accéder aux paramètres de votre navigateur. Serious adverse events are rare following immunization and, in most cases, data are insufficient to determine a causal association. Pre-exposure immunization and post-exposure prophylaxis result in antibodies that prevent the virus from entering the peripheral nervous system. Rabies Vaccine Clinic Listings in Ontario Options for consideration in the management of travellers exposed in developing countries include initiating or repeating all or part of the post-exposure management obtaining post-vaccination serology or both. In addition, it has been determined that, to prevent one case of rabies from bedroom exposure to a bat, using a conservative estimate, 314,000 people would need to be treated. Once the bat has been captured, local public health officials should be contacted. A 10-year follow-up study of subjects who received three doses of HDCV, followed by a booster dose at 1 year, has shown the maintenance of protective antibody up to 5 years in 96.2%. For hematopoietic stem cell transplant recipients, pre-exposure rabies vaccination can be started 6 to12 months after transplant. If an alternative vaccine is not available, post-exposure prophylaxis using PCECV should be administered to a person with a hypersensitivity to egg with strict medical monitoring. Post-exposure prophylaxis is recommended in rare instances, such as inhalation of aerosolized virus by spelunkers exploring caves inhabited by infected bats or by laboratory technicians homogenizing tissues infected with rabies virus without appropriate precautions; however, the efficacy of prophylaxis after such exposures is unknown. The more common, agitated (furious) form presents with the classic symptoms of hydrophobia and aerophobia (severe laryngeal or diaphragmatic spasms and a sensation of choking when attempting to drink or when air is blown in the face) with a rapidly progressing encephalitis and death. Refer to Vaccine Safety in Part 2 for additional general information. If the intradermal route is used, rabies vaccine should be administered only by fully trained staff in settings in which there is a well-established cold chain. Charitable Business # 88969-1044-RR0002. These recommendations are intended as a guide and may need to be modified in accordance with the specific circumstances of the exposure. Petting a rabid animal or handling its blood, urine or feces are not considered exposures. In evaluating each case, local public health officials should be consulted. All dogs, cats and ferrets over three months of age in Ontario must be immunized against rabies and re-immunized in accordance with the certificate of immunization issued. The annual clinics are sponsored by Dr. Jeff Rabinovitch, DVM. Humans. Refer to Principles of Vaccine Interchangeability in Part 1 for additional general information. For a listing of additional low-cost rabies vaccine clinics outside of Simcoe Muskoka, please refer to the Ontario Association of Veterinary Technicians. Flushing for approximately 15 minutes is suggested. RabIg is not indicated and should not be given to someone who has been previously appropriately immunized as indicated below. This clinic is for rabies vaccinations and microchipping only. Vaccination schedules for post-exposure prophylaxis should be adhered to as closely as possible; it is essential that all doses be received. Read details and maps of confirmed cases of rabies in Ontario from 1958 until today. Local injection site reactions such as pain, erythema, swelling, pruritus and induration at the injection site were reported in 60% to close to 90% of recipients. If the dog, cat or ferret is healthy after a 10-day observation period, the animal would not have been shedding rabies virus in their saliva and would not have been infectious at the time of the exposure. Determination of antibody response is also advisable if post-exposure vaccination is given to those whose immune response may be reduced by illness or medication. Based on expert opinion, live vaccines given by nasal or oral route and essential inactivated vaccines, may be administered at the same time as rabies vaccines. If illness suggestive of rabies exists at the time of the bite or develops during the observation period, the animal should be humanely euthanized in a way that does as little damage to the brain as possible, and the head submitted for laboratory examination and rabies testing. If there has been no direct contact with the bat, the bat should not be captured for testing and should be safely released. For post-exposure prophylaxis of immunocompetent persons previously unimmunized with rabies vaccine, four 1.0 mL doses of HDCV or PCECV should be administered IM. This is the first City-sponsored low cost rabies clinic in recent history. Pour avoir une meilleure expérience, vous devez : You are using an outdated browser that is no longer supported by Ontario.ca. Pre-exposure immunization for high risk persons produces rabies neutralizing antibodies. Pre-exposure immunization is given to people at high risk of close contact with rabid animals or the rabies virus (e.g., people with occupational exposure to animals; laboratory workers handling the rabies virus; certain travellers; hunters and trappers in areas with confirmed rabies; and spelunkers). Refer to Table 1 and Table 2 in Contents of Immunizing Agents Available for use in Canada in Part 1 for lists of all vaccines and passive immunizing agents available for use in Canada and their contents. If you missed this year’s clinic, please call your veterinarian directly for more information about protecting your pet from rabies. If in doubt, consultation with an infectious diseases or public health physician is recommended. Only eight instances of human rabies from cutaneous or mucous membrane exposures were found in a review published in 2002 and these were not well documented, raising the possibility of other routes of exposure. Once reconstituted, these vaccines should be administered promptly. A veterinarian should be consulted to determine if the animal is up-to-date with its vaccinations. En savoir plus sur les navigateurs que nous supportons. Vaccination is not just for children. HDCV or PCECV administered at the same time as RabIg (using a separate needle, syringe and injection site) and local treatment are highly effective in preventing rabies in exposed individuals. In Canada and the US, foxes, skunks, raccoons and bats may be reservoirs capable of transmitting infection to dogs, cats, livestock and people. Pre-exposure rabies immunization with either HDCV or PCECV should be offered to people at high risk of close contact with rabid animals or the rabies virus, for example: Rabies prophylaxis must be considered in every incident in which human exposure to potentially rabid animals has occurred, unless rabies is known to be absent from the local animal population. Transmission of rabies occurs most commonly through bites. Mild systemic reactions such as headache, nausea, abdominal pain, muscle aches and dizziness were reported in about 6% to 55% of recipients. For safety reasons, dogs must be on a leash or in a carrier, and cats must be in a carrier. For enquiries, contact us. Following vaccination, neutralizing antibodies begin to develop within seven days and persist for at least two years. Rabies is a disease of mammals, both domestic and wild. Post-exposure prophylaxis is ineffective after the rabies virus invades the nervous system. Rabies is a rare viral central nervous system infection most often transmitted to humans through the bite of an infected mammal. Refer to Storage and Handling of Immunizing Agents in Part 1 for additional information. In situations in which immunosuppression is planned (such as before organ transplant) and pre-exposure rabies vaccine is necessary, the vaccine series should be given only by the intramuscular route and should be completed at least 14 days prior to starting immunosuppression if possible. 500-plus confirmed rabies cases in Ontario since 2015 The Humane Society is encouraging pet owners to keep their communities rabies-free by having their animals vaccinated against the disease. The fee is $20.00 per vaccination or microchip, and payment is cash only. Between 1990 and September 2007, 36 bat-related human rabies cases were identified in Canada (3 cases) and the US (33 cases), resulting in an incidence rate of 6.7 cases per billion person-years. Humans get rabies when they are bitten or scratched by infected animals. Generally, it is not possible to assess animal behaviour in wild animals. If the incident involves a dog or cat, determining if it is a stray or domestic animal assists with the risk assessment. Cost: $10-$15. A higher density of nerve endings in the region of the bite increases the risk of developing rabies encephalitis. A rapid anamnestic response is obtained, regardless of whether the primary vaccine was HDCV or PCECV. As the distribution of animal rabies and the species involved vary considerably across Canada, it is important to consult local public health officials in cases of possible exposure. Post-exposure prophylaxis should not be delayed beyond 48 hours while waiting for test results in wild animals. There is currently no effective way to vaccinate bats in Ontario. If these animals - are alive and healthy at the end of the 10-day period, they would not have transmitted rabies in their saliva at the time of the bite. A provincewide shutdown is in effect as of Saturday, December 26, 2020 at 12:01 a.m. Systemic allergic reactions characterized by generalized urticaria and accompanied in some cases by arthralgia, angioedema, fever, nausea and vomiting have been reported. Rabies cases. Rabies occurs worldwide, although most human deaths occur in Asia and Africa. Corticosteroids, other immunosuppressive agents, and immunosuppressive illnesses (e.g., congenital immunodeficiency, human immunodeficiency virus [HIV] infection, leukemia, lymphoma, generalized malignancy) may interfere with the antibody response to rabies vaccine. If the dog, cat or ferret has or develops signs of rabies, post-exposure prophylaxis should be initiated as soon as possible. Improper technique may result in a suboptimal dose of vaccine being administered or inadvertent subcutaneous injection of the vaccine. When rabies vaccine is administered ID, post-immunization antibody titres should be determined at least 2 weeks after completion of the vaccine series to ensure that an acceptable level of protection has been achieved. Refer to Immunization of Immunocompromised Persons in Part 3 for additional information. The animal should be immediately humanely euthanized in a way that does as little damage to the brain as possible, and the head submitted for laboratory examination and rabies testing in consultation with the local CFIA veterinarian. Post-vaccination serology is recommended: after pre-exposure immunization using the ID route; following immunization of immunocompromised individuals or people taking chloroquine; or if there has been a significant deviation from the recommended vaccination schedule. Generally, rabies is less likely in domestic animals, particularly domestic dogs, compared to stray animals, due to the following factors: domestic animals are more likely to be vaccinated; and domestic animals may spend less time outdoors where exposure to a potentially rabid animal could occur. Therefore, it is important for health care providers to consult local public health departments regarding local epidemiology and for public health officials to remain current, based on information from the Canadian Food Inspection Agency (CFIA) website: Positive Rabies in Canada. Refer to Ontario Association of Veterinary Technicians for additional rabies vaccine clinics outside of North Bay Parry Sound. In the event of exposure to a fox, skunk, raccoon or bat in areas where rabies is known to occur in these animals, post-exposure prophylaxis should begin immediately unless the animal is available for rabies testing and rabies is not considered likely. Protective antibodies are present immediately after passive vaccination with RabIg and have a half-life of approximately 21 days. Post-exposure prophylaxis should not be delayed more than 48 hours. Post-exposure prophylaxis of previously unimmunized individuals should consist of both RabIg and rabies vaccine. latex). Hunter and trappers in areas with confirmed rabies. Expert opinion should be sought in the management of these individuals. The location and severity of the bite (e.g., the size and number of bites). Each 1.0 mL dose of HDCV or PCECV contains at least 2.5 international units (IU) of rabies antigen, which is the WHO recommended standard. External Resources. Rabid bats have been found in most regions across Canada. Rabies occurs in larger rodents such as ground hogs (woodchucks) and beavers in some areas of the US. History of household exposure to a bat: 16.7%, * NACI has not yet deliberated on the use of KamRAB™ or HyperRAB®. Aerosol transmission is rare as is transmission when scratches, wounds, or mucous membrane are contaminated from saliva or infected neural tissue. Rabies: The rabies vaccine is used to prevent infection caused by the rabies virus. The vaccine has been tested and is safe if consumed by domestic animals. There may be discomfort or pain at the exposure site (i.e., the site where the person was bitten). There are regional differences in the prevalence of animal rabies and the specific species infected in each region vary over time. Post-exposure prophylaxis or testing of a bat is generally recommended after direct contact with the bat (refer to Bat Exposure) because it is very difficult to ensure that a bite did not take place. There is no evidence that interference occurs with antimalarial drugs other than chloroquine. Refer to. This is a histogram that identifies that there was one death from rabies in 1925, 1926 1931, 1933, 1944, 1964, 1967, 1970, 1977, 1984, 1985, 2000, 2003, 2007. Persons with minor acute illness (with or without fever) may be vaccinated. If antibody levels fall below an acceptable concentration (less than 0.5 IU/mL), a booster dose of HDCV or PCECV is recommended. The reports of scratches consist of a facial scratch from a bat in 1985 and a scratch from a rabid calf in the 1940s. Anaphylactic reactions have occurred in up to 1 in 10,000 vaccine recipients. Rabies vaccine must never be given into the gluteal muscle due to the risk of a decreased immune response. Upcoming low-cost rabies vaccination clinics: Please check back often for updated clinic listings. Early symptoms of rabies may include headache, malaise, fever and fatigue. The contamination of open wounds, abrasions, scratches or mucous membranes with saliva or neural tissues are also considered forms of non-bite exposures. Post-exposure prophylaxis of immunocompetent persons who have not been previously immunized with rabies vaccine consists of: local wound treatment; rabies immunoglobulin (20 IU/kg body weight) given on day 0 with as much as possible infiltrated into and around the wound; and four 1.0 mL IM doses of rabies vaccine given on days 0, 3, 7 and 14. Raccoon rabies arrived in Canada from the US in 1999 and was found mainly in Ontario, New Brunswick, and Quebec. 1. Neurologic complications are rare, but three cases of neurologic illness resembling Guillain-Barré syndrome, which resolved without sequelae within 12 weeks, were reported in the early 1980s, but a causal relationship has not been established. Pre-exposure vaccination was given by the ID route. If you are a member of the media, call Communications and Marketing Branch at 416-314-6197 or visit our News Room section. Bats, foxes, dogs and raccoons are of primary concern in Niagara. Clinical manifestations 3. In those who have not previously been immunized, and either are immunocompromised or are taking antimalarial drugs, a fifth dose of vaccine should be given on day 28. Visit our Rabies Clinic page to learn about low-cost rabies vaccination clinics. The prevalence of rabies in developing countries is generally higher than in Canada, and there may be concerns about the potency of available vaccines in these countries. However, for pre-exposure vaccination, an alternative vaccine, HDCV, should be used in vaccinees with a history of hypersensitivity reactions to egg or egg products. For specific advice, consult an allergy specialist. Such reactions have been shown to follow the development of IgE antibodies to beta propiolactone-altered human serum albumin in the vaccine. Nova Scotia reported 3 cases, New Brunswick 2 cases and Prince Edward Island 1 case. When PCECV was administered according to the recommended immunization schedule, 100% of subjects attained an adequate antibody titre by Day 28 or earlier. In these individuals, vaccine should be administered by the IM route only. This vaccine is administered three times over the course of several weeks for a total cost of $60-$90. Ontario.ca needs JavaScript to function properly and provide you with a fast, stable experience. Rabies may be transmitted to domestic pets during exposure to rabid wild or outdoor animals. A history of abnormal or aggressive behaviour in a domestic animal, potential for exposure of a domestic animal to other animals that could transmit rabies to the domestic animal, and a previous encounter of a domestic animal with a wild animal should be considered as factors that increase the likelihood that a domestic animal exposure carries a risk of rabies transmission. Vaccine wastage should be minimized by immunizing enough individuals at the same time to use all of the contents of a vial of vaccine, whenever possible. veterinarians, animal control officers, laboratory workers). Because of possible interference of RabIg with the immune response to the rabies vaccine, the dose of RabIg should not be exceeded. In a child, a bat landing on clothing could be considered a reason for intervention, as a history to rule out a bite, scratch or mucous membrane exposure may not be reliable. Laboratory workers who handle the rabies virus. The test has a reported sensitivity of 98% to 100%. If the vaccination schedule has been altered and there is doubt about a sufficient immune response, post-vaccination serology should be obtained 7 to 14 days after completing the vaccination series. Because these small animals are not known to have caused human rabies in North America, post-exposure prophylaxis should be considered only if the animal's behaviour is highly unusual. Learn more about the rabies treatment from the Ministry of Health. Facilities for emergency treatment of anaphylactic reactions should be available. Data are not available regarding the concurrent administration of rabies vaccines with other vaccines. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI. NML conducts testing on serum and cerebrospinal fluid samples from all provinces and territories in Canada with the exception of Ontario, where serological testing is performed by the Public Health Ontario Laboratory (PHOL). Local injection site pain, erythema and induration are commonly reported following administration of RabIg, as are systemic reactions such as headache and low-grade fever. Refer to Immunization of Travellers in Part 3 for additional general information. Refer to Reporting adverse events following immunization (AEFI) in Canada for additional information about AEFI reporting. Refer to. A bite, scratch, or saliva exposure into a wound or mucous membrane cannot be ruled out. Exposure to small rodents (such as squirrels, chipmunks, rats, mice, hamsters, guinea pigs, gerbils) and lagomorphs (such as rabbits and hares) has rarely been known to transmit rabies; therefore, post-exposure prophylaxis is rarely indicated after exposure to these animals. 1 In most countries, the risk of rabies is an encounter with an animal. The length of time virus may be excreted in saliva before the development of symptoms (asymptomatic carriage) has not been determined for the purpose of defining rabies exposure except in dogs, cats and ferrets. Vaccine should be administered IM into the deltoid muscle in older children and adults or into the vastus lateralis muscle (anterolateral thigh) in infants, but never in the gluteal region as this may result in decreased response to the vaccine. Rabies is spread to humans when virus in the saliva of an infected animal enters through a bite, scratch, broken skin, the mucous membranes or the respiratory tract. Four provinces accounted for the majority of these cases: Ontario (35%), Manitoba (22%), Quebec (16%) and Saskatchewan (13%). Depending on the risk of exposure, it may be appropriate to consider temporarily discontinuing immunosuppressive medications, in consultation with the attending physician, or to vaccinate once the person is no longer considered immunocompromised. In Toronto, TTY 416-327-4282 Hours of operation : 8:30am - 5:00pm. People with ongoing high risk of exposure and inadequate titres should be given a booster dose of either rabies vaccine. All horses, cattle and sheep intended to come into direct contact with members of the public must be immunized against rabies. National Advisory Committee on Immunization. If rabies immunoglobulin is administered, this may interfere with the response to live vaccines. If using the ID route for a booster dose, serology should be checked at least 2 weeks after the booster dose. 2. If you missed this year’s clinic, please call your veterinarian directly for more information about protecting your pet from rabies. Public Health Agency of Canada. RabIg should not be repeated at the initiation of this second course. Between 1924 and 2009, 24 people in six provinces died of rabies (Figure 1): Quebec (12), Ontario (6), Saskatchewan (2), Alberta (2), British Columbia (1) and Nova Scotia (1). With reports of rabies disease on the rise in Southern Ontario, a Waterloo vet is offering a low-cost vaccine clinic this weekend. If the site of the wound is unknown, the entire dose should be administered intramuscularly at a separate site from the administration of rabies vaccine. Lymphadenopathy, nausea and rash have been reported occasionally. This vaccine is usually required by state law. Local injection site reactions were reported in 11% to 57% of recipients, consisting of pain, tenderness, swelling, erythema and induration at the injection site lasting for 2 to 3 days. These handbooks contain the basic informationyou need to successfully integrate a new pet into your family, and ensure that it lives a happy and healthy life. Refer to Immunization in Pregnancy and Breastfeeding in Part 3 for additional general information. Refer to Vaccine Administration Practices in Part 1 for additional information. Seaton Village. The person has been immunized with a vaccine other than HDCV or PCECV. The length of time you are immune to rabies varies from person to person. It is particularly important to do so when the exposure involves the face, neck or hands, or when the behaviour of the bat is clearly abnormal, such as a bat that attacks a person or hangs on tenaciously. En savoir plus sur les navigateurs que nous supportons. The IM dose is 1.0 mL; the ID dose is 0.1ml. People who require a booster dose of rabies vaccine can be given PCECV or HDCV, regardless of the vaccine used for the initial vaccination series. Any animal that has bitten a human or is suspected of being rabid should be reported to local public health officials. Of these 36 bat-related human cases, the types of exposures reported were as follows: Figure 1: Rabies - Number of Deaths in Canada, 1924-2009. Ontario controls rabies in wildlife by dropping baits that contain the rabies vaccine in urban, forested and rural agricultural areas. No case of rabies acquired in this way has been documented, but post-exposure prophylaxis should be considered for individuals exposed to saliva or neural tissue from a person with rabies. The ID route should not be used in persons who are immunocompromised due to illness or medication, or are taking chloroquine, as the immune response to the vaccine may not be protective under these circumstances. Systemic reactions are generally less common (i.e., 1% to 10% of recipients) and may consist of malaise, myalgia, arthralgia, headache and fever. The animals in Canada most often proven rabid are wild terrestrial carnivores (e.g. In addition, an encounter with a potentially rabid animal is more likely to be recognized in a domestic animal. For more information, call the Health Unit at 1-866-888-4577, ext. The virus then gains access to the central nervous system through peripheral nerves. If indicated, initiate post-exposure prophylaxis as soon as possible but administer regardless of the time interval since exposure. Some immunocompromised people may never mount an appropriate immune response. 1 Certain areas of the world still have a major problem with rabies in dogs. When a bat is found in the room with a child or an adult who is unable to give a reliable history, assessment of direct contact may be difficult. Risk to travellers varies depending on itinerary, purpose and duration of the trip, as well as activities and access to medical care. If an acceptable concentration is not obtained, revaccination with a second rabies vaccine series is recommended, followed by further serologic testing. If a bat tests positive for rabies, the need for post-exposure prophylaxis should depend on whether direct contact with the bat occurred and not the rabies status of the bat. No post-exposure prophylaxis failures have occurred in Canada or the US. Contact Us; Animal Centre Locations; Adopt; Volunteer ; Blog; Media Releases; Employment; SPCA Professional; Follow Us. purified chick embryo cell culture vaccine. Because of the excellent immune response to rabies vaccine, healthy people immunized with an appropriate regimen do not require routine antibody determinations after either pre-exposure or post-exposure rabies vaccination, unless one of the following applies: People with ongoing high risk of exposure to the rabies virus or potentially rabid animals require periodic serological testing to ensure the persistence of circulating antibodies. Adverse reactions for rabies vaccines include injection site reactions, such as pain, erythema, swelling and itching. If possible, pre-exposure immunization should be delayed in immunocompromised individuals until the immunocompromised state has resolved. Travellers to rabies endemic areas where there is poor access to adequate and safe post-exposure management, as well as frequent and long-term travellers to high risk areas, should seriously consider receiving pre-travel rabies immunization. While IM administration of pre-exposure rabies vaccine is the gold standard, the WHO considers the ID regimen an acceptable alternative, as it uses less vaccine to produce a comparable degree of protection against rabies. The virus may enter a nerve rapidly or it may remain at the site of the bite for an extended period before gaining access to the nervous system. The vaccination status and behaviour of a domestic animal. Rabies immunoglobulin should not be given to persons who have previously received appropriate rabies vaccinations. The animal should be humanely euthanized in a way that does as little damage to the brain as possible, and the head submitted for immediate laboratory examination and rabies testing. 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