Rabies management in the ED.

Interesting article in the Journal of the Royal Army Medical Corps on the management of Rabies. Now, we don’t get a lot of Rabies in Virchester, but the weather is so terrible here lots of our patients come back having been bitten by dogs in foreign climes.There was even a death recently in the UK from Rabies contracted abroad. Apparently the patient was sent home from the ED at one point which got the media excited (though the details were somewhat more complicated).

A few key points to pick up.

1. Don’t forget to treat the wound as a bite. Obvious, but you can get so caught up in the rabies question that you forget about the basics.

2. Get advice from the HPA or local communicable diseases experts. They know more than you do!

3. Know where you can access Rabies immunoglobulin and vaccine.

As an extra thought don’t forget that European Bat Lyssavirus does occur in the UK and you should think about this in people who handle bats and occasionally in fly fisherman who may catch a bat on the wing whilst fishing.

Simon Carley

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