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Rabies Info for Healthcare Providers

HEALTH DEPARTMENT AUTHORIZATION NEEDED PRIOR TO ADMINISTERING POST-EXPOSURE VACCINATION - It is important to note that you must contact the health department for authorization prior to administering rabies shots.  Contact information is listed below.  The exception to this rule is when prior notification would compromise the health of the patient.  By receiving "authorization" from the health department, you are assuring the patient that the health department has reviewed the case and is accepting financial responsibility for the portion of the hospital charges that are not covered by insurance.  This is to ensure that a patient does not decline proper treatment due to an inability to pay for the treatment.  Once the health department has reviewed the case and determined that it will not authorize the rabies shots, the physician and patient may agree to provide/receive the treatment but only with the understanding that any cost not covered by insurance will be the financial responsibility of the patient.

CONTACT INFORMATION:  You can reach the health department during normal business hours (8:00 AM to 4:30 PM, Monday through Friday excluding holidays) by calling 737-2019.  To send us reports of animal bites or exposures to potentially rabid animals, our fax number is 737-2059

For after hours emergencies, you can reach the answer service at 737-2028.  They will contact the "on-call" staff who will attempt to review the case to determine whether authorization will be given.   

NOTE:  ALL POTENTIAL RABIES EXPOSURES (including bites by pets) ARE REQUIRED TO BE REPORTED TO THE HEALTH DEPARTMENT, REGARDLESS OF THE VACCINATION STATUS OF THE ANIMAL THAT THE PATIENT WAS EXPOSED TO.

Listed below you will find a lot of helpful information regarding treatment for potential rabies exposures:


*NEW!!!! Health Advisory For Rabies Post-Exposure Prophylaxis - 5th Dose of Vaccine No Longer Necessary For Most Persons - To read the about this important change in PEP protocol, click HERE.


ON-LINE COURSE ON RABIES POST-EXPOSURE PROPHYLAXIS AVAILABLE.....Rabies Postexposure Prophylaxis (PEP) Basics: Case Illustrations of the 2010 Advisory Committee on Immunization Practices (ACIP) Guidelines is a free online course developed by the Maryland Department of Health and Mental Hygiene (DHMH) in collaboration with CDC. It is designed to educate health-care and public health professionals about rabies, the approach used in assessing rabies virus exposure, and administration of rabies PEP based on ACIP recommendations. Continuing Education credits are available to any physician, nurse, pharmacist, or veterinarian who takes the training. To learn more about this on-line course, click HERE.


TITLE IV of PUBLIC HEALTH LAW - This covers Sections 2140 through 2146 of New York State Public Health Law addressing such rabies topics as compulsory vaccination, seizure and disposal, county responsibilities, and the definition of "confinement and observation".  For a copy of this law, click HERE.


PART 2 of the STATE SANITARY CODE - This covers Section 2.14 regarding the "reporting of suspected rabid animals and persons exposed to them".  For a copy of this regulation, click HERE.


FORMS FOR ON-CALL NURSES:  There are 2 important forms that you should have available while you are "on call".  The first form is the RABIES EXPOSURE REPORT FORM.  This form should be completed for all reported animal bites (except for bat exposures).  The second form is the BAT INQUIRY PROTOCOL.  That form should be completed for all reports related to bats.  Both forms should be completed and returned to Environmental Health the next business day.  They can either be faxed (737-2059) or dropped off in person. To download a copy of the forms, click on the name of the form above.  For a copy of the handouts from the recent 2008 "in-service" training on Rabies 101, click HERE.


RABIES TREATMENT ALGORITHM - This decision chart was prepared by the New York State Department of Health (3/2004) and provides the latest guidance on providing human treatment for a potential exposure to rabies.  To download a copy of the treatment algorithm, click HERE.


HUMAN RABIES IMMUNE GLOBULIN (HRIG) ALGORITHM - Once a decision has been made to provide post-exposure vaccine after consultation with the local health department, this algorithm will assist in determining how to administer HRIG.  This chart was prepared locally with input from the NYSDOH.  To download a copy of the HRIG algorithm, click HERE.


CDC GUIDE FOR HUMAN RABIES PREVENTION, 2008 - To download a copy of this document, click HERE.


GUIDANCE REGARDING HUMAN RABIES EXPOSURE AND TREATMENT DECISIONS - The NYSDOH has prepared a guide that addresses many questions that arise regarding what an exposure is and how to treat for potential exposures.  To download a copy of the State guide, click HERE.


GUIDANCE FOR MANAGING BATS AND RISK OF RABIES TRANSMISSION - The NYSDOH has prepared a guide for managing bats and answers questions about exposure and prevention of rabies transmission.  To download a copy of the State guide, click HERE.


MMWR (Morbidity & Mortality Weekly Report) Compendium of Animal Rabies Prevention & Control - 2008:  This guide is published in conjunction with the National Association of State Public Health Veterinarians, Inc. annually and provides information primarily for veterinarians in the prevention and control of rabies.  It also includes a list of the rabies vaccines that are currently licensed and marketed in the United States.  To download a copy of the 2007 Compendium, click HERE.

Chemung County Health Center
103 Washington Street
Elmira, NY

Public Health
607.737.2028
cchd@co.chemung.ny.us

Environmental Health
607.737.2019
ehs@co.chemung.ny.us
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