Rabies Risk Assessment Flowchart

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A flow chart describing rabies risk assessment  Veterinarian receives report of domestic animal exposure to a potentially rabid animal (could be report on a single animal or herd) Was there any human exposure? (bite, scratch, orally medicating a neurologic animal?) Yes: Refer to local public health unit for risk assessment on human exposure (risk assessment for animals will occur after public health assessment)(end) No: Did a category 2 or higher exposure occur? (see table below for details) No: Negligible risk. Recommend rabies vaccination if animal not up to date. (end) Yes/Maybe: Is the offending animal a rabies reservoir species? (Bat, raccoon, skunk, fox) Yes: What is the local epidemiology of rabies? Did the exposure occur in a higher-risk area for the reservoir species? AND Was the animal displaying abnormal behaviour or neurologic signs? AND Was the offending animal unprovoked? Was the offending animal's behaviour abnormal considering the situation? Yes to all: Significant risk. Recommend testing if available and post-exposure management options if testing not available or tests positive. Recommend rabies vaccination within 7 days of incident. (end) Yes to one or two: Increased risk. Consider testing or post-exposure management options if testing not available. Recommend rabies vaccination within 7 days of incident. (end) No to all: Negligible risk. Recommend rabies vaccination if animal not up to date. (end) No: Was the animal displaying abnormal behaviour or neurologic signs consistent with rabies? Yes: Increased risk. Consider testing or post-exposure management. Recommend rabies vaccination within 7 days of incident. (end) No: Does local rabies epidemiology support an increased risk of rabies in the offending species? Yes: Increased risk. Consider testing or post-exposure management. Recommend rabies vaccination within 7 days of incident. (end) No: Negligible risk. Recommend rabies vaccination if animal not up to date. (end) WHO categories of exposure Category 1: Touched of licked on intact skin by offending animal Category 2: Nibbled, minor skin lesions in contact with saliva of offending animal Category 3: Bitten, deep scratches, broken skin or mucus membranes in contact with saliva of offending animal