Rabies is a viral disease that affects the central nervous system of warm-blooded animals, including humans. Once symptoms appear, rabies is almost always fatal. People and pets can be exposed to rabies through bites and scratches from animals infected with rabies through their saliva. Exposure to a wild or outdoor animal is considered a higher risk of rabies transmission as part of the overall assessment of risk. In Ontario, animals most at risk for having rabies are raccoons, foxes, skunks, and bats.
Duty to Report
Ontario Regulation 557/90: Communicable Diseases - General sets out the duty to report animal bite and contact information:
“A physician, registered nurse in the extended class, veterinarian, police officer or any other person who has information concerning either or both of the following shall, as soon as possible, notify the medical officer of health and provide the medical officer of health with the information, including the name and contact information of the exposed person:
- Any bite from a mammal.
- Any contact with a mammal that is conducive to the potential transmission of rabies to persons.”
How to Report
To report the animal exposure, complete the rabies investigation form, https://www.wechu.org/rabies-investigation-form. The form can be submitted electronically via email at rabiesfax@wechu.org, or by fax to 226-783-2113. The exposure can also be reported to 519-258-2146 ext. 4475, Monday through Friday from 8:30 am to 4:30 pm, and after-hours at 519-973-4510.
Frequently Asked Questions for Rabies Post-Exposure Prophylaxis (PEP)
Rabies PEP is a treatment protocol administered after a potential rabies exposure, such as an animal bite, to prevent the virus from infecting the person. High-risk exposures include bites to the face, neck and hands. Bat bites are not always visible, and direct contact with a bat, or when a bite, scratch or saliva exposure into a wound or mucous membrane cannot be ruled out, rabies post-exposure prophylaxis (PEP) is recommended.
- Immediate wound cleansing: Thoroughly wash the wound with soap and water for at least 15 minutes. Suturing the wound is not advised. Viricidal can be applied (such as alcohol solutions or iodine-based solutions).
- Rabies Immunoglobulin (RIG): Administered as soon as possible, preferably within 7 days of the exposure. Rabies immune globulin should be administered in and around the wound (bite, scratch) with the remainder given as a deltoid IM injection on the opposite side from the rabies vaccine.
- Contact Public Health Unit to request rabies PEP (RIG and rabies vaccine).
- Refer to the Canadian Immunization Guide for the Rabies Vaccine Schedule and vaccine information:
| Person | Rabies immune globulin* | Rabies vaccine** |
| Previously unimmunized and immunocompetent | Day 0 | Days 0, 3, 7 and 14 (4-dose series) |
| Previously unimmunized and immunocompromised | Day 0 | Days 0, 3, 7, 14 and 28 (5-dose series) |
The schedules for PEP should be adhered to as closely as possible. It is essential that all doses be received, and doses should not be given early to allow for sufficient immune response.
If a dose is delayed, it should be given as soon as possible and the schedule resumed. If there has been a significant deviation from the recommended schedule, immunity can be assessed with serology testing 7 to 14 days after the last vaccine dose. Refer to the Canadian Immunization Guide – Vaccine Administration for more information.
Yes, Rabies PEP is available in all hospitals in Windsor and Essex County.
The initiation of rabies PEP is the responsibility of the health care provider as they are assessing and treating the patient. Based on the assessment of the animal exposure, health care providers should contact the Public Health Unit if PEP is required.
It is important to note that rabies PEP will only be processed and delivered if the health care provider is willing to administer the full treatment course (rabies immunoglobulin and vaccines) and meet additional requirements.
The Public Health Unit will then confirm the clinic's location and deliver the PEP to the health care facility.
Health care providers at the hospital are to determine if rabies PEP is required.
If required, health care providers must contact the Public Health Unit for approval during regular operating hours or through the after-hours phone line. Approval is required as this is a provincially funded vaccine.
Once the approval is given, health care providers can administer the rabies PEP (usually rabies immunoglobulin and first dose of vaccine) from their own hospital supply.
After administering the initial rabies PEP, health care providers must complete the Rabies Investigation Form and document the rabies immunoglobulin and vaccine information on the form and submit to the Public Health Unit.
If rabies PEP is required, the patient should be re-directed to another health care provider who is able to administer rabies PEP. The Health Unit does not administer rabies PEP.
Health care providers can contact WECHU for support and further guidance:
- Environmental Health Intake line 519-258-21146 ext. 4475 or after hours at 519-973-4510 for questions about rabies investigations and requesting rabies PEP
- Immunization Department at vaccine@wechu.org or 519-258-2146 ext. 1121 for questions about rabies vaccine products and administration
Additional resources are available here: