Rabies: Dog Bite — What to Do, When to Go

Key takeaways

Once rabies has produced symptoms it is almost always fatal — but handled correctly straight after the bite, it can be prevented. The whole value of this article lies in getting you seen today rather than waiting and watching.
Wash the wound at once with clean water and soap, thoroughly and for a long time under running water. This is the one thing here you can do yourself, and it genuinely helps.
Not only dogs. Cats, bats and wild animals also transmit it. A bat bite can be so small that you do not know you were bitten — waking up with a bat in the room also means being seen.
Do not treat «the animal looks perfectly well» or «it is the family dog, it has had its shots» as a reason to skip the appointment. Ask the owner whether the animal has been vaccinated, then take that information in with you.
Saliva licked onto broken skin, or splashed into the eyes, nose or mouth, also counts as exposure. It is not only a bleeding bite that counts.
What is given, and whether immunoglobulin is needed, is the doctor's decision after they have looked at the wound and heard what you can tell them about the animal. Do not work it out for yourself at home.

Just bitten by a dog, scratched by a cat, or found a bat in the bedroom — the two most important things can both be done today: wash the wound very thoroughly, then be seen. Once rabies has set in there is almost nothing to be done; handled correctly straight after the bite, it can be prevented.

Recognising it: what counts as having been exposed

Most people who come in late do so not because they did not know rabies was dangerous, but because they decided for themselves that their own wound was «nothing much». The size of the wound does not tell you how dangerous it is.

Bitten or scratched by a mammal — a dog, a cat, a bat, a monkey, a wild animal; a tiny wound that did not even bleed counts too
The animal's saliva in contact with an open wound or broken skin, or splashed into the eyes, nose or mouth — even if it only licked you
Any possibility of having touched a bat directly, even without seeing a bite mark: per CDC, a bat bite can be very small and you may not know you were bitten
Waking up with a bat in the room: CDC advises treating this as possible exposure and being seen
Per CDC, worldwide the domestic dog is the source of most human rabies deaths; rabid cats are also reported regularly
Small children are at greater risk: CDC gives the reasons as children being curious, not yet able to read an animal's warning signs, and being small, so that bites more easily land on the head and face
Conversely, simply stroking or holding an animal without being bitten, without being scratched and without saliva reaching broken skin does not count as exposure — but CDC advises that if you are unsure whether you had contact, ask the health authorities anyway

What to do now

Nothing below needs a prescription.

Wash the wound at once with clean water and soap, running it under a flowing tap and washing for a good long while — per CDC, 15 minutes — so that as much of the virus as possible is flushed away.
Once washed, cover it with clean gauze, then be seen today. Do not put the appointment off in order to wash it more.
Note down the time of the injury, what the animal was, where it happened, and whether it belonged to somebody or was wild.
If the animal has an owner, ask the owner whether it has been vaccinated against rabies and ask for proof. Take that information in with you — it is a fact the doctor needs, not a reason for you to stay home.
Do not try to catch the animal yourself. Report it to the local veterinary or health authorities so that they can deal with it and keep it under observation.
If there is a bat in the house, do not let it out before asking the health authorities — CDC says this explicitly, because that bat may need to be tested.

What you must NOT do

Do not wait to see whether the animal develops anything before deciding: per CDC, the decision to be seen must not be delayed. Keeping the animal under observation is the job of the health and veterinary authorities, and the doctor may take account of it — but that is their assessment, not a reason for you to skip the appointment
Do not treat «the wound has healed» or «it was a while ago» as a reason not to go
Do not apply leaves, powders, toothpaste, oil or grease to the wound
Do not suck the wound, squeeze it or cut it open wider; do not stitch it at home
Do not buy antibiotics and consider the matter closed — antibiotics do not prevent rabies

Signs that the disease has set in

Rabies does not begin straight away. Per CDC, the interval between exposure and the appearance of symptoms can run from weeks to months. That is why families often fail to connect the two things: the bite healed long ago and nobody remembers it any more.

The early stage resembles flu: tiredness, feeling unwell, fever, headache
Discomfort, tingling or itching at the site of the old bite — a very characteristic sign, per CDC
After that: unusual anxiety, confusion, agitation, hallucinations
Very thirsty but panicking at the sight of water; a lot of saliva
Aggressive behaviour, thrashing about, biting people

When you must go to hospital

Call 115 (the emergency number in Vietnam) or go to emergency care NOW if any of the onset signs above is already present — fever and headache, tingling or itching at the site of an old bite, confusion, agitation, a lot of saliva, thirst with a fear of water, thrashing about — after any occasion on which an animal bit, scratched or licked you, including one many weeks earlier. When you call, say clearly that there was an animal bite beforehand. Also go to emergency care NOW, even with no symptoms, if: the wound is bleeding heavily or is very deep · the wound is on the head, face or neck · there are several bites at once · the bite was from a bat or a wild animal · a small child was bitten on the head or face. BE SEEN TODAY, do not wait until tomorrow, in every remaining case: bitten or scratched by a dog, cat, monkey or unfamiliar animal, however tiny the wound · licked on broken skin, or saliva splashed into the eyes, nose or mouth · waking up with a bat in the room · the animal ran off, was wild, or has no known owner.

Per CDC, most exposures need to be assessed promptly but do not require going straight to an emergency department, unless the wound itself needs emergency treatment. The two levels above therefore differ by the wound and the animal, not by whether the illness is mild or severe — your part is to be seen, not to grade yourself.

What has to be done at a medical facility

Plainly: this is an illness that has to go to a medical facility. Rabies vaccine and immunoglobulin are given at a medical facility, not at home. What Y Te Xanh can do sits around the wound: listening to what you tell us over a video call and then saying clearly whether this case needs to be seen, and changing dressings and removing stitches on the treating doctor's orders once the medical facility has dealt with it. If any sign in the box above is present, go in first and call afterwards.

Per CDC, rabies is transmitted mainly through the bites and scratches of an infected animal, and CDC advises washing a bite or scratch immediately with water and soap and then being seen, treating being seen as something that must not be delayed. Source: CDC. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.

Sources

CDC — About Rabies

Frequently asked questions

Our dog has had its shots and the bite was only slight — do we still need to be seen?

You should still be seen. The fact that the animal has been vaccinated is important information, so ask the owner for proof and take it with you — but it is something the doctor uses to make an assessment, not something you use to decide for yourself. Per CDC, the decision to be seen must not be delayed. Wash the wound with clean water and soap under a running tap, then be seen today and say clearly whose animal it was, what it has been given, and where it is now.

I was bitten by a dog several days ago and have only just started worrying. Is it too late to be seen?

Go today and say clearly that you were bitten several days ago. Do not decide for yourself that it is too late and give up — the interval between exposure and the appearance of symptoms can run from weeks to months, so skipping the appointment because you think you are late is trading something that can still be done for something that can no longer be done. What needs doing now is exactly what needed doing on the day: be seen, describe the animal and the circumstances accurately, and let the doctor decide.

Can a rat bite give you rabies?

The risk is very low. CDC places small rodents such as mice, rats and squirrels in the group with negligible risk, and rabies in them is rare. Still wash the wound with clean water and soap, and still be seen if the wound is deep, bleeding heavily, on the head or face, or if the animal was behaving oddly in a neurological way — in which case CDC advises asking the health authorities. Quite apart from rabies, animal bites can become infected, so if the wound grows more swollen and painful or starts discharging pus, be seen.

The animal ran off and nobody knows whose it was — does that change anything?

It does, in the direction of making the appointment more necessary rather than less. When the animal cannot be found, nobody can keep it under observation, so the doctor has to decide on the basis of the wound, the species and the circumstances you describe. Be seen today and say clearly: what it was, where it happened, whether it had been provoked or came at you unprompted, and whether you noticed anything odd about it. If you know roughly where it is, report it to the local veterinary or health authorities.

The wound only grazed the skin and did not bleed, and I washed it well — is that enough?

Not yet. A scratch that breaks the skin can still have been contaminated with the animal's saliva, so it is a route of transmission. The size of the wound does not tell you how dangerous it is, and that is also the reason not to decide for yourself that yours is small. Washing thoroughly with clean water and soap under a running tap is still the right thing to do and well worth doing, but it does not replace the appointment — go today and let the doctor see the wound.

Can a nurse come to the house to give the rabies vaccine?

No. Rabies vaccine and immunoglobulin are given at a medical facility, where there are the means to observe and to handle a reaction, so we do not do this at home. What we can do sits before and after: listening to what you tell us over a video call so we can say clearly whether this case needs to be seen, and then changing dressings, monitoring the wound and removing stitches on the treating doctor's orders once the medical facility has dealt with it. If any sign in the red-flag box is present, go in first and call afterwards.