Epidemiology
Rabies Health Advisory Update 

Rabies is a viral disease that affects the central nervous system. It is transmitted to humans through the saliva of infected animals. After the onset of symptoms, rabies is almost always fatal. Vaccinated pets are a barrier between humans and the wildlife reservoir of rabies. However, unvaccinated animals present a very high risk. Rabies is rare in Western Europe; however it is a major health risk in Eastern Europe and countries throughout Africa and Asia. DoD health officials would like to remind the U.S. military community to:

rabies advisory
  • Follow General Order #1: Don’t keep mascots when deployed.
  • Avoid wild or unvaccinated animals.
  • If you are bitten or if an animal’s saliva contacts your broken skin, eyes or mouth, immediately wash the area with soap and water and seek immediate medical attention.
  • Report bite incidents immediately.

Who Must Receive Medical Evaluation for Treatment Now to Ensure the Health of All Personnel?

Individuals who meet the following criteria are to report for a medical evaluation as soon as possible:

  • Those who had a possible animal exposure that occurred after 01 March 2010. A possible exposure is a bite or contact with the saliva of warm-blooded animals, such as dogs, cats, bats, foxes, skunks, raccoons, and jackals.
  • Those who had no medical evaluation or incomplete / undocumented evaluation or post-exposure prophylaxis (PEP) following an exposure incident. Individuals who are not 100-percent confident they received appropriate and completely documented care must be evaluated.

If you believe you have been exposed to rabies please call the wounded soldier and family hotline:
COM: 800-984-8523
DSN: 312-421-3700



Key Facts about Rabies:

rabies advisory
  • Rabies is a viral infection that can be transmitted to humans through the saliva of infected animals.
  • Animals present in deployment settings are not vaccinated against rabies as pets are in the United States.
  • Humans can be infected with rabies by being bitten by an infected animal or getting saliva from an infected animal in open wounds, mouth, or eyes.
  • You cannot always tell if an animal has rabies.
  • Once the signs and symptoms of rabies develop, the disease is almost always fatal.
  • Rabies is preventable. Treatments for rabies are available at medical treatment facilities in theater and in fixed medical treatment facilities worldwide.

How to Prevent Rabies:

  • Don't adopt mascots or pets when deployed!
  • Do not approach, feed or handle wild or stray animals.
  • If you are bitten or get animal saliva on broken skin or in your eyes or mouth, immediately wash the area with soap and water and seek immediate medical attention-rabies is preventable if exposed individuals receive prompt medical care after being exposed.
  • Report animal exposures immediately.
  • Capturing animals for observation or euthanizing animals for rabies testing is best performed by qualified veterinary or force health protection personnel who are already vaccinated against the disease.
  • Failure to follow proper procedures can result in greater potential exposure to rabies.

Medical Treatment for Rabies:

  • All individuals who may have been exposed to an animal bite or saliva should seek immediate medical evaluation and treatment. Medical treatment may include what's known as post-exposure prophylaxis (PEP). PEP includes wound care, injection of human rabies immune globulin (HRIG) and a series of four or five rabies vaccinations (doses may be reduced if the individual was vaccinated before the exposure). Medical record reviews in Afghanistan and Iraq identified individuals who did not have a complete PEP regimen documented in their medical records. These individuals must be re-evaluated to ensure proper PEP was administered.
  • If medical treatment is obtained promptly following a rabies exposure, nearly all cases of rabies will be prevented. Cleaning of the wound or exposure site with soap and water for at least 15-minutes is the most important first step in treatment, followed by administration of PEP. PEP is still effective if given weeks, months, or even years after a potential exposure, so older exposures still require evaluation and, if required, treatment with PEP.
  • It is important to report and seek evaluation for all animal exposures regardless of how the animal was behaving. Animals can be infected with rabies while still appearing healthy.

Who Must Receive Medical Evaluation for Treatment Now to Ensure the Health of All Personnel?

Individuals who meet the following criteria are to report for a medical evaluation as soon as possible:

  • Those who had a possible animal exposure that occurred after 01 March 2010. A possible exposure is a bite or contact with the saliva of warm-blooded animals, such as dogs, cats, bats, foxes, skunks, raccoons, and jackals.
  • Those who had no medical evaluation or incomplete / undocumented evaluation or post-exposure prophylaxis (PEP) following an exposure incident. Individuals who are not 100-percent confident they received appropriate and completely documented care must be evaluated.

All individuals described above, whether active duty (AD) personnel, national guard (NG) or army reserve (AR) in any status, individuals separated from service, DoD civilians, or retirees can report to military medical treatment facilities (MTFs) and receive treatment at no cost once it has been established they were potentially exposed while in a theater of operation. Individuals should report to the patient administration division at these MTFs for coordination of their evaluation and treatment.

All current or former contractors or contractor employees should call the wounded soldier and family hotline for assistance identifying treatment options: com: 800-984-8523, DSN: 312-421-3700.

For those individuals not near a military MTF, eligible beneficiaries may also use their TRICARE benefit for evaluation and treatment at a civilian treatment facility. Any veteran who has deployed to a combat zone in the past 5-years is also eligible for care at department of Veterans Affairs (VA) hospitals and clinics.

Individuals who are not currently eligible for care and who live more than 100-miles from an MTF or VA hospital or clinic should call the wounded soldier and family hotline for coordination of their evaluation and care at the nearest MTF: com: 800-984-8523, DSN: 312-421-3700.