Local treatment of wounds
Elimination of rabies virus at the site of the infection by chemical or physical means is an effective mechanism of protection. Local treatment of wounds involving possible exposure to rabies is recommended in all exposures.
Recommended first-aid procedures include immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances of proven lethal effect on rabies virus.
If soap or an antiviral agent is not available, the wound should be thoroughly and extensively washed with water. If suturing after wound cleansing cannot be avoided, the wound should first be infiltrated with passive rabies immunization products and suturing delayed for several hours.
Other treatments, such as the administration of antibiotics and tetanus prophylaxis, should be applied as appropriate for other bite wounds.
The recommendations given here are intended as a general guide. It is recognized that, in certain situations, modifications of the procedures laid down may be warranted. Such situations include exposure of infants or mentally disabled persons and other circumstances where a reliable history cannot be obtained, particularly in areas where rabies is enzootic, even though the animal is considered to be healthy at the time of exposure. Such cases may be treated as category II or III.