Rabies, a viral infection, is transmitted in the saliva of infected animals, such as bats, raccoons, skunks, cats, and dogs. Serologic testing is diagnostic for the presence of rabies in animals. It also indicates the degree of antibody responses to rabies immunization (e.g., for people who routinely work with animals).
Humans
Collect a 7-mL blood serum sample in a red-topped tube. Observe standard precautions.
Label the specimen with the patient’s name, date, and test(s) ordered and place in a biohazard bag.
Animals
If the suspect animal exhibits abnormal behavior, standard procedure is to euthanize the animal and examine its brain for Negri body inclusions in the neurons.
Rabies testing is usually performed in a public health laboratory.
An elevated titer in humans indicates an adequate response after immunization. A rabies titer of 1:16 or greater is considered protective.
Pre-exposure vaccination should be offered to individuals in high-risk groups such as veterinarians, animal handlers, or international travelers if they are likely to come in contact with rabid animals and medical care is limited.
Postexposure vaccination should be administered to previously vaccinated individuals if exposed to rabies.
Postexposure prophylaxis is considered a medical urgency, and each situation should be evaluated by trained medical personnel and in consultation with public health officials. The individual should not be vaccinated unless the animal develops clinical signs of rabies during a 10-days observation period. If the animal is rabid, the person should be vaccinated immediately.
Pretest Patient Care
Explain test purpose and procedure.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.