Rabies, readiness, and role 1 medical care

As medics and doctors prepare for deployment to a combat zone, there are countless specified and implied tasks needed to prepare the medical support of an Infantry unit in theater. Appropriately, units spend the lion share of their efforts in trauma training and medical readiness (vaccinations, medication prescriptions, eye glasses, etc.) while ensuring that the sets, kits, and outfits are all fully stocked with the required items needed to execute the mission. Unfortunately, this training and preparation included little on the major challenges units currently face from rabies. With the unfortunate recent death of a soldier from rabies, medical personnel were required to become experts in animal control, the prevention of animal bites and scratches, and the most appropriate treatment of service members with potential exposure to rabid animals. This article will discuss the challenges of rabies management in Afghanistan, appropriate provider and unit preparation to minimize risk of developing rabies, the need for establishment of an animal control team and prerequisite training of soldiers, leaders, and medics before and during deployment. Finally, we will review published guidelines for treating individuals exposed to rabies with a discussion of our units experience with postexposure prophylaxis.