Postexposure rabies prophylaxis in an urban emergency department

The purpose of this retrospective study was to identify those patients presenting to an urban emergency department with animal-related wounds, define source animal demographics, and assess adequacy of wound care, rabies immunoprophylaxis, and follow-up. Sixty-three patients comprised the study population; dogs (76%) and cats (16%) were the principal source animals. Postexposure rabies prophylaxis was indicated in ten patients (16%) due to wounds inflicted by stray dogs and cats. Animal behavior and vaccination history were inconsistently addressed, but were documented significantly more often in patients who received prophylaxis. Inclusion of soap in wound care was not significantly more common in the treated group. Human rabies immune globulin was administered incorrectly at least one-third of the time. Appropriate follow-up was arranged in only 31% of cases; this occurred significantly more often with treated patients. An awareness of both regional epidemiological trends in animal rabies and local health department treatment recommendations will encourage optimal delivery of postexposure treatment in cases of potential rabies exposure.