If a person is exposed to a potentially rabid animal, he or she should receive both the rabies vaccine and rabies immune globulin. The vaccine will help produce antibodies in the long run but take about two weeks to start working. The rabies immune globulin is an injection of antibodies filtered from the blood of other people who have had the vaccine. These antibodies can start attacking the virus in the blood immediately.
There are complicated rules as to who should get the vaccine and immune globulin based on what species of animal was encountered, what type of exposure occurred, and whether the animal was captured or not. The reason for capturing the animal, dead or alive, is so that it can be tested for rabies. If the animal does not have the disease, then the human contact does not need treatment.
One of the rules for giving the vaccine and immune globulin is based on a case report of human rabies that had been transmitted from a bat without a known scratch or break in the skin. In this case, a woman woke up to find a bat in her bedroom, which she let fly out the window. Since she did not recall any contact with the bat and it was felt that she would have woken up if the bat had touched her, she was not treated. Unfortunately, she developed rabies, presumably from an unknown contact with the bat.
For this reason, if a sleeping person wakes up to find a bat flying around in the room, they are advised to capture the bat, if possible, and to contact the health department for guidance. If the bat is not captured, the general rule is to treat the situation as if the bat had made contact with the sleeping person and to give the exposed person the vaccine and the immune globulin.
The vaccine is given in a series of five doses over twenty-eight days. If rabies immune globulin is necessary, it is only given once, when the person presents to medical attention. In general, the health department and emergency room are the most common sources of the vaccine and immune globulin, although some travel clinics may also have supplies.