Rabies Reporting & Vaccines
You must report all animal exposures to Public Health Services
Report high risk exposures by phone.
Report low risk exposures by phone or fax.
Complete the Mandatory Reporting Form for Possible Rabies Exposure for all cases of bites, scratches, or suspect exposures between mammals and people.
Rabies vaccine and RabIg
The Ontario Public Health Standards’ Rabies Prevention and Control Protocol recommend that individuals start rabies post-exposure prophylaxis, or PEP, within 24 hours after the decision is made that PEP is required.
A physician’s decision to order PEP can be supported by:
- Public Health Services Rabies Risk Assessment Guideline
- The Canadian Immunization Guidelines on rabies
- Rabies Vaccine & Immune Globulin fact sheet
- Consultation with public health staff such as public health inspectors, program manager or Associate Medical Officer of Health
Post exposure prophylaxis involves administering Rabies Immune Globulin (RabIg) and a schedule of rabies vaccine. The recommended dosage and schedule is below.
- For persons not immunocompromised RabIg is administered on Day 0 (the day the first dose is administered) and four doses of vaccine are administered on Day 0, 3, 7, 14
- Previously unimmunized immunocompromised persons including people who take corticosteroids or other immunosuppressive agents, who have immunosuppressive illnesses and who take chloroquine and other antimalarials - RabIg is administered on Day 0 the day the first dose is administered) and five doses of vaccine are administered on Day 0, 3, 7, 14 and 28
Post-exposure prophylaxis of previously immunized individuals
RabIg is not indicated and should not be given to someone who has been previously appropriately immunized as indicated below. In previously appropriately immunized individuals who require post-exposure prophylaxis, two doses of HDCV or PCECV, one administered immediately and the other 3 days later, are recommended. Appropriate previous rabies immunization consists of:
- Documentation of a complete course of pre-exposure or post-exposure prophylaxis with HDCV or PCECV, OR
- Documentation of complete immunization with other types of rabies vaccine, or with HDCV or PCECV according to unapproved schedules, with the demonstration of an acceptable concentration of neutralizing rabies antibody in serum after completion of the series. Refer to Serologic Testing for information regarding criteria for serologic testing.
A complete course of either HDCV or PCECV, as well as RabIg, is recommended for those who may have received rabies vaccines in the past but do not fulfill the criteria listed above for appropriate vaccination. A serum sample may be collected before the initiation of post-exposure prophylaxis to test for rabies antibody, and if an acceptable antibody concentration (0.5 IU/mL or greater) is demonstrated, the vaccine course may be discontinued, provided that at least two doses of vaccine have been given. If in doubt, consultation with an infectious diseases or public health physician is recommended.
Emergency rooms ordering PEP will only receive the required RabIg and one dose of vaccine, unless arrangements are clearly made for the ER to complete the series of vaccine shots for a patient.
- If an ER only administers Day 0 vaccine and RabIg, the patient’s family physician must call to order the remaining doses.
Order PEP by phone:
- Monday to Friday 8:30 am to 4:30 pm: 905-546-2424 ext. 3327
- After hours, weekends and Holidays: 905-546-3570
Indicate that you wish to order rabies vaccine and the answering service will contacts the public health inspector on call.
You need to provide the following when you call:
- Requesting physician’s full name
- Address for delivery
- Requested time for delivery
- Patient name, date of birth, current weight (rabies immune globulin is administered based on weight) and patient contact information
- Basic exposure details such as location of incident, date of exposure and type of animal
You may receive a call back to discuss the PEP order if the circumstances of the exposure do not meet PEP recommendations.
Delivery may take from one to 24 hours from the time you place your order; however usual delivery time is between one to four hours on a 24 hour basis.
Once we supply rabies vaccine and RabIg to a hospital emergency room, physician or nurse practitioner’s office, whether a part of a series or a full series, they cannot be returned to Public Health Services.