Red flags & when to go in person for Rabies Exposure (Post‑Exposure) - Triage

Audience: pediatric

Rabies is a serious infection that can happen after an animal bite or scratch. It affects the brain and can be deadly if not treated quickly. If a child has been bitten or scratched by an animal that might have rabies, it is important to act fast. Medical care often involves cleaning the wound and getting special shots called post-exposure prophylaxis (PEP) to prevent the virus from causing illness. Telemedicine can help assess the situation and guide families on what to do next. However, some signs mean the child needs to see a healthcare provider in person right away. This guide helps parents and caregivers understand when to seek urgent care, what to watch for, and how telemedicine can support safe and timely treatment after possible rabies exposure.

Red flags — go in person / ER

• Deep or bleeding wounds needing urgent cleaning and care — seek emergency medical attention immediately.
• Signs of infection around the wound such as redness, swelling, warmth, or pus — see a healthcare provider in person promptly.
• Symptoms like fever, headache, confusion, weakness, or difficulty swallowing after an animal bite or scratch — go to emergency care without delay.

What telemedicine can do

• Initial risk assessment and guidance after animal bite or scratch.
• Advice on wound cleaning and home care.
• Determining if post-exposure prophylaxis (PEP) is needed and helping arrange in-person care.
• Answering questions about rabies exposure and prevention.

What telemedicine cannot do

• Administering rabies vaccine or immune globulin shots.
• Treating deep, bleeding, or infected wounds in person.
• Managing neurological symptoms or signs of rabies illness.
• Performing physical examination or laboratory tests requiring in-person visit.

What is Rabies and How It Spreads

Rabies is a virus that affects the brain and nervous system. It usually spreads through the saliva of an infected animal, often through bites or scratches. Common animals that can carry rabies include bats, dogs, raccoons, foxes, and skunks. Once symptoms start, rabies is almost always fatal, so early care after exposure is very important.

When to Seek In-Person Medical Care Immediately

If your child has been bitten or scratched by an animal that could have rabies, go to a healthcare facility right away. Also seek urgent care if you notice:

Immediate treatment can prevent rabies from developing.

How Telemedicine Can Help

Telemedicine can provide quick advice on what to do after a possible rabies exposure. A healthcare provider can:

Telemedicine is a good first step but may not replace urgent in-person care.

Post-Exposure Prophylaxis (PEP)

PEP is a series of shots given after exposure to rabies to prevent illness. It usually includes a rabies vaccine and sometimes rabies immune globulin. PEP is most effective when started as soon as possible after the bite or scratch. Your healthcare provider will explain the schedule and importance of completing all doses.

Preventing Rabies Exposure

To reduce the risk of rabies:

Early action after exposure is key to keeping your child safe.

How to prepare for your tele-visit

• Have details ready about the animal involved (type, behavior, vaccination status if known).
• Know the time and location of the bite or scratch.
• Prepare to describe the wound size, depth, and any bleeding.
• List any symptoms your child is experiencing.
• Have your child’s medical history and vaccination records available.

After your tele-visit

• Follow instructions for wound cleaning and care carefully.
• Complete all recommended doses of rabies post-exposure prophylaxis on schedule.
• Watch for signs of infection or worsening symptoms and seek in-person care if they develop.
• Keep follow-up appointments as advised by your healthcare provider.
• Educate your child and family on avoiding future animal exposures.

FAQs

Can rabies be treated after symptoms start?

Rabies is almost always fatal once symptoms begin. That is why immediate care after exposure is crucial to prevent the disease from developing.

What animals should I worry about for rabies?

Common animals that can carry rabies include bats, dogs, raccoons, foxes, and skunks. Any bite or scratch from these animals or unknown animals should be taken seriously.

Is it safe to clean the wound at home?

Yes, gently washing the wound with soap and water for 15 minutes can help reduce the risk of infection. However, medical evaluation is still needed to decide if further treatment is required.

How soon should my child get rabies shots after exposure?

Post-exposure prophylaxis should start as soon as possible, ideally within 24 hours after the bite or scratch, to be most effective.

Can telemedicine replace going to the clinic for rabies exposure?

Telemedicine can help assess risk and guide next steps but cannot replace urgent in-person care for wound treatment and vaccination.

Sources

1. Rabies — Centers for Disease Control and Prevention (CDC).
2. Rabies — MedlinePlus, U.S. National Library of Medicine.
3. Rabies: Prevention and Treatment — Mayo Clinic.
4. Rabies Post-Exposure Prophylaxis (PEP) — World Health Organization (WHO).

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical evaluation and treatment. If your child has a possible rabies exposure, especially with red flag signs, seek immediate medical care.