39 y/o F presents to your ED after a bite from a squirrel. She was attempting to feed to squirrels in Central Park when one of them bit down hard on the index finger of her dominant hand, drawing blood. She does not report any unusual behavior from the squirrel, although she admits she is not an expert in squirrel behavior. The bleeding from the wound site is now controlled, and looks free of contamination.
She is worried about getting rabies, and asks you to give her a shot to prevent this. Should you?’
No, rabies prophylaxis is unnecessary for most small rodent bites. This includes wild and domesticated gerbils, chipmunks, rats, hamsters, guinea pigs, mice, and rabbits. While these animals have been rarely noted to contract the rabies virus, there has NEVER been a reported case of animal-human transmission from one of these animals. If the animal is reported to be acting strangely, or rabies is endemic in your area, rabies prophylaxis should be initiated only in consultation with your local health department.
Woodchucks, groundhogs or other larger rodents HAVE been reported to transmit rabies to humans, but incidence is also very low, so consultation is recommended with your local health department. The largest reservoir of rabies is raccoons, followed by bats, skunks, foxes and dogs.
Weber EJ, Ramanujam P: Rabies, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 129:p 1723-1731.