Sweet Deal On Rabies Shots

When I started in business the Humane Society was giving rabies pre-exposure shots to all of their people. I asked if I could get

them and they were happy to oblige. The cost was less than $50 and nobody believed that I could 3 shots for less than the serum

cost but I'm sure I got a deal through the humane society. Anyway, a friend of mine had a technician that got bit by a raccoon and

he went to the emergency ward for his shots. Guess how much those shots were? He got a bill for $21,000.00. I told him to make a

couple of phone calls and I guess he got it knocked down, but 21 grand, seriously?

Just got the news, for me its going to be about $800 for the pre exposure. Now I am considering just dieing of rabies.

Ouch Wink!

That sounds like a rough deal, though life is of course priceless, $20K can sure set someone back in many ways.....

Gotta love the medical field, must be like the guy who can find the squeaky stair and fix with the .01 nail, the doc must have
some special power to put that magic potion in the right spot and over the right number of days that no lesser skilled person can do...

Oh wait, it typically is a nurse isn't it that puts it in?



Someone is making some bank somewhere on that deal!

Just talked with a family that had to have the post-exposure shots. 12k each person. This was 3 weeks ago. (Bat in home, people asleep, bat tested positive for rabies).

Cost 750.00 for three shots two months ago at health dept. My insurance covered all but my co-pay. This was pre- exposure

Kurt Temple

Travel clinics that give shots for international travel have lower costs in my area. A colleague mentioned this about his own post exposure, I think it was $250.00 percent per shot, so more than some here but no where near the thousands being reported.

Worth looking into for pre or post.

Man you guys sure pay for that sort of thing , I got post exposure shots for free

So the employers bet was 1000.00 up front for pre exposure shots against 21,000.00 for post exposure which may never happen? Did they even have bite gloves on there trucks? Will this raise his workmen' s comp insurance?
Why not set up a employee payment plan to pay off the cost of the shots to the employer by having a weekly amount taken out of payroll check, and make it a condition of getting the job. Or they get shot before being hired.
Does this not open the employer to a possible law suit or a OSHA visit for not making sure the employee could safety do the job, since rabies is a known safety hazard in many states.
Just askin....

Kurt Temple

Good questions Kurt! This should be interesting.

I'm not a doctor, but this is what I know so far, if things have changed, then I may no longer be correct. Pre-exposure shots were

different and you never really knew if you were completely protected unless you were tittered ( Tested ). On the bright side, you are

always somewhat protected and may just need a booster if you are bitten by a rabid animal. My son P.J. was given post exposure shots

to the tune of $4000.00 but was also told that he would be protected for life. Like I said, things may have changed but I know the

collective minds on this site are have better information about rabies than any of the collective minds of doctors in our area.

Bite gloves don't work 100%, handled a rough looking raccoon back in April, tooth went through a sew hole in the left glove & found me. went to ER & found the county pays for post exposure shots.

It was suggested to me to get tested each year to make sure its still valid protection. If bite happens you get 2 or three more shots. Seems the post exposures shots must be a different med and cost much more. Not sure what type you get and cost if you have had the pre exposure shots.
trapdye,
It sounds like a design flaw in the glove which brand was it? Did you contact the seller or manufacturer


Kurt Temple

FWIW: Any Veteran can get the pre-exposure shots at the VAMC. Tell your primary care Doc that you handle wild animals, and NEED the shots. May have to argue a bit and go see the Patients Advocate, and/or a VA Rep, but don't take no for an answer.
If your not registered in the VAMC system, do so, you never know when your gonna need it.

Justin, you are right about Kurt's questions being interesting. Since no raccoons tested in the state of Wisconsin have ever come

back positive for rabies, this puts an additional twist on law suits and OSHA. If my previous post is correct, the post exposure

rabies shot is the most effective one anyway so I doubt there would be any problems unless you failed to provide those shots after

someone is bitten.

Kurt in Va, Don't think it was a flaw in the glove, just bad luck to hit a sew hole & a tooth made it through. I was told when shots were given, 9 because they go by weight, that if bitten again, I would need a booster shot. must be a different med for pre. & post shots as you said , some say with pre. shots you just get your level check every couple years

In regard to OSHA, I'd think that it is not a requirement for an employer to get shots for their employees (I was told this was the result from OSHA when this question was asked by several large companies). With that being said, the employer is response to ensure that the employee is provided with personal protection equipment for performing their task. This includes not only the respirator, but also the annual pulmonary test to ensure the employee is healthy enough to wear it and the annual fit test to ensure the respirator fits correctly. Additionally, the employer is responsible for providing eye and hearing protection, gloves, capture and confinement equipment, fall protection, and any additional equipment and materials required to complete the job. Additionally, the employer must have a training program related to bat work and be able to show proof that the employee has gone through the training program. (This is where companies hiring day help for clean outs are really taking chances.)

Should a bite happen, in most cases I'd believe nothing would happen as it is a health department/worker's comp issue. Based on how big of a company you have, there may or may not be OSHA paperwork involved.

Where it gets more difficult is when the bite is not reported to the employer or it is reported and the employer does nothing and then issues occur at some other time down the road. The training program now becomes very important as it is something the employer can show to prove that they didn't just send someone into an attic with a bat problem telling them to figure it out as they go. I'm not saying that the employer wouldn't get fined by OSHA as there are too many other factors including supervision, how in-depth the training program is, etc., but at the very least it would help against a law suit by the employee or their family.

My last job as an employee I wrote two OSHA programs. One for a business office and one for a hotel. Very different with some cross over, here is what I learned.

There are some good DVD programs to walk you step by step through it. Also good info on OSHA site.

The MSDS book you have to create is a lot of work, once done do not allow employee's to bring any chemicals to work.
It makes it easier keeping the MSDS book current.

Train for everything your required too and keep all training in files and up to date.

You do have rights as an employer on how a visit from OSHA is handled, learn them.

There is a standard that has to do with chemicals. Hazard Communication Standard I think its called, make sure your employees are trained to it, and all your labeling and storage meet it.

Since half or more is construction type work make sure your meeting that standard, ladder safety, roof work, man lift work.
Last they told us in class that a new law was passed because companies were taking fines instead of creating the safety programs. They can now send owners and managers to jail for non compliance for not having a program. An incentive of sorts.

Hope some of this helps you.

Kurt Temple

No, not free. The government charged everyone a part of the outrageous fee. Rather than grinning, you should be ashamed. Some people just don't get it.

DuxDawg, I think you should have looked at where coonwild is from. I don't think we really care about the government of Canada and

they probably don't charge our outrageous fees in the first place.

From what I understand Rabies Post Exposure shots ARE NOT covered under Workers Comp. The illogical logic behind this is that Workers Comp covers an injury, disease, or malady that you have definitively experienced while working.

The Post exposure shots are a preventive measure. Unless you can confirm that the animal had rabies, you can't confirm that the tech has been exposed to the virus and Workers Comp doesn't cover treatments that simply act as a vaccination. Now once you start showing symptoms (actually have the disease), Workers Comp will cover your hospice care!!!

I could be totally off base on this and hope I am, but that is what I was told. Workers Comp covers NO preventative treatments.

I did Paul. Cross the border and suddenly it's not Socialism and not wrong?? Stinks the same in my sight. Among other examples, it's hard watching a friend pay thousands for their sick kid while another parent grins and says it's free for her. Everyone should pay for what they have/use/etc.

Anyhow, will check with the local Humane Society about this. Me and my Drahthaar are into critters all year long. We've both been bit by many species. I do 99% of my own vet and doc work. Worry the most about feral cats and coons. Distemper more than rabies. Have dealt with a few emaciated, stumbling coons over the years. Not common yet not rare enough for my liking.

I systematically get bitten by all sorts of things, Sure is nice having a dad as an ER doc! I get mine for free.

I'm sure that I get bitten more than the average lunatic and I sure hope that all those animals that bit me went to a vet and got

treated. Can you imagine how much damage I could do to the animal kingdom?

Ha ha, Wink!
Dirk, my wife/sometimes assistant - you've met her - was covered for post ex shots by our Worker's Comp. Can't speak for all programs, but this is coverage I would certainly expect of insurance.

This is for Justin and all the rest of you guys that know the proper procedure. One of our guys got bit by a lactating female raccoon

today. He took the animal into the Humane Society to be tested. What happens next? I probably get bit like that every year but I've

never taken an animal in for testing and I'm interested in what's supposed to happen next. I really would like to know!

Paul,

Unless Justin says otherwise, my understanding is that each State has it's own protocol for "what's supposed to happen next" within some very basic guidelines.

Starting with the testing, in Ohio it is the Health Department that is responsible for testing, not the Humane Society (this isn't to say that our Health Department won't hire an outside company for certain testing processes, just that they are the responsible agency to make sure testing happens.) They file an annual report with the CDC for animal bites the previous year along with how many animals were tested, breakdown of species, and number that tested positive for rabies.

Here is how it would work for a business in Ohio. Your technician gets bit, you capture the animal and submit it for testing to the health department (or their designated testing facility) and file a report. Then you file a worker's comp claim for the bite to protect yourself from a lawsuit. If the animal comes back positive, your technician starts the post exposure treatment, if it comes back negative no further action is required. If you were unable to have the animal tested for whatever reason, you'd have the tech start the post exposure treatment anyway.

Since you've filed a workers comp claim, you will get audited by WC to ensure everyone is classified properly and you've been paying the proper amounts. Additionally, expect your rates to increase for at least several years because you are now considered a "risk" company. If the tech had to be administered shots, you may even get a call/visit from OSHA (although I don't know anyone that this has happened to, it is still a possibility as you need to file the report with the health department regardless). OSHA would then investigate the accident and inspect the business (training programs, PPE, reporting requirements, etc). This would either lead to a "make these changes" citation or actual fines. For those businesses not covered by WC, they would need to pay all medical expenses for their employee at a minimum and probably consult with a lawyer for what they need to do to protect themselves. For those that don't file a report, not only are they at risk from the bitten employee (keep in mind that just because the employee is great and would never sure you, it isn't the same for their family who hears about all the money your making especially if something would happen to the employee that may be traced back to this issue), they are also at risk for fines from the state.

Thanks Eric, that is just about what I thought. Our tech's doctor insisted that he get one of seven or eight expensive shots

immediately and I didn't think that was protocol. We have never had a raccoon test positive for rabies and I guess the doctor didn't

want to lose a chance to screw us over. If my info is correct I'm sure I'll have more on this later.

Why should I be ashamed that I reside in a place where previous leadership saw the benifets of a health care system run in the manner we have here ?

Are you insinuating I'm some kind of leach on the system ? If so don't worry the taxes I pay every year more then make up for my use of our Canadian healthcare system the once in a blue moon I need to use it .

Paul,

I'm amazed at the number of doctors that aren't even familiar with CDC recommendations. The CDC guideline is that rabies is an urgency, not an emergency so provided testing can be done it is better to wait for the results.

There are two areas here that I've discovered over the years. The first is what our doctors are being taught in medical school, the second is treatment based on legal protection instead of medical knowledge.

I remember talking with a doctor in residency who was treating one of my kids about 10 years ago. He had been out of med school about a year/year and a half and once he found out what I did we started discussing rabies. I had to inform him that rabies is not passed by urine or feces and referred him to the CDC for verification. His response was that he had been taught in med school that it was transmitted in urine and feces (and I've worked with many doctors, including infection disease specialists that believed this as well). If this one thing is being taught incorrectly, just image all of the other updated information that is being left out of a doctor's education (or don't, as it may keep you up at night).

In my experience, (some time ago), The Humane Society will only confine an animal for a 10 day observation, not an actual brain test, because they'd "Have to kill it". County Health does an actual test.

Paul,

Have been swamped too much for T'man lately (imagine that!).

Eric fielded this well and I'll just add some thoughts and color from other aspects and some of the same.

First, Eric is right that every state is different, heck even counties can be different, though they are supposed to follow the state health department.

If the animal is available as Eric said generally they would hold off on the shots until confirmation which is rapid in terms of knowing positive or negative.

In terms of strain of rabies that "typing" analysis is done at CDC after the state lab sends it out to them.

In most states there is an authority agency that will do the testing in state, if you get bit in a county, they generally ship the animal immediately to the state
lab for testing.

***

In terms of the animals behavior, if for example you were hiking and the same raccoon jumped out and climbed your leg and bit you, they would likely just start
the shots immediately based on the behavior being "likely rabid."

If however you have any other scenario and certainly the human provoked kind where your bitten while trying to grab an animal, they are going to test it just as
a precaution.

***

In terms of conspiracy about wanting people to spend money on worthless shots, I'd say in most cases folks are just following whatever protocol is in place in their
state or in their hospital, etc....

When folks have questions they shoot to me from the public I always counsel them to go to the county health department or the state for rabies questions.

Simply put as Eric mentioned doctors through no fault of their own are sincerely and woefully lacking in zoonotic disease risk unless they had a specialty class or
decided to focus on infectious diseases in med school.

I believe one doc told me they did 1 day on wildlife related diseases during his education.

When my wife was dealing with illness and we had just been on multiple field projects with serious blood, necropsy and parasite exposure, we asked the doc to test
her for a variety of things.

He literally had to blow the dust off of a thick book on his shelf to know what he needed to do and what samples and also to know what the disease was we were asking
about.

I have had multiple experiences like that with her and doctors and it never ceases to make us lose a bit of faith that anything is going to come of it or that they 'd have a clue
what they are looking for.

***

Some docs will overreact, others will not know which in my book can be worse.

On another case from years back a young park service biologist who was tracking mountain lion died after being sent home as having the "flu" by his local doctor. Days later
folks found him dead in bed from something (pneumonic plague) that if caught would have been a survival story versus a fatality.

Though cases where folks instigate the bite are obviously more common and more logically not rabies, one can never know if the animal was carrying rabies and was in the stages
where the bite could inoculate the victim.

So I definitely understand your concerns about someone overreacting and costing tons of money, but I think understanding the policy is important in each of our individual states
and more importantly to have a good relationship with your primary care docs so that you know they know what you are exposed to on a daily basis.

Good topic.

Justin

You're right, Justin, this is a great topic. My general practitioner is also a customer. He understands our business enough to

realize that I know more about animal related diseases than he does. And that this isn't because I'm smarter than he is, but that

it's because I get the opportunity to read about it a lot more than he does. When P.J. got bit by the pit bull, the first thing he

did was to call a doctor that knew about rabies shots and get the scoop. That's why we have specialists; so that doctors don't have

to guess about our health.