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Immunization Action Coalition

Ask the Experts

Rabies

General information - rabies
Who should be offered pre-exposure rabies vaccination?
Pre-exposure vaccination should be offered to persons in high-risk groups, such as veterinarians and their staff, animal handlers, rabies researchers, and certain laboratory workers. Pre-exposure vaccination also should be considered for other persons whose activities bring them into frequent contact with rabies virus or potentially rabid bats, raccoons, skunks, cats, dogs, or other species at risk for having rabies. In addition, some international travelers might be candidates for pre-exposure vaccination if they are likely to come in contact with animals in areas where dog or other animal rabies is enzootic and immediate access to appropriate medical care, including rabies vaccine and immune globulin, might be limited.
Where can I find the current recommendations for prevention of rabies?
The ACIP statement ("Human Rabies Prevention-United States, 2008, Recommendations of the Advisory Committee on Immunization Practices") was published in MMWR on May 23, 2008. It updates the 1999 recommendations and reflects the status of rabies and antirabies biologics in the United States. To view this document, go to www.cdc.gov/mmwr/PDF/rr/rr5703.pdf. In June of 2009, ACIP voted to eliminate the fifth dose of vaccine given post-exposure to previously unvaccinated persons with no immunosuppression. This decision was based upon evidence that immunity would not be compromised, a need to conserve vaccine supplies, and the benefit to the patient's health as well as economics by minimizing the number of visits and vaccine doses required. To view the recommendations, go to www.cdc.gov/mmwr/pdf/rr/rr5902.pdf
If a bat is found in a room and the occupants are uncertain if direct contact has occurred (e.g., a baby is sleeping, a mentally disabled person is present), do you need to give postexposure prophylaxis?
Unless rabies can be ruled out by diagnostic testing of the bat, rabies postexposure prophylaxis (PEP) is recommended. Because the details of these recommendations are fairly complex and depend on various factors, consultation with state and local health departments should be sought.
Who should I contact if I have a patient who may have been exposed to a rabid animal?
Your best source is to contact your local or state public health agency. You can find contact information by going to www.cdc.gov/rabies/resources/contacts.html.
Reviewed on 9/10
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 5U38IP000290) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.