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| Ask the Experts |
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| Rabies |
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| General information - rabies |
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| Who
should be offered pre-exposure rabies vaccination? |
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| 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. |
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| Where can I find the current
recommendations for prevention of rabies? |
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| 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 |
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| 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? |
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| 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. |
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| Who should I contact if I have a
patient who may have been exposed to a rabid animal? |
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| 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. |
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| Reviewed on 9/10 |
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| Immunization Action Coalition • 1573 Selby Avenue • Saint Paul, MN 55104 |
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| tel 651-647-9009 • fax 651-647-9131 |
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| email admin@immunize.org |
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