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| Ask the Experts |
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| Rabies |
| Who
should be offered preexposure rabies vaccination? |
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| Preexposure vaccination should be offered
to persons in high-risk groups, such as veterinarians, animal handlers,
and certain laboratory workers. Preexposure
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,
international travelers might be candidates for preexposure vaccination if
they are likely to come in contact with animals in areas where dog rabies is
enzootic and immediate access to appropriate medical care, including biologics,
might be limited. |
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| An ACIP statement on rabies was released
in January 1999. What was new in the recommendations? |
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| The most recent rabies ACIP statement
("Human Rabies Prevention–United States,
1999, Recommendations of the Advisory Committee on Immunization Practices") was
published in MMWR on January 8, 1999. The 1999 statement contains information
on a human rabies vaccine that was FDA-approved for use in the U.S. in 1997,
recommendations regarding exposure to bats, recommendations regarding an observation
period for domestic ferrets, and changes in how to administer rabies immune globulin. |
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| If a bat is found in a room where
a baby is sleeping, do you need to give postexposure prophylaxis? |
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| Yes, rabies postexposure prophylaxis
(PEP) is recommended. When a bat is found in a dwelling, even in
the absence of a known bite or scratch, the recommendation
calls for aggressive use of PEP. If possible, the bat should be safely collected
and submitted for rabies diagnosis. Details of these recommendations were published
in MMWR 1998; 47(01):1-5. The indications for PEP are fairly complex and depend
on several factors. Providers who are responsible for decisions on PEP should
also be familiar with the complete ACIP recommendations on human rabies prevention
(MMWR 1999; 48(RR-1):1-21. |
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| Reviewed on 5/07 |
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