Rabies Pre-Exposure Prohylaxis Regimen
Animal Bites and Rabies Risk:A Guide for Health Professionals
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Rabies Pre-Exposure Prohylaxis Regimen
Who should receive rabies pre-exposure prophylaxis?
Pre-exposure rabies vaccination series
Antibody titers and booster vaccination
Laboratories offering RFFIT rabies antibody titer testing
Rabies Pre-Exposure Prohylaxis Regimen
Pre-exposure vaccination against rabies simplifies the rabies post-exposure treatment and it may protect in cases of unrecognized rabies exposure or when post-exposure treatment is delayed. It does not eliminate the need for appropriate treatment following a known rabies virus exposure.
Who should receive rabies pre-exposure prophylaxis?
- Veterinarians, veterinary technicians, animal control officers, wildlife rehabilitators, zoo employees, and others who have regular contact with potentially rabid animal species and certain laboratory workers.
- International travelers to areas with endemic canine rabies who are likely to come into contact with dogs or wild animals and where access to medical care and appropriate biologics may be limited.
Pre-exposure rabies vaccination series
- Three 1.0 mL doses of rabies vaccine are given IM, one injection per day, on days 0, 7, and 21 or 28, in the deltoid area of adults or in the anterolateral thigh of young children.
- Human diploid cell vaccine (HDVC) or purified chick embryo cell vaccine (PCEC) may be used, although it is recommended that the vaccine series be initiated and completed with the same vaccine product.
- No HRIG should be given.
Antibody titers and booster vaccination
- Vaccinated persons in high-risk occupations should have their virus neutralizing rabies antibody titers checked periodically (Table 5).
- Every 6 months in persons in the continuous-risk category.
- Every 2 years for persons in the frequent-risk category.
- A single booster rabies vaccination is given when the titer drops below 1:5 by the rapid fluorescent focus inhibition test (RFFIT), a virus neutralization test. Other available titer tests (such as the ELISA test) are not recommended for this purpose.
- Table 5: Rabies recommendations for pre- exposure vaccinated persons (PDF:87KB/1 page)
Laboratories offering RFFIT rabies antibody titer testing
All require 2.0 mL serum.
Rabies Laboratory
Kansas State University
2005 Research Park Circle
Manhattan, KS 66502
785-532-4483
www.vet.k-state.edu/depts/dmp/service/rabies/rffit.htm (form available online) Attention: Non-MDH link.
Atlanta Health Associates
309 Pirkle Rd, Suite D-300
Cummings, GA 30040
1-800-717-5612
www.atlantahealth.net (form available online) Attention: Non-MDH link.
J. Mehsen Joseph-Public Health Laboratory
Maryland Department of Health and Mental Hygiene
201 W. Preston St.
Baltimore, MD 21201
410-767-6177
(form not available online)