Rabies

Indication for Prophylaxis* Bite or salivary exposure from bat, or mammalian carnivore* Inhalation counts (e.g. dead bat in room)

• Not needed if non-salivary exposure, or if bird, reptile, or rodent (rare cases)
• Call CDC if questions

Was animal captured?

Yes:

    Is animal dog or cat?

         Yes: Observe 10 days, if abnormal, sacrifice and treat with vacc and RIG

              discontinue if animal negative path for rabies

         No: Sacrifice animal and begin RIG and vaccine

              discontinue if animal negative path for rabies

No:

    Is Animal dog or cat?

         Yes: Give vacc and RIG only if rabies risk for species in area

         No: Treat with  full course vacc and RIG 

Treatment* Clean wound

• Rabies vaccine: human diploid cell vaccine (HDCV): 1ml IM* Day 0, 3, 7, 14,and 28
• Give in deltoid not buttock (since Ab not created in fat cells)
• If previously immunized: HDCV on day 0, 3; no RIG

• RIG (rabies immune globulin): 20 IU/kg (infiltrated SC around wound) if possible* place remainder opposite arm of vaccine
• can administer up to 7 days after the first vaccine dose