Requirements for programs, services, and accountability standards are published by the minister of health and longterm care under the authority of section 7 of the health protection and promotion act hppa to. Update on rabies vaccine availability and dose schedule. The effectiveness of the rabies vaccines may be compromised if the recommended vaccination schedule is not followed. Recommendations for preexposure prophylaxis also remain unchanged, with 3 doses of vaccine administered on days 0, 7, and 21 or 28. Rabies postexposure prophylaxis in the philippines. Rabies postexposure prophylaxis pep administration. Rabies preexposure prophylaxis guide united states, 2008. Fox, cow, raccoon, skunk, bat, horse, goat, coyote, ferret, cat, dog, wild animal, or unknown animal. Rabies exposure risk assessment requires balancing a number of criteria. Postexposure prophylaxis postexposure prophylaxis, which has been shown to be uniformly effective when appropriately administered, consists of. The person does not need human rabies immune globulin. Evidence for a 4dose vaccine schedule for human rabies. Persons who have previously received rabies pep or preexposure vaccination should only receive two doses. Every effort should be made to adhere to the recommended pep regimen schedule.
Rupprecht ce, briggs d, brown cm, franka r, katz sl, kerr hd, et al. Protocol for rabies postexposure prophylaxis rpep after. These updated recommendations are based on new evidence and directed by public health needs that are cost, dose and timesparing, while assuring safety and clinical effectiveness. Prompt rabies pep combining wound care, infiltration of rig into and around the wound, and multiple doses of rabies cellculture vaccine continue to be highly effective in preventing human rabies. For persons never vaccinated for rabies, treatment. Human rabies immune globulin post exposure prophylaxis using human diploid cell vaccine, rabies vaccine adsorbed, or purified chick embryo vaccines, should receive two doses of rabies vaccine on days 0 and 3. Postexposure prophylaxis against rabies institute of tropical. What if a patient cannot does not adhere to the rabies post exposure vaccination schedule. Check the address of the content you are looking for is correct and try again use your browser back button and try again start from the home page of the site home.
Use of a reduced 4dose vaccine schedule for postexposure prophylaxis to prevent human rabies. Rabies post exposure prophylaxis department of health. Mean annual pep incidence rates were highest in rural counties and during the summer months. Rabies postexposure prophylaxis immunocompromised persons pdf. For persons never vaccinated for rabies, treatment includes. Rabies information for healthcare providers, veterinarians. Who guide for rabies pre and post exposure prophylaxis in. Recommendations of the advisory committee on immunization practices acip mmwr 2010. Oklahoma state department of health 012018 revised rabies pre and postexposure prophylaxis 3 2. Rabies postexposure prophylaxis pep administration guidance and schedule for healthcare providers all rabies pep should begin with immediate thorough cleansing of all wounds with soap and water.
Pdf evidence for a 4dose vaccine schedule for human. Rabies postexposure prophylaxis schedule for human. Rabies chapter 4 2020 yellow book travelers health. Idrv is found to be equally effective as intramuscular rabies vaccination and at the same time reduces cost of pep by 6070%. Schedule for postexposure prophylaxis to prevent human rabies. Rabies postexposure prophylaxis healthy, immunocompetent persons, including pregnant women pdf. Arkansas department of health procedures for postexposure. If available, a virucidal agent, such as povidineiodine solution, should be. Intradermal rabies vaccination idrv for postexposure prophylaxis was approved by who as early as in 1992 and has now been extensively used in india since 2006. Rabies vaccines and immunoglobulins world health organization. Rabies postexposure prophylaxis costspatient assistance programs.
Intramuscular regimens for rabies postexposure prophylaxis there are 3 intramuscular schedules for category ii and iii exposures. Prior to july 2009, the standard rabies postexposure prophylaxis pep regimen for previously unvaccinated persons included human rabies immune globulin hrig given on a per weight basis on day 0, and five doses of human rabies vaccine given on days 0, 3, 7, 14, and 28. Rabies post exposure prophylaxis rpep 1 algorithm pdf, 316kb, 1 pg. Rabies exposure management for batrelated incidents. The epidemiology of human rabies postexposure prophylaxis pep in 4 upstate new york counties was described from data obtained from 2,216 incidences of pep recorded by local health departments from 1995 to 2000. Vaccine schedule for postexposure prophylaxis to prevent human rabies recommendations of the advisory committee on immunization practices mmwr 2010. Rpep generally not indicated6 discuss indications for rpep on a casebycase basis bnormal ormal e e e e e ee e e no s no s no s animal healthy for entire 10 days animal appears sick or develops signs of rabies during 10 days rabies post exposure prophylaxis rpep1 algorithm 1. Who recommends 2 main immunization strategies for the prevention of human rabies. Rabies postexposure prophylaxis pep schedule and administration guidance. The 5 dose regimen the 211 regimen the 4 dose regimen with rig in both categories ii and iii vaccines should be injected into the deltoid muscle for adults and children aged 2 years and more. Revised rabies postexposure prophylaxis protocol effective july 28, 2009 guidance regarding 10day confinement of animals for rabies observation pdf, 32kb, 4pg. Recommendations from the advisory committee on immunization practices. Rabies postexposure prophylaxis, new york, 19952000. Historically, the total number of rabies vaccine doses administered during human prophylaxis has decreased, as modern biologics have improved and scientific knowledge has grown.
Every effort should be made to administer the vaccines in accordance with the recommended schedule. Postexposure prophylaxis pep and preexposure prophylaxis prep. After exposure, human rabies is preventable by prompt application of postexposure prophylaxis. Postexposure prophylaxis pep rabies vaccine plus immunoglobulin if prior prep, only vaccine 11,00036,000 personsyear receive pep in the us. Rabies post exposure prophylaxis guide san antonio. A rabies vector species bat, raccoon, skunk that is unavailable for testing the first day of the pep treatment regimen is designated as day 0. Postexposure prophylaxis protocol for people exposed to animals 8.
Management of potential rabies exposures guideline, 2019. Rabies postexposure prophylaxis individual is previously immunized documentation of complete course of preexposure or pep with hdcv or pcecv with approved schedule 2 doses of vaccine day 0,3 individual immunocompromised or taking corticosteroids, immunosuppressive agents, chloroquine documentation of complete immunization with hdcv or. Rabies postexposure vaccine schedules should be adhered to as closely as possible and it is essential that all recommended doses of vaccine be administered. Rabies postexposure prophylaxis schedule for human cases it is here. Rabies postexposure prophylaxis wisconsin department of.
Use of a reduced 4dose vaccine schedule for postexposure prophylaxis to prevent human rabies recommendations of the advisory committee on immunization practices vol. Evidence for a 4dose vaccine schedule for human rabies postexposure prophylaxis in previously nonvaccinated individuals. Rabies postexposure prophylaxis guide rabies postexposure prophylaxis, or pep, is recommended if a person was bitten by or had a highrisk exposure to. Rabies is a fatal neurologic illness transmitted to people by direct contact with the saliva of a rabid animal. Rabies vaccine should not be administered im in the gluteal area. Change in rabies postexposure prophylaxis vaccine schedule on june 24th, 2009 the advisory committee on immunization practices acip approved the recommendation to change the current rabies pep schedule of 1 dose of human rabies immune globulin hrig followed by 5 rabies vaccines to 1 dose of hrig followed by 4 rabies vaccines. Previous rabies preexposure prophylaxis or postexposure treatment. This vaccine schedule is the only schedule recommended by the centers for disease control and prevention cdc shown to. Return to rabies prevention flowchart introduction rabies postexposure prophylaxis pep schedule1 adapted from. This has now been adopted by the centers for disease control and prevention, with official guidelines given in the document, use of a reduced 4dose vaccine schedule for postexposure prophylaxis to prevent human rabies, recommendations of the acip. Indications to prevent rabies infection, postexposure prophylaxis should be administered to all patients who have had a known or likely exposure to rabies. Who guide for rabies pre and post exposure prophylaxis in humans.
Recommendations of the advisory committee on immunization practices. Rabies vaccine patients who have never received any form of rabies vaccine will receive four doses of the rabies vaccine. If available, a viricidal agent such as a povidoneiodine solution should be used to irrigate the wounds. Pdf rabies postexposure prophylaxis in the philippines. Rabies postexposure prophylaxis pep schedule and administration guidance all postexposure treatment should begin with immediate and. In addition, new guidance on prudent use of rabies immunoglobulins rig is provided. Choice of rabies pep schedule if there was complete preexposure vaccination in the past. This algorithm only addresses rabies postexposure prophylaxis. All postexposure treatment should begin with immediate and thorough cleansing of all wounds with soap and warm water. Health status of patients having received purified equine fab2 fragment rabies immunoglobulin favirab. A detailed discussion of the regimens used for postexposure prophylaxis is found elsewhere. Rabies postexposure prophylaxis regimen, animal bites and. Rabies post exposure prophylaxis guide was patient exposed to one of the following high risk animals. There is no cost to view the course or to receive continuing education ce credit.