Postexposure prophylaxis is the provision of medication to prevent disease in persons who are not protected against a particular disease by vaccination but who have been exposed to it.Implementation
Degree of exposure | Type of exposure: by a rabid or suspected rabid wild or domestic animal, bat | Type of exposure: through a rabies vaccine bait | Immune prophylaxis* |
I | Touching/feeding animals; licking intact skin. | Touching vaccine baits with skin intact | No vaccination |
II | Non-bleeding, superficial scratches or skin abrasions, licking or nibbling on non-intact skin. | Contact with inoculation fluid of damaged bait with skin not intact. | Rabies vaccination |
III | Bite wounds or scratch wounds, contact of mucous membranes or wounds with saliva (e.g., from licking), suspected bite or scratch by a bat, or contact of mucous membranes with a bat. | Contamination of mucous membranes and fresh skin lesions with inoculant from damaged bait. | Rabies vaccination and simultaneous administration of rabies immunoglobulin (20 IU/kg body weight) once with the 1st dose |
* Carefully document each vaccination and the administration of rabies immunoglobulin.
- Vaccination is given on days 0 (exposure (“exposure”)), 3, 7, 14, and 28.
- For exposure level III, passive immunization with a human rabies immunoglobulin (human rabies antibody) is performed simultaneously on day 0 (20 IU/kg bw) – once.
- Furthermore, an intensive mechanical as well as chemical cleaning of the skin site / wound must always be performed.
- Note: Due to the great variability of the incubation period, which can range from < 10 days to > 1 year, post-exposure prophylaxis is still useful weeks to months after exposure if there is a reasonable suspicion.