Table 1. Rabies post-exposure prophylaxis recommendations*

Animal species	Evaluation and disposition of animal	Post-exposure prophylaxis (PEP) recommendations
Dog, cat, ferret	Apparently healthy and available for observation	No PEP unless animal develops clinical signs within 10 days and tests positive for rabies^†
	Rabid or suspected rabid	Immediate PEP
	Unknown (e.g., escaped)	Consult public health officials
Skunk, raccoon, fox other wild carnivore; bat	Regarded as rabid unless animal tests negative^‡	Consider immediate PEP
Small rodent (mouse, squirrel), lagomorph (rabbit, hare)	Consider individually	Almost never require PEP
Livestock, large rodent (woodchuck, beaver); other mammal	Consider individually	Consult public health officials

*Adapted from Recommendations of the Advisory Committee on Immunization Practices: Human rabies prevention—United States, 2008.

^†PEP should be withheld until animal tests positive unless test results are likely to be delayed.

^‡Wild animals should not be held for observation; rather, they should be euthanized and tested for rabies virus infection as soon as possible

after a human exposure. PEP can be discontinued if test results are negative.

Table 2. Rabies post-exposure prophylaxis schedule*

Vaccination status	Treatment	Regimen
Not previously vaccinated	Local wound cleansing	Immediately cleanse all wounds with soap and water and irrigation with a virucidal agent such as povidone-iodine solution.
	RIG	Administer 20 IU/kg body weight on day 0^†. If anatomically feasible, the full dose should be infiltrated around the wounds(s). Any remaining volume should be administered IM at a site distant from vaccine administration. RIG should not be administered in the same syringe as vaccine. Because RIG might partially suppress the active antibody response, no more than the recommended dose should be given.
	Vaccine	HDCV or PCECV: 1.0 mL, IM (deltoid^‡) days 0^†, 3, 7, 14, and 28.
Previously vaccinated^§	Local wound cleansing	Immediately cleanse all wounds with soap and water and irrigation with a virucidal agent such as povidone-iodine solution.
	RIG	RIG should not be administered.
	Vaccine	HDCV or PCECV: 1.0 mL IM (deltoid^‡) on days 0^†and 3.

*Adapted from Recommendations of the Advisory Committee on Immunization Practices: Human rabies prevention—United States, 2008.

^†Day 0 is the first day of vaccine administration, not necessarily the day of exposure.

^‡Vaccine may be administered in the lateral thigh in young children; vaccine should never be administered in the gluteal area.

^§Any person with a history of pre-exposure vaccination or PEP with approved vaccine or vaccination with any other type of rabies vaccine

and documented neutralizing antibody response.

Abbreviations: HDCV – human diploid cell vaccine; PCECV – purified chick embryo cell vaccine; RIG – rabies immune globulin

Table 3. Rabies pre-exposure prophylaxis schedule*

Type of Vaccination	Regimen
Primary	HDCV or PCECV: 1.0 mL IM (deltoid) on days 0^†, 7, and 21 or 28
Booster	HDCV or PCECV: 1.0 mL IM (deltoid) on day 0^† only

*Adapted from Recommendations of the Advisory Committee on Immunization Practices: Human rabies prevention—United States, 2008.

^†Day 0 is the day the first dose of vaccine is administered.

Abbreviations: HDCV – human diploid cell vaccine; PCECV – purified chick embryo cell vaccine