When is preexposure, prophylaxis or immunization against rabies indicated?

Updated: Jun 21, 2019
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Preexposure, active prophylaxis or immunization is recommended for veterinarians, veterinary students, persons who regularly explore or hike in caves, laboratory workers who are exposed to rabies virus or who handle specimens considered high risk for rabies, and persons who visit countries where rabies is a significant problem (ie, visits >30 d). (See Table 1, below.)

Table 1. Risk Categories for Active Preexposure Immunization and Rabies Titer Monitoring (Open Table in a new window)

Category

Target Population

Immunization Regimen

Serologic Testing

Continuous

Rabies research laboratory or biologics production workers

Primary course; booster when serum antibody is less than 1:5 dilution based on RFFIT results

Every 6 months

Frequent

Rabies diagnostic laboratory workers, spelunkers, veterinarians and staff, animal control and wildlife workers in rabies-enzootic areas, travelers to areas of enzootic rabies for more than 30 days

Primary course; booster every 2 years or when serum antibody is less than 1:5 dilution based on RFFIT results

Every 2 years if not regularly boosted

Infrequent

Veterinarians and staff/students, animal control and wildlife workers in areas of low rabies risk

Primary course; no booster

None

Rare

US population at large

None

None


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