Rabies Prevention in Washington State: A Guide for Practitioners
Introduction | Clinical features | Epidemiology | Evaluating encounters | Laboratory testing | Prevention | References
Back to the Rabies prevention page.

Table 2

Rabies preexposure prophylaxis guide,
United States, 2001

Risk Category Nature of risk Typical populations Preexposure recommendations
Continuous Virus present continuously, often in high concentrations. Aerosol, mucous membrane, bite, or nonbite exposure. Specific exposures may go unrecognized. Rabies research lab worker*; rabies biologics production workers. Primary course. Serologic testing every six months; booster vaccination when antibody level falls below acceptable level.+
Frequent Exposure usually episodic, with source recognized, but exposure may also be unrecognized. Aerosol, mucous membrane, bite, or nonbite exposure. Rabies diagnostic lab workers*, spelunkers, veterinarians and staff, and animal-control and wildlife workers in rabies ezootic areas. Travelers visiting foreign areas of enzootic rabies for more than 30 days. Primary course. Serologic testing or booster vaccination every 2 years.+
Infrequent (greater than population at large) Exposure nearly always episodic with source recognized. Mucous membrane, bite, or nonbite exposure. Veterinarians and animal-control and wildlife workers in areas of low rabies enzooticity. Veterinary students. Primary course; no serologic testing or booster vaccination.
Rare (population at large, e.g., Washington State) Exposure always episodic. Mucous membrane, or bite with source unrecognized. U.S. population at large, including persons in rabies epizootic areas. No vaccination necessary.
*Judgment of relative risk and extra monitoring of vaccination status of laboratory workers is the responsibility of the laboratory supervisor.
+Minimum acceptable antibody level is complete virus neutralization at a 1:5 dilution. A booster serum dose should be administered if the titer falls below this level.

Back to the Rabies prevention page.
Introduction | Clinical features | Epidemiology | Evaluating encounters | Laboratory testing | Prevention | References
This monograph was produced for the World Wide Web by the Northwest Center for Public Health Practice in cooperation with the Washington State Department of Health. See references for further acknowledgements.