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Rabies Postexposure Prophylaxis
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Animal type and availability decide PEP.
Decision
Outcome
Decision
Mammalian bite with possible rabies exposure (broken skin/mucous membrane). Type of animal?
✓
Low-risk wild animal (squirrel, chipmunk, mouse, rabbit)
✓
High-risk wild animal (bat, raccoon, skunk, fox, coyote)
✓
Pet (dog, cat, ferret)
✓
Livestock / unknown wild animal
Outcome
No PEP needed
These species rarely carry rabies.
Decision
High-risk wild animal — available for testing?
✓
Yes → euthanize, test brain; PEP if positive
✓
No → start PEP empirically
Outcome
PEP only if brain test positive
Outcome
PEP: rabies immune globulin (20 IU/kg, infiltrate around wound) + 4-dose rabies vaccine (days 0, 3, 7, 14)
Wash wound thoroughly with soap and water. Immunocompromised: 5 doses + check titer.
Decision
Pet — available for 10-day quarantine?
✓
Yes → observe; no PEP if animal stays healthy
✓
No → start PEP
Outcome
10-day quarantine; no PEP unless animal develops signs of rabies
Outcome
Contact public health for guidance
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