Guidance

Rabies post-exposure treatment: management guidelines

A practical guide to undertaking a risk assessment of potential rabies exposures and the correct use of post-exposure treatment (PET).

Applies to England

Documents

Rabies: guidelines on managing rabies post-exposure treatment

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Rabies: summary of risk assessment and treatment (visual)

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Letter to A&E consultants and pharmacists: important information regarding rabies post-exposure treatment

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Details

This guidance is aimed at duty doctors at the UK Health Security Agency Colindale, health protection teams and other health professionals who may be involved in the assessment and management of potential rabies exposures.

Rabies is a viral encephalitis and can be fatal. Prompt treatment after exposure is the most effective way to prevent disease.

Post-exposure treatment (PET) using rabies vaccine with or without human rabies immunoglobulin (HRIG) is highly effective in preventing disease if given correctly and promptly after exposure.

The letter is to all A&E departments and hospital pharmacists requesting them to hold or have access to rabies vaccines so that rabies post-exposure treatment can be started promptly.

Published 1 January 2013
Last updated 23 January 2023 + show all updates
  1. Updated sections C1 and D1 of 'Rabies: guidelines on managing rabies post-exposure treatment'.

  2. Updated Rabies: guidelines on managing rabies post-exposure treatment and letter to A&E consultants and pharmacists.

  3. Updated Rabies: guidelines on managing rabies post-exposure treatment.

  4. Updated summary of risk assessment and treatment.

  5. Added letter for accident and emergency consultants and pharmacists.

  6. Updated guidelines on managing rabies post-exposure August 2020.

  7. Updated guidelines with reference to a new version of the form. Added clarification on category 2 and 3 bites. Updated information about compliance with Falsified Medicines Directive. Also added new telephone numbers for the Rabies and Immunoglobulin service and Animal Plant Health Agency.

  8. Updated summary and guidelines - see page 4 for details of changes.

  9. Added summary of risk assessment and treatment.

  10. Updated guidelines - see page 3 for details of changes.

  11. Patients started on alternative regimens section revised.

  12. Revised guidelines - see page 2 for details of changes.

  13. Updated information about the new Rabies and Immunoglobulin Service and updated risk assessment to include HRIG for primate category III bites to the head and neck.

  14. The document has been updated to reword section ‘B9 Imported pets (dogs, cats or ferrets)’, on page 14.

  15. Changes to the guidance include a new category of ‘partially immune’ for those individuals who are not fully immune but have received vaccine in the past, advice on what to do if it is more than 10 years since the last rabies vaccine, and information on dealing with animals imported into the country under the EU PETS passport scheme.

  16. First published.