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Risk Assessment and Management of Exposures

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Rabies in Man and Animals

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Abstract

The assessment of risk of rabies transmission in individual cases is important in arriving at appropriate decision regarding the course of postexposure prophylaxis (PEP) requirements. The World Health Organization has laid down guidelines for differentiating the categories of potential rabies exposure and taking appropriate prophylactic measures. Development of a decision tree assists in risk evaluation. A three-pronged strategy is adopted to manage the exposures. It involves bite wound management, postexposure passive immunisation through rabies immunoglobulin (RIG), and vaccination for active immunity. Wound treatment includes mechanical and chemical action against rabies virus. RIG neutralises and destroys the virus while postexposure antirabies vaccination helps in developing active immunity against rabies. Pre-exposure prophylactic vaccination is also recommended in high-risk individuals. Intradermal rabies vaccination has emerged as a less expensive alternative to intramuscular route of vaccine administration. PEP treatment is a proven method of rabies prevention; however, prophylaxis failures and rabies-related deaths are encountered largely due to deviations from the recommended guidelines. There is no specific treatment after the onset of symptoms of rabies.

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  1. Veterinary Public Health & Epidemiology, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India

    Sudhi Ranjan Garg

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Garg, S.R. (2014). Risk Assessment and Management of Exposures. In: Rabies in Man and Animals. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1605-6_5

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