Table 1 Criteria for rabies risk assessment and recommended PEP prescription in case of potential exposure to “suspect or rabid animals”, extracted from the WHO adapted National Rabies Management Guidelines (2014) in Bhutan
Exposure type | Risk category | Recommended PEP |
|---|---|---|
Licks on intact skin, touching, feeding of animals. 1Consumption of butter, curd, cheese, whey (dachu), cooked meat. Petting, bathing or coming in contact with utensils used on a suspected rabid animal. | None (Category 1) | Not recommended, if reliable case history available. |
Person consuming unboiled or unpasteurized milk, buttermilk, uncooked meat from rabid animal. Nibbling of uncovered skin by potentially rabid animal. Minor scratches or abrasions without bleeding. Person who handles or prepares meat or handles carcass of rabid animals. | Moderate (Category 2) | Wound management, as appropriate Provide anti-rabies vaccine immediately Stop vaccination if animal remains healthy throughout the observation period of 10 days or if the animal is proven to be negative for rabies by a reliable laboratory using an appropriate diagnostic technique |
Single or multiple transdermal bites or scratches Licks on broken skin Contamination with mucous membrane with saliva (i.e. licks or splash on oral cavity, eyes, nose, external genitalia) | Severe (Category 3) | Wound management Provide anti-rabies vaccine immediately Provide rabies immunoglobulin Stop vaccination if animal remains healthy as described above in Category 2 |