Antimicrobial prescribing: NHS Forth Valley
Bats:
- In the UK/Ireland = Low risk
- Outside the UK/Ireland = High risk
Primate or rodent: Low risk
Other terrestrial animal (e.g. dog etc): Varies by country; see here
Assessment for Rabies PET
This should be conducted in conjunction with the on-call infection doctor (adults) or paediatric clinician.
If there is repeat exposure (within 3 months) following PET: Nil vaccines required
Assess risk as determined in the following table:
NB: concerning ‘Bat in room’ exposures:
- Except for the UK & Ireland, any bat found in the room of a sleeping or intoxicated person = category 2 exposure
In the UK and Ireland most bats found in houses and attics are pipistrelles, which are rarely infected with rabies-related viruses. Bats behaving normally (that is, flying into a room but not grounded or acting aggressively) do not constitute any risk (category 1).
Using Animal & Exposure risk determined above:
Discuss all cases involving a confirmed rabid animal with the infection doctor.
According to the composite rabies risk, patient’s vaccination status & if they are immunocompromised:
*HRIG is only for non-immunised; see below.
** End of treatment rabies antibody level should be obtained.
- HRIG provides short-term immunity in the first 7 days post initiation of treatment, but beyond this vaccine-induced antibody levels are much higher.
- If the assessment above recommends HRIG, consult the table below:
