Risk Assessment and Management of Exposures

  • Sudhi Ranjan Garg


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.


Rabies Virus Rabies Vaccine Human Rabies Postexposure Prophylaxis Rabies Vaccination 
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Copyright information

© Springer India 2014

Authors and Affiliations

  • Sudhi Ranjan Garg
    • 1
  1. 1.Veterinary Public Health & EpidemiologyLala Lajpat Rai University of Veterinary and Animal SciencesHisarIndia

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