Includes first aid recommendations for animal bites.
New and updated recommendations regarding postexposure prophylaxis from the Advisory Committee on Immunization Practices (ACIP) for human rabies prevention. Previous recommendations advised the use of a 5-dose rabies vaccination regimen for people possibly exposed to rabies and previously unvaccinated. However, the new recommendations have suggested a 4-dose regimen. Postexposure prophylaxis recommendations for previously vaccinated individuals remain the same.
Recommendations from the Advisory Committee on Immunization Practices (ACIP) for human rabies prevention.
Pre-exposure vaccination should be offered to high-risk groups (e.g., vets, animal handlers, rabies researchers, certain laboratory workers) and for people who are frequently in contact with rabid bats, raccoons, skunks, cats, dogs, or other animals at risk for having rabies.
Pre-exposure booster doses are recommended every 6 months for those working with the rabies virus in laboratories if the serum titer falls, to maintain a serum titer corresponding to a value of at least complete neutralization at a 1:5 serum dilution by the rapid fluorescent focus inhibition test.
The need for postexposure prophylaxis requires physician evaluation of possible rabies and may require consultation with public health officials.
Immediate vaccination should be considered for people bitten by skunks, raccoons, foxes, most other carnivores, and bats.
Recommendations of the Advisory Committee on Immunization Practices and Healthcare Infection Control Practices Advisory Committee on prevention of tetanus, diphtheria, and pertussis.
Vaccination is routinely recommended for tetanus. Tetanus toxoid-containing vaccine and tetanus immune globulin is recommended as part of standard wound management to prevent tetanus.
Guidelines state that empiric treatment should aim to treat the most probable organisms. Adjunctive therapy is just as important as therapeutic measures. Also, follow-up of outpatients is considered vital.