Dawaa Reference

infectious

Post-Exposure Rabies Prophylaxis (Animal Bite)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Egyptian MOH Rabies Protocol · WHO. Rabies vaccines: WHO position paper - April 2018. Wkly Epidemiol Rec. 2018;93(16):201-220 (who-rabies-position-paper-2018.txt), Administration of rabies vaccines and Table 1 Post-exposure prophylaxis (PEP) by category of exposure · WHO. Rabies vaccines: WHO position paper - April 2018. Wkly Epidemiol Rec. 2018;93(16):201-220 (who-rabies-position-paper-2018.txt), Administration of rabies immunoglobulin

Verified against2 documents
  • WHO. Rabies vaccines: WHO position paper - April 2018. Wkly Epidemiol Rec. 2018;93(16):201-220 (who-rabies-position-paper-2018.txt), Administration of rabies vaccines and Table 1 Post-exposure prophylaxis (PEP) by category of exposure
  • WHO. Rabies vaccines: WHO position paper - April 2018. Wkly Epidemiol Rec. 2018;93(16):201-220 (who-rabies-position-paper-2018.txt), Administration of rabies immunoglobulin

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • Any wound where teeth broke the skin, or where saliva reached mucous membranes, eyes, or an open cut, carries a possible rabies risk worth assessing.
  • There is no cutoff on how long ago the exposure happened - a risk review is still worth doing months or years later.
  • Finding a bat in the room of a sleeping child, or a heavily sedated, cognitively impaired, or intoxicated adult, is generally treated as an exposure unless circumstances make it unlikely.

Signs — what you find (2)

  • A head-to-toe skin check is worthwhile even when the main wound is obvious, since small bites elsewhere - especially in children - get missed.
  • Marks left by a bat bite or scratch can be too tiny to spot on exam. [animal bite]

Tests (4)

  • Antibody testing after finishing preventive vaccination is reserved for immunocompromised patients, not routinely needed in healthy ones.
  • A protective antibody level per WHO guidance is a titer above 0.5 IU/mL.
  • Dogs, cats, and ferrets involved in a bite are usually watched for 10 days rather than tested right away, since their incubation timing is well known.
  • Labs and imaging generally aren't needed to work up an exposure unless the wound itself is severe.

SourceStatPearls "Rabies" - disease-level clinical article

Presentation findings are traced to the source above.

1

RABIES VACCINE

1st line

Forminjection

Adult dose and duration

IM: 1 full vial (0.5 mL or 1.0 mL depending on product) into deltoid on days 0, 3, 7, and between days 14-28 (4-dose IM regimen); OR ID: 2-site ID (0.1 mL per site, total 0.2 mL per visit) on days 0, 3, and 7 (WHO 1-week ID regimen). - Days 0, 3, 7, 14-28

Paediatric dose

(Same dose (1 full vial IM or 2-site 0.1 mL ID) for children as adults: IM into anterolateral thigh in infants <2 years, deltoid in children >=2 years.)

Dose by age
Under 2 years:As for adults (1 full vial IM, or 2-site 0.1 mL intradermal), given intramuscularly into the anterolateral thigh
2 years and over:As for adults (1 full vial IM, or 2-site 0.1 mL intradermal), given intramuscularly into the deltoid
Dose source

WHO. Rabies vaccines: WHO position paper - April 2018. Wkly Epidemiol Rec. 2018;93(16):201-220 (who-rabies-position-paper-2018.txt), Administration of rabies vaccines and Table 1 Post-exposure prophylaxis (PEP) by category of exposure

Why

Cell-culture rabies vaccine available in Egyptian MOH anti-rabies centers (VACSERA / fever hospitals)

Cautions
  • Immediate local wound washing with soap and running water for 15 minutes is critical first step.
  • Category III bites (transdermal, mucous contact) require RIG.
  • Give IM, NEVER in the gluteal region (reduces antibody response).
Egyptian brands
Egyptian brandManufacturerIndicative price
RABIES VACCINE (VERO CELL) 2.5I.U./0.5ML FREEZE-DRIED I.M.INJ.CHANGCHUM CHANGSHENG LIFE SCIENCES-CHINA > ACDIMA INTERNATIONAL TRADING67.50 EGP
RABIPUR 2.5I.U./VIAL (PCEC RABIES VACCINE FOR HUMAN )NOVARTIS > RAMCO70.00 EGP
VERORAB 2.5I.U./0.5ML VIALSANOFI PASTEUR-FRANCE > ETIMEX-EGYPT75.00 EGP
RABIES VACCINEVACSERA198.40 EGP
2

RABIES IMMUNE GLOBULIN (HUMAN)

add-on - not a substitute

Forminjection

Adult dose and duration

20 IU/kg (Human RIG) infiltrated into and around all wound sites on Day 0 - Single dose on Day 0

Paediatric dose

20 IU/kg HRIG (or 40 IU/kg equine RIG) infiltrated in/around wounds; remaining volume IM

Dose source

WHO. Rabies vaccines: WHO position paper - April 2018. Wkly Epidemiol Rec. 2018;93(16):201-220 (who-rabies-position-paper-2018.txt), Administration of rabies immunoglobulin

Why

Passive immunization for WHO Category III exposures available via VACSERA/MOH centers in Egypt

Cautions
  • Do NOT exceed calculated dose (may inhibit active vaccine antibody response).
  • Do not give after Day 7 of vaccine series (active antibodies already forming).
Egyptian brands
Egyptian brandManufacturerIndicative price
BERIRAB P 300I.U./2ML I.M INJ.CSL BEHERING-GMBH -GERMANY > 2S PHARMA GROUP480.00 EGP
BERIRAB P 750I.U./5ML I.M INJ.CSL BEHERING-GMBH -GERMANY > 2S PHARMA GROUP1100.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.