# Post-Exposure Rabies Prophylaxis (Animal Bite) - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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 ## Treatment metadata - Rabies vaccine — injection - Rabies immune globulin (human) — injection ## Complete treatment card ```text POST-EXPOSURE RABIES PROPHYLAXIS (ANIMAL BITE) 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 Review status: REVIEWED against the source listed above (2026-08) 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. Source StatPearls "Rabies" - disease-level clinical article Status traced to the source above 1. RABIES VACCINE [1st line] Adult 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 Peds 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 (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.) 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) Caution 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). Egypt RABIES VACCINE (VERO CELL) 2.5I.U./0.5ML FREEZE-DRIED I.M.INJ. CHANGCHU... 67.50 EGP RABIPUR 2.5I.U./VIAL (PCEC RABIES VACCINE FOR HUMAN ) NOVARTIS > RAMCO 70.00 EGP VERORAB 2.5I.U./0.5ML VIAL SANOFI PASTEU... 75.00 EGP RABIES VACCINE VACSERA 198.40 EGP 2. RABIES IMMUNE GLOBULIN (HUMAN) [add-on - not a substitute] Adult 20 IU/kg (Human RIG) infiltrated into and around all wound sites on Day 0 - Single dose on Day 0 Peds 20 IU/kg HRIG (or 40 IU/kg equine RIG) infiltrated in/around wounds; remaining volume IM 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 Caution Do NOT exceed calculated dose (may inhibit active vaccine antibody response). Do not give after Day 7 of vaccine series (active antibodies already forming). Egypt BERIRAB P 300I.U./2ML I.M INJ. CSL BEHERING-... 480.00 EGP BERIRAB P 750I.U./5ML I.M INJ. CSL BEHERING-... 1100.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)