Public Health Advisory
April 2, 2010

Officials at the West Virginia Bureau for Public Health and the Wheeling-Ohio County Health Department are issuing this advisory.If you have any questions or concerns, please contact the Wheeling-Ohio County Health Department at (304) 234-3682.

UPDATED RABIES POST EXPOSURE PROPHYLAXIS (PEP) GUIDELINES

Rabies immune globulin (RIG) and 4 (four) doses of rabies vaccine are now sufficient for post-exposure prophylaxis in immunocompetent patients. Previously, 5 (five) doses of vaccine plus RIG were recommended. This new recommendation from the Centers for Disease Control and Prevention (CDC) should make it easier for patients and physicians to complete the post-exposure vaccination series while still offering full protection against rabies.

Previously unvaccinated immunocompromised patients should still receive 5 doses, and post-vaccination serology is necessary to assure full protection. Management of previously vaccinated immune-compromised persons requires evaluation on a case-by-case basis, using serologic response as a guide.

Providers should implement the new recommendations as soon as possible. A summary document is attached for emergency room and other medical staff who may see patients with animal bites. Of course, all animal bites and potential rabies exposures must be reported to the local health department of the county of residence of the bite victim. For questions about possible rabies exposure and rabies risk assessment, please contact your local health department or the Bureau for Public Health Division of Infectious Disease Epidemiology at (800)-423-1271.

This message was directly distributed by the West Virginia Bureau for Public Health to local health departments and healthcare associations. Receiving entities are responsible for further disseminating the information as appropriate to the target audience.

Categories of Health Alert messages:

• Health Alert: Conveys the highest level of importance, warrants immediate action or attention.
• Health Advisory: Provides important information for a specific incident or situation. May not require immediate action.
• Health Update: Provides updated information regarding an incident or situation. Unlikely to require immediate action.