Rabies post exposure prevention

Rabies virus is found in large quantities in the saliva of infected animals, and transmission occurs almost exclusively through inoculation of the infected saliva through a bite or scratch from a rabid mammal. Initial aggressive management with adequate supportive therapy may help in the survival of the patient. Rabies is generally fatal, and neither rabies immunoglobulin (RIG) nor rabies vaccine provides benefit once symptoms have appeared. The three-pronged approaches to prevent death caused by rabies in humans are stray animal control, post-exposure prophylaxis, and prior vaccination of people with a higher risk of exposure. Modern rabies vaccines have been proven to be safe, well- tolerated, and highly effective in preventing rabies, even if administered after exposure to bites. PEP consists of wound cleaning, rabies vaccination, and passive immunization with rabies immune globulin (RIG), of which the most important treatment is rabies vaccination. Several regimens of rabies vaccination approved by WHO have shown to be immunogenic. Smaller doses and more advanced processing techniques have a relatively higher safety for the patients, especially for the young children. No significant differences in safety and immunogenicity between PVRV and PCECV both in Zagreb and Essen regimens. WHO recommends completing PEP against rabies with the same cell culture or embryonated egg rabies vaccine and with the same route of administration and any deviation from this shall be an exception. PEP was safe and effective despite changes in the route of administration and brand/ or type of rabies vaccine.