Who are the individuals at high risk of rabies who may require pre-exposure vaccination?

Individuals at highest risk of rabies who may require pre-exposure prophylaxis (PrEP) are those whose occupation or personal activities involve potential direct contact with infected animals, or who work with the rabies virus in laboratory settings. This also includes individuals living in remote areas that are highly endemic for rabies, where access to medical care is limited [1].

High-Risk Occupational Categories

Certain professions increase the risk of rabies exposure and warrant pre-exposure vaccination, including:

• Laboratory Workers: Individuals handling live rabies virus or related viruses are at high risk [1].
• Animal Disease Control Personnel and Wildlife Rangers: These individuals interact directly with potentially infected animals, increasing the likelihood of exposure through bites or scratches [1].
• Veterinarians and Veterinary Assistants: Due to their continuous interaction with a wide range of animals, they are at increased risk.

Pre-exposure vaccination does not eliminate the need for post-exposure prophylaxis (PEP) if a suspected exposure occurs. Anyone exposed to an animal suspected of having rabies must seek immediate medical care [1].

Travel and Residence in Endemic Areas

Pre-exposure vaccination may be necessary for people planning to travel to or reside in certain regions where rabies is highly prevalent, particularly in Asia and Africa, where the majority of human deaths due to rabies occur [1]. It is also recommended for those living in remote, highly endemic areas with limited access to rabies vaccines or rabies immunoglobulin [1]. In the Americas, where dog-transmitted rabies is largely controlled, bats have become a primary source of human rabies [1].

Importance of Post-Exposure Vaccination

Once clinical symptoms of rabies appear, the disease is nearly 100% fatal [1]. However, rabies deaths can be prevented through immediate post-exposure prophylaxis (PEP), which prevents the virus from reaching the central nervous system [1]. PEP consists of thorough wound washing, a series of human rabies vaccines, and, when indicated, an injection of rabies immunoglobulin [1].

If a person is bitten or scratched by an animal potentially infected with rabies, they must seek post-exposure care immediately and without exception [1]. Even if pre-exposure vaccination has been received, a suspected exposure requires immediate medical evaluation and care [1]. You can learn more about first aid and post-exposure vaccination by visiting Rabies: Prevention, First Aid, and the Importance of Post-Exposure Vaccination (Arabic).

When Should You Consult a Doctor?

A doctor should be consulted immediately after any potential rabies exposure, even if there is no obvious bite, especially if you have had contact with animals such as bats, foxes, or skunks [2]. Bats can transmit rabies through minor or unrecognizable bites or scratches that you might not notice [2]. If you find a bat in your home, you should contact a healthcare provider or the health department, even if you did not feel or see a bite [2].

Medical references

• Rabies
• Rabies