CDC ISSUES HEALTH ADVISORY REGARDING RISE IN RABIES EXPOSURES AND POST-EXPOSURE TREATMENT ERRORS
The Centers for Disease Control and Prevention has issued a Health Alert Network advisory following a notable rise in human rabies exposures and post-exposure prophylaxis (PEP) administration errors across multiple U.S. jurisdictions.
Data from July through August indicate a 17% increase in rabies-related inquiries compared to the same period last year, alongside reports of mass exposure events. Pharmacy data shows a 33% increase in rabies vaccine utilization and a 76% surge in rabies immune globulin (HRIG) usage. While the national supply remains stable, health officials emphasize that incorrect administration can lead to avoidable costs—ranging from $11,000 to $14,000 per patient—as well as potential adverse effects and unnecessary treatments.
Frequent errors identified by the agency include administering vaccines in the gluteal area, failing to infiltrate HRIG around all identifiable wounds, mixing HRIG and vaccines in the same syringe, and misclassifying patient vaccination histories.
Key Guidance for Clinicians and the Public
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Risk Assessment: Clinicians should perform thorough rabies risk assessments with local health departments before initiating PEP.
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Proper Administration: HRIG must be calculated at 20 IU/kg based on body weight, infiltrated into and around all wounds, and given exclusively to unvaccinated patients.
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Vaccination Schedule: Unvaccinated individuals require a four-dose vaccine series on days 0, 3, 7, and 14 in the deltoid or anterolateral thigh, never the gluteal muscle.
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Public Safety: Individuals should keep a safe distance from wildlife, ensure pets are vaccinated, and immediately wash any animal-related scratches or bites with soap and water for 15 minutes before seeking medical evaluation.
