Rabies Post-Exposure Prophylaxis for Rodent Bites

Risk Assessment for Rodent Bites

• Small rodents, including rats, are almost never found to be infected with rabies and have not been documented to transmit rabies to humans 2, 4
• Rats were not significantly represented in the statistics of rabies among rodents reported to CDC from 1990-1996 in areas with endemic raccoon rabies, with woodchucks accounting for 93% of the cases 5, 4

Decision Algorithm for Rodent Bites

• Immediate and thorough washing of all bite wounds with soap and water for 15 minutes is required for all bites, and a virucidal agent such as povidone-iodine solution should be applied to the wound 6, 7
• The Centers for Disease Control and Prevention (CDC) recommends assessing the need for tetanus prophylaxis and antibiotics for bacterial infection for all bite wounds 7

Special Considerations

• Even in areas with endemic wildlife rabies, rats remain an extremely low-risk species for rabies transmission 4, 3
• The Advisory Committee on Immunization Practices (ACIP) guidelines should be followed, but local public health authority recommendations should also be considered, as they may have region-specific guidance 1, 2

Important Caveats

• If the rat's behavior was highly unusual, consultation with public health authorities is still warranted, though rabies remains extremely unlikely 8, 7
• The risk of bacterial infection, particularly rat bite fever, is a more significant concern than rabies with rat bites, and appropriate antibiotic treatment should be considered 7