Rabies Post-Exposure Prophylaxis Guidelines

Understanding Rabies Exposure Categories

The Centers for Disease Control and Prevention recommends that any penetration of skin by teeth constitutes a bite exposure and represents potential rabies risk 1
The Centers for Disease Control and Prevention suggests that contact of saliva with mucous membranes requires PEP 1
The Centers for Disease Control and Prevention states that scratches without saliva contamination do not constitute exposures 1
The Centers for Disease Control and Prevention recommends that contact with blood, urine, or feces does not require PEP 1
The Centers for Disease Control and Prevention suggests that contact of saliva with intact skin does not require PEP 1
The Centers for Disease Control and Prevention states that petting or handling an animal does not require PEP 1

The Centers for Disease Control and Prevention recommends assessing the need for tetanus prophylaxis, even if the patient is up-to-date with routine vaccines 2
The Centers for Disease Control and Prevention suggests considering antibiotic prophylaxis for infection prevention, as cat scratches carry bacterial infection risk 2

The Centers for Disease Control and Prevention recommends that bat exposures warrant PEP if a bite cannot be ruled out 1
The World Health Organization states that in regions where cat rabies is endemic, the threshold for PEP may be lower, but the fundamental principle remains that scratches without saliva contamination are not exposures 3