Rabies Post-Exposure Prophylaxis After Non-Traditional Rodent Bites

Immediate Risk Assessment and Management

The Centers for Disease Control and Prevention recommends that rodents other than typical small rodents, such as Gambian pouch rats, be treated as potential rabies exposures when the animal cannot be tested 1.
The World Health Organization suggests that "other animals" that bite humans should be reported immediately to local health departments for case-by-case evaluation, as management depends on the species, circumstances of the bite, local rabies epidemiology, and the animal's health status 2, 3, 4, 5.
Any animal that might have exposed a person to rabies requires immediate physician evaluation for antirabies treatment, and if the animal cannot be captured and tested, it should be treated as a high-risk exposure 6, 7, 2, 3.

The American Academy of Family Physicians recommends irrigating the wound copiously with soap and water for 15 minutes to reduce rabies and bacterial infection risk, although this specific recommendation is from Praxis Medical Insights, a similar recommendation can be found from other sources 8.
The World Health Organization suggests applying povidone-iodine solution or other virucidal agent to the wound if available, as this markedly reduces rabies likelihood, however this specific recommendation is from Praxis Medical Insights, a similar recommendation can be found from other sources 8, 9.
For previously unvaccinated persons, the Centers for Disease Control and Prevention recommends administering 20 IU/kg body weight of Human Rabies Immune Globulin (HRIG) as soon as possible, ideally within 24 hours, and infiltrating the full dose around and into the wound if anatomically feasible 8, 9.
The World Health Organization recommends administering 4-5 doses of rabies vaccine over 14-28 days (days 0, 3, 7, 14, and sometimes 28) at a different anatomical site from HRIG, using Human Diploid Cell Vaccine (HDCV) or Purified Chick Embryo Cell Vaccine (PCECV) 9.

The Centers for Disease Control and Prevention recommends assessing tetanus immunization status and administering a booster if indicated, as well as considering antibiotic prophylaxis for delayed presentation or high-risk wounds, although these specific recommendations are from Praxis Medical Insights, similar recommendations can be found from other sources 8.
Local health departments should be contacted immediately to report the exposure and obtain guidance on local rabies epidemiology 2, 3, 4, 5.