Rabies Prophylaxis for Rodent Bites

Risk Assessment and Prophylaxis Guidelines

The Centers for Disease Control and Prevention recommends that small rodents and lagomorphs (rabbits and hares) almost never require rabies postexposure prophylaxis, as they do not serve as rabies reservoirs and transmission from these species to humans has not been documented in the United States 1
In contrast to rats, bites from wild carnivorous mammals (skunks, raccoons, foxes, coyotes, bobcats) or bats should be considered rabid unless proven otherwise and require immediate postexposure prophylaxis, according to the CDC guidelines 1, 2

The American Academy of Family Physicians suggests that immediately irrigating the wound thoroughly with copious amounts of water or normal saline solution for at least 15 minutes with soap and water is essential for reducing the risk of bacterial infection, which is the primary concern with rodent bites 3

The World Health Organization recommends that previously unvaccinated persons require Human Rabies Immune Globulin (HRIG) 20 IU/kg infiltrated around the wound plus 5 doses of rabies vaccine on days 0, 3, 7, 14, and 28 for Category III exposures, which include any penetration of skin by teeth from high-risk animals (bats, wild carnivores), contamination of mucous membranes with saliva, or licks on broken skin 1, 2
The CDC advises that previously vaccinated persons require only 2 doses of vaccine on days 0 and 3, without immunoglobulin, for Category III exposures 2