Healthcare providers often recommend pre-exposure treatment for rabies for people in high-risk groups. These groups include:
- Veterinarians, animal handlers, and certain laboratory workers
- Other people whose activities bring them into frequent contact with the rabies virus or potentially rabid bats, raccoons, skunks, cats, dogs, or other species at risk of having rabies
- International travelers likely to come in contact with animals in areas of enzootic (affecting animals in a specific geographic area) dog rabies, which lack immediate access to appropriate medical care.
People who work with live rabies virus in research laboratories or vaccine production facilities are at the highest risk of unapparent exposures. Such people should have a serum (blood) sample tested for antibody every six months and receive a booster vaccine when necessary. In most circumstances, doctors do not recommend routine pre-exposure prophylaxis with the rabies vaccine.
Pre-exposure rabies treatment consists of three doses of the rabies vaccine given on days 0, 7, and 21 or 28.
No one in the United States has developed rabies when the post-exposure treatment regimen discussed in this article was followed. Therefore, as long as treatment for rabies is begun prior to the appearance of symptoms, the prognosis is excellent. When treatment is started after rabies symptoms begin, the prognosis is poor. Death is almost certain to occur within one to two weeks.