Rabies post-exposure prophylaxis advice

Rabies is caused by exposure to saliva or neural tissue from an animal infected with rabies virus or other lyssaviruses. It is invariably fatal.

Post-exposure prophylaxis (PEP) includes prompt wound management, administration of rabies vaccine and, in some cases, human rabies immunoglobulin. Both provided at no cost from The WA Department of Health.

Humans can be exposed through animal scratches or bites, or by direct contact of mucosal surfaces with infected saliva. Common exposures are from mammals (such as dogs or monkeys) in countries where rabies affects animals (often Asia and including Bali). However, exposure can also occur from bats in any country in the world.

Evidence of Australian bat lyssavirus infection has been identified in all four species of Australian fruit bats (flying foxes) and in several species of Australian insectivorous bats.

If patients have had possible exposure to rabies or other lyssaviruses (including Australian bat lyssavirus) overseas or within Australia, health providers should contact Public Health for advice to access rabies PEP, which can be provided urgently. Providers do not need to write a script or use private stock.

PEP depends on the type of exposure, the animal source (terrestrial mammal or bat), and the patient’s immune status and vaccination history.  The Australian Immunisation Handbook describes detailed protocols.

You will be asked to provide details on the incident (including date, animal, country, wound), any prophylaxis already given (including overseas), vaccinations, and the patient’s medical conditions (including weight, allergies and immunocompromise).

In metropolitan Perth, phone 9222 8588 (8.30am to 5.00pm, Monday to Friday, excluding public holidays).

In regional areas, contact your local public health unit .

After hours, phone the on-call public health physician on 9328 0553.  More information is available from WA Health.