[Immunoprophylaxis of rabies: current recommendations].
Pre-exposure rabies vaccination should comprise 3 injections (day 0, day 7, day 28) followed by boosters 1 year later then every 5 years. Populations who are particularly exposed due to occupation, regular contact with animals in endemic areas during leisure activities or holidays should be vaccinated, especially if access to post-exposure treatment is difficult. Post-exposure treatment should comprise 5 injections (day 0, day 3, day 7, day 14, day 28) which must be given with specific immunoglobulins on day 0 if there are penetrating wounds. In persons whose prior vaccination status is well-documented and correctly maintained, post-exposure treatment may be limited to 2 injections on day 0 and day 3. The vaccine is given is intramuscular injection in the deltoid region. Immunoglobulins are used at the dose of 20 IU/kg for human immunoglobulins and at 40 IU/kg for horse immunoglobulins. The injections are infiltrated around the lesions and the remaining quantity injected in the gluteus muscle. Seroconversion must be monitored by assaying neutralizing antibodies (titre > or = 0.5 IU/ml with the RFFI Test) in vaccinated populations who regularly exposed. Monitoring can also be useful after post-exposure treatment in certain specific cases (immunosuppressed subjects, treatment protocol incorrectly or incompletely applied). An antibody titre under 0.5 IU/ml requires an immediate vaccine injection.
Strady
A
A
Centre antirabique, Hôpital Robert Debré, Reims.
Lang
J
J
Rotivel
Y
Y
Jaussaud
R
R
Fritzell
C
C
Tsiang
H
H
D017408:Guidelines as Topic; D006801:Humans; D011818:Rabies / Q000453:epidemiology / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D012698:Serologic Tests
D011819:Rabies Vaccines
L'immuno-prophylaxie de la rage: actualisation des recommandations.