Rabies post-exposure prophylaxis (PEP)
People may be exposed to rabies and other lyssaviruses through animal scratches or bites, or by direct contact of mucosal surfaces with infected saliva.
Exposure can be from:
- Terrestrial (land-dwelling) mammals in an overseas country with rabies
- Bats anywhere in the world (including Australia)
Anyone who has potentially been exposed should receive post-exposure prophylaxis (PEP) with rabies vaccine. In some cases, rabies immunoglobulin is also required. Recommendations are provided in the Rabies and other Lyssaviruses chapter in the Australian Immunisation Handbook.
If you are unsure if your patient has had a potential rabies or lyssavirus exposure, contact Boorloo PHU urgently by phone.
Free vaccine and immunoglobulin are provided by WA Health for rabies PEP and require approval from public health.
Members of the public potentially exposed to rabies should seek urgent medical attention.
Boorloo PHU can provide advice to health care providers and the public on accessing rabies PEP if required (including if a rabies PEP course has been started overseas).
How to access rabies PEP in Perth area
To access government funded rabies PEP stock in metropolitan Perth, clinicians should follow the process outlined below. Use of rabies PEP needs approval from public health.
1. Assess exposure
- Apply first aid and wound management, as required. Consider tetanus and other infections
- Collect details about exposure, rabies vaccinations, and patient.*
2. Complete online exposure form
In office hours (NB Perth area only**) Monday to Friday 8am to 5pm excluding public holidays.
Complete form while patient is at your clinic. Call Boorloo PHU on 1300 623 292 if support is required.
Outside office hours (all of WA) call on-call public health physician on 1800 434 122.
**Outside metro Perth contact your local public health unit.
Alternatively, if you are unable to administer rabies PEP to the patient, call Boorloo PHU on 1300 623 292 and we can provide advice on referral to another provider with government rabies PEP stock on-site.
3. Boorloo PHU reviews exposure, approves PEP use, and organises delivery of PEP stock (unless government stock is already held on site).
4. Administer rabies PEP
- Communicate plan to patient and provide written patient information.
- Prior to administration, read Administration of rabies vaccine and HRIG for PEP (PDF).
Please note that the online exposure form is only to be used by health professionals.
*Information needed for exposure assessment (also see online form):
- Exposure date, country, animal, site and severity of wound.
- Is patient immunocompromised or has an egg allergy?
- Has patient been previously vaccinated against rabies (i.e. prior to this exposure) and/or have they already received any PEP for this exposure (including overseas).
- Patient weight (if immunoglobulin may be indicated).
Additional resources for health professionals
Administration of rabies vaccine and HRIG for post-exposure prophylaxis (PDF)
Australian Immunisation Handbook- Rabies and other lyssaviruses (external site)
Rabies and other lyssavirus – CDNA National Guidelines for Public Health Units (PDF)
Rabies and other lyssaviruses (including Australian bat lyssavirus) (external site)
Rabies and lyssavirus - consumer information (external site)