SINCE the number of animal bites in the United States exceeds 1 million each year,1 practicing physicians will at times be forced to make a decision whether to initiate postexposure rabies prophylaxis. The basic guidelines for the treatment of individuals bitten by animals have been outlined by the Center for Disease Control (CDC).2 However, unusual circumstances not well covered by these guidelines occasionally arise. We have recently seen two cases involving animal bites in which the person had previously received one or more courses of rabies prophylaxis. Because the recommendations for repeated rabies prophylaxis in previously unimmunized individuals seem somewhat arbitrary, we are reporting these incidences to stress the importance of the pretreatment rabiesneutralizing antibody titer in directing the length of treatment.
Report of Cases
A 16-year-old high school student was referred to the University of Iowa, Iowa City, because of a recent potential rabies exposure.
Lutwick LI, Shanley JD. Pretreatment Antibody Titers in Repeated Rabies Prophylaxis. JAMA. 1980;244(7):691. doi:10.1001/jama.1980.03310070041028