Administration of rabies immunoglobulin
Rabies immunoglobulin (RIG) should be given for all category III exposures, irrespective of the interval between exposure and beginning of treatment. Two kinds of rabies antibody preparations may be used: human rabies immunoglobulin (HRIG) and equine rabies immunoglobulin (ERIG). A skin test must be performed prior to the administration of ERIG. As much as possible of the recommended dose (20 IU/kg of body weight of HRIG or 40 IU/kg of body weight of ERIG) should be infiltrated around the wounds if anatomically feasible. The remainder should be administered intramuscularly (into gluteal region) in a single dose and followed by a complete course of vaccine.
Rabies immunoglobulin of human origin (HRIG) is available in some countries; however, it is expensive and only limited amounts are available.
Rabies immunoglobulin of equine origin (ERIG) is available in many countries and is considerably cheaper than HRIG. Most of the currently available preparations of ERIG are highly purified and quite safe.
Certificate of post-exposure treatment
A certificate of post-exposure rabies treatment should be filled in and given to each vaccinee.