At present, it is difficult to confirm in a timely manner in clinical work whether a wound or mucous membrane is contaminated with rabies virus, so whether to carry out post-exposure treatment requires a comprehensive assessment based on local epidemiological findings. Theoretically, all mammals are at risk of rabies, and as China is a high-risk area for rabies, we classify the animals that cause injuries into three categories: high risk, low risk and no risk of transmitting rabies, and judge post-injury management measures accordingly.
High risk: ① dogs and cats (both stray and domestic); ② stray or wild mammals, mainly carnivorous mammals; ③ bats (contact is a high risk exposure). Post-exposure treatment must be carried out after injury by a high-risk animal.
Low risk: domestic animals such as cattle, sheep, horses and pigs, rodents such as rabbits and rats. Post-exposure treatment after injury by low-risk animals should be based on the local epidemiological situation and is generally not required. If an unexplained death of a low-risk animal is found locally, or if a low-risk animal is found to have rabies, or if there is extreme anxiety, post-exposure treatment is recommended.
No risk: All animals other than mammals do not transmit rabies, e.g. turtles, fish, birds, etc. Injuries caused by them are a no-risk exposure and no post-exposure rabies management is required. Domestic and laboratory (not exposed to rabies virus) rodents that do not come into contact with the outside world can also be considered risk-free.
Exception: humans, if injured by a rabid patient, need to be treated as a high risk exposure, no other exposure is required.