Table 3. Risk assessment to maximize the utility of rabies prophylaxis after human exposure ^{10, 48, 75}.

Category	Issue	Outcome
Species	Is the mammal a reservoir?	Non-reservoirs or non-vectors are less likely to be rabid.
Exposure	Was the exposure due to a bite?	Non-bite exposures are less likely to cause rabies.
Health	Does the animal show compatible clinical signs with an encephalitis or other behavioral abnormalities suggestive of rabies?	In general, apparently healthy animals (even near the end of the incubation period) are less likely than ill animals to excrete virus.
Epidemiological status	What is the occurrence of rabies in the area?	Unless an epizootic or enzootic status is apparent, rabies is less frequent in areas without cases for several years, assuming adequate laboratory-based surveillance.
Event circumstances	Was the exposure provoked?	Often animals may bite if provoked (for example, protecting young, sleeping, or eating).
Observation	Can the dog, cat, or ferret be observed?	If the animal stays apparently healthy during at least 10 days after the bite, no post-exposure prophylaxis (PEP) is needed (or initiated PEP can be discontinued).
Vaccination status	Is the animal up to date on rabies vaccination?	Vaccine failures are possible, but rare, with modern veterinary biologics.
Diagnosis	Is the brain available for a timely examination?	If no rabies virus antigens are detected by a qualified laboratory using an approved test, no PEP is needed.
First aid	Were all wounds washed well?	Proper cleansing with soap and water reduces the viral load in local wounds.
Injury	Does the injury require sutures?	If at all practical, suturing should be postponed, to avoid the opportunity to further contaminate the locality and drive virus deeper in tissues.
Biologics	Are modern vaccines and rabies immune globulin (RIG) available?	If the diagnosis is positive or (under the worst conditions when rabies is strongly suspected) if an unprovoked bite is from an ill, unavailable dog or other reservoir in an enzootic area, begin PEP per current World Health Organization recommendations to the extent possible or support transport to the nearest suitable facility immediately.
Patient health	Is the person immune-competent?	In the severely immune-suppressed patient, such as someone with AIDS, passive immunization with rabies immune globulin (RIG) becomes an even more critical part of PEP.