Gewijzigde Nederlandse rabiësrichtlijnen

The WHO aims to eliminate dog-transmitted rabies deaths in humans by 2030 (‘zero by 30’).

The Dutch rabies policy advisory board has revised its national rabies guidelines on the basis of the WHO guidelines revised in 2018.

In the revised Dutch guidelines, there is increased focus on the importance of instant wound care after potential exposure to the rabies virus.

Pre-exposure prophylaxis (PrEP) is limited to two vaccines given on days 0 and 7, rather than the previous regime of three vaccines.

Post-exposure prophylaxis (PEP) no longer consists of five vaccines for unvaccinated individuals; instead it is four vaccines on days 0, 3, 7, and 14-28.

For type III wounds, when indicated, rabies immunoglobulin (RIG) is only injected into and around the wound bed; residual volumes are no longer administered intramuscularly.

RIG no longer needs to be administered in cases of potential mucosal contact exposure to the rabies virus where there is no injury.

The vaccination scheme for PrEP (3) and PEP (5) does not change for immunocompromised patients, and RIG is administered regardless of the vaccination status of the affected individual.

Conflict of interest and financial support: none declared.