Rabies Risk Stratification (Harrison’s Reference):
According to rabies exposure categories:
🟡 Category III Exposure (High Risk):
Bites or scratches on head, neck, face, or genitals
Even licks on broken skin or mucosa
Contact with bats (even without visible bite) is automatically high-risk
💡 Conclusion: Since a bat cannot be ruled out, and the head is involved (highly innervated area), this should be considered Category III exposure.
✅ Recommended Action:
1. Start Rabies Post-Exposure Prophylaxis (PEP) Immediately
Rabies Vaccine (Day 0, 3, 7, 14)
Rabies Immunoglobulin (RIG) if not previously vaccinated and exposure is Category III
2. Clean the Wound Thoroughly
Wash with soap and water for at least 15 minutes
Apply antiseptics like povidone-iodine
3. Observe Animal (if captured and identifiable)
If it was a domestic bird: No vaccine needed
If it was a wild bat or untraceable animal: Assume rabies risk
❗Special Note:
Birds do not transmit rabies
Bats are known rabies carriers, and any physical contact is considered a risk
📘 Reference:
Harrison’s Manual of Medicine, Rabies chapter: “All contact with bats, even in the absence of a visible wound, warrants PEP due to possible unnoticed bites.”
Oxford Handbook of Palliative Care supports PEP for high-risk exposures, especially involving head and face.
🟢 Final Advice:
➡️ Start rabies PEP without delay unless it is confirmed that the animal was a non-rabid bird.
Answered2025-06-24 10:14:03
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