Common dilemmas in managing rabies exposed subjects

Health care staff managing rabies exposures in a canine endemic or epidemic environments are often faced with having to make treatment decisions where there are no firm guidelines from WHO or local public health authorities. We have made an attempt to identify several common events that presented to a busy animal bite clinic in a rabies endemic country. Leading experts in this field have been queried about their management opinions in such situtions. They have revealed little uniformity. It appears that there is still much controversy and lack of evidence-based approach from international authorities, and that more research and data collection is needed to resolve some of these issues and provide better guidelines in this field.