Rabies Post-Exposure Prophylaxis for Rat Bites
No, you do not administer rabies post-exposure prophylaxis for rat bites. Small rodents including rats, mice, squirrels, hamsters, guinea pigs, gerbils, and chipmunks are almost never found to be infected with rabies and have not been known to transmit rabies to humans. 1
Why Rats Don't Require Rabies PEP
Rats and other small rodents are not rabies reservoirs and do not transmit rabies to humans. The CDC explicitly states that bites from rats, mice, and other small rodents almost never require anti-rabies post-exposure prophylaxis. 2
Epidemiologic Evidence
- Small rodents are almost never found to be infected with rabies and have not been known to transmit rabies to humans 1
- From 1990-1996, in areas where raccoon rabies was endemic, woodchucks (large rodents) accounted for 93% of the 371 cases of rabies among rodents—notably, small rodents like rats were not implicated 1
When to Consult Public Health
In all cases involving rodent bites, the state or local health department should be consulted before deciding to initiate antirabies post-exposure prophylaxis. 1 This consultation is recommended to:
- Confirm local epidemiology
- Rule out unusual circumstances
- Document the decision-making process
What You Should Do Instead
Immediate Wound Management
- Thoroughly wash and flush the wound for approximately 15 minutes with soap and copious amounts of water 2
- Apply povidone-iodine solution or similar virucidal agent to the wound if available 1, 2
- Assess for tetanus prophylaxis needs 2
Infection Prevention
- Consider antibiotic prophylaxis, as rat bites carry significant risk of bacterial infection (including Streptobacillus moniliformis causing rat-bite fever and Pasteurella species) 3
- Monitor for signs of wound infection over the following days
Animals That DO Require Rabies PEP
For context, rabies post-exposure prophylaxis is indicated for:
- Wild terrestrial carnivores: raccoons, skunks, foxes, coyotes—all bites must be considered possible rabies exposures 1
- Bats: any direct contact where a bite cannot be ruled out requires PEP 1
- Dogs, cats, and ferrets: if the animal cannot be observed for 10 days or shows signs of rabies 1, 2
- Monkeys and other primates: treated as high-risk exposures when the animal cannot be tested 4
Critical Caveat
The one exception among rodents is woodchucks (groundhogs), which are large rodents that have accounted for documented rabies cases. 1 Even in these cases, consultation with local health departments is essential before initiating prophylaxis.