What is the postexposure prophylaxis (PEP) for consuming milk from a cow with rabies?

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Last updated: April 17, 2025View editorial policy

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From the Guidelines

Postexposure prophylaxis is not typically recommended for individuals who have consumed milk from a rabid cow, as the risk of transmission through milk consumption is extremely low. The rabies virus is primarily spread through saliva via bites or direct contact with mucous membranes, and it is destroyed by pasteurization and stomach acid, making transmission through ingestion highly unlikely [ 1 ]. According to the most recent and highest quality study available, which is not the case here as the most recent study provided is from [ 1 ], pasteurization temperatures will inactivate the rabies virus, and thus drinking pasteurized milk does not constitute a rabies exposure.

Key points to consider in this scenario include:

  • The mode of transmission of the rabies virus, which is mainly through bites or contact with mucous membranes [ 1 ].
  • The effect of pasteurization on the rabies virus, which renders it inactive [ 1 ].
  • The lack of documented cases of human rabies resulting from the consumption of milk from rabid animals.

However, in rare circumstances where there might be a potential risk, such as cuts or abrasions in the mouth or esophagus, or if unpasteurized milk came into contact with mucous membranes, consultation with a healthcare provider is advisable. In such cases, standard rabies postexposure prophylaxis (PEP) might be considered, consisting of rabies immune globulin and a series of rabies vaccine doses. For the vast majority of individuals who have consumed milk from a rabid cow, especially if the milk was pasteurized, reassurance rather than medical intervention is the appropriate course of action, given the negligible risk of rabies transmission through this route [ 1 ].

From the Research

Postexposure Prophylaxis for Drinking Milk of Rabid Cow

  • There is no direct evidence in the provided studies regarding postexposure prophylaxis for drinking milk of a rabid cow.
  • However, the studies provide general information on postexposure prophylaxis for rabies and other infectious diseases.
  • According to 2, postexposure prophylaxis is effective in preventing illness after potential or documented exposure to various microbial pathogens.
  • The studies 3, 4, 5 focus on rabies postexposure prophylaxis, including wound washing, administration of rabies immunoglobulin, and vaccination schedules.
  • 6 discusses postexposure prophylaxis for various infectious diseases, including rabies, but does not specifically address drinking milk of a rabid cow.
  • It is essential to note that the provided studies do not directly address the question of postexposure prophylaxis for drinking milk of a rabid cow, and therefore, no specific recommendations can be made based on this evidence.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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