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To the Editor: The article by Dr Moran and colleagues¹ provides useful information about postexposure prophylaxis (PEP) for rabies. The figure, however, does not provide current rabies PEP treatment information. The figure caption refers to the 1991 Advisory Committee on Immunization Practices (ACIP),² while the text references the 1999 ACIP guidelines.³ There are significant differences between the 1991 and 1999 ACIP recommendations. The PEP recommendations in the 1999 guidelines reflect both the developing epidemiology of the disease and advances in medical knowledge. One of the changes, for example, involves rabies PEP recommendations for high-risk exposures to skunks and raccoons when the brain of the animal is available for testing. In this situation, the algorithm in the article recommends withholding PEP until the results of the brain test are available and initiation of treatment only if the result is positive for rabies. The 1999 ACIP guidelines, however, recommend initiating rabies PEP . . . [Full Text of this Article]

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Appropriateness of Rabies Postexposure Prophylaxis Treatment for Animal Exposures
Gregory J. Moran, David A. Talan, William Mower, Michael Newdow, Samuel Ong, Janet Y. Nakase, Robert W. Pinner, James E. Childs, and for the Emergency ID Net Study Group
JAMA. 2000;284(8):1001-1007.
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