Question & AnswerQ&A (DA DEPARTMENT OF HEALTH ADMINISTRATIVE ORDER NO. 2011-002 AND DEPARTMENT OF AGRICULTURE ADMINISTRATIVE ORDER NO. 01, SERIES OF 2011)
The primary objective is to provide updated guidelines and procedures to ensure effective and efficient management of rabies exposures toward eventual reduction, if not elimination of human rabies in the Philippines.
The provision of PEP is mandated under Republic Act No. 9482, known as the Anti-Rabies Act of 2007.
An updated rabies vaccination means the dog or cat is at least 1 year and 6 months old, has a valid vaccination certificate issued by a duly licensed veterinarian for the last 2 years, and the last vaccination was administered within the past 12 months.
The Department of Health, in collaboration with Local Government Units (LGUs), is responsible for the management of animal bite victims including the provision of human rabies vaccine.
There are three categories: Category I involves minimal contacts like feeding or touching an animal; Category II includes nibbling of uncovered skin and minor scratches without bleeding; Category III involves transdermal bites, licks on broken skin, mucous membrane exposure, and exposure to rabid or sick animals.
PEP is required immediately in cases of Category III exposure; when the biting dog/cat is proven or suspected rabid, sick, or dead; when the animal is involved in multiple biting incidents within 24 hours; or when the animal displays clinical signs of rabies before, during, or after the bite.
No, PEP is not recommended for all Category I exposures.
Yes, PEP can be delayed for Category II exposures if the dog/cat is healthy and available for 14-day observation, and has an updated rabies vaccination as defined in the guidelines. If the animal becomes sick or dies during the observation period, PEP must be started immediately.
PEP is not required for bites from rats, mice, rabbits, snakes and other reptiles, birds and other avian species, insects, and fish.
Signs include changes in behavior (aggressiveness, restlessness, solitude), dilated pupils, hypersalivation, difficulty swallowing, paralysis, and erratic or vicious behavior among others detailed in the prodromal, furious, and paralytic stages.
The Department of Health through the National Center for Disease Prevention and Control and its Centers for Health Development, the Department of Agriculture through the Bureau of Animal Industry and Regional Field Units, and the Local Government Units through Provincial Health and Veterinary Offices.
Batas Pambansa Blg. 97 provides for the compulsory immunization of livestock, poultry, and other animals against dangerous communicable diseases.
Post-Exposure Prophylaxis (PEP) should be started immediately for the bite victim.
The order took effect immediately upon its adoption on February 2, 2011.