POST-EXPOSURE
This does not happen very often, but when it does, practices need to know what to do. Details are per Chapter 27 of the Green Book.
If a patient has been exposed the risk is determined by a combination of the country they were in and the type of exposure (see Table 27.3, 27.4 and 27.5).
Normally a patient will have attended secondary care first either in the country of exposure or in UK. If a patient is medium or high risk, they should have the wound treated (cleaned and antiseptic applied) normally in secondary care and Human Rabies Immunoglobulin (HRIG) plus five doses of vaccine on days 0, 3, 7, 14 and 30.
If you are notified that a patient has been exposed and been given the HRIG and initial vaccine abroad, it would be better to plan to be ready for the follow up vaccinations in advance.
There are two steps required:
- 1) Contact UK Health Security Agency (UKHSA) to request the vaccine. Full Details here. Phone number 0330 128 1020 between 8am to 5.30pm Monday to Friday.
- 2) Contact LLR ICB to request funding in advance for the vaccinations.
Email: llricb-llr.primarycareteam@nhs.net. You will be given instructions how to invoice. Without this you will be working outside of a contract and may not be indemnified.
PRE-EXPOSURE
Practices are contracted through the Global Sum to provide primary course and reinforcement vaccination for high risk people due to employment as defined in Table 1 of the Statement of Fees and Entitlements.
Please contact the LMC to let us know if you have any concerns or problems.