Rabies vaccination after dog bite/monkey bite

rabies    

rabies

Rabies vaccination after dog bite/monkey bite

Dog bite/ Monkey bite is very scary situation for young kids and their parents. We need to consult doctor immediately as treatment has to be started within 24 hours.  Dog bites can lead to rabies disease.

Rabies disease can be prevented with vaccination, but if it occurs it is 100% fatal worldwide.

Rabies can occur with dog bite, monkey bite or any other domestic or wild animals.

Specially if dog bite is unprovoked, chances of dog being rabied is high. Beside as we know the illness is 100% fatal, so whenever in doubt its better to vaccinate the child.

 

Category of bite:

 

Table 1: Type of contact, exposure and recommended post-exposure prophylaxis

 

Category Type of contact Type of exposure Recommended post-exposure prophylaxis
I  Touching or feeding of animals Licks on intact skin  None 
  • None, if reliable case history is available

 

II  Nibbling of uncovered skinMinor scratches or abrasions without bleeding Minor
  • Wound management
  • Anti-rabies vaccine

 

III Single or multiple transdermal bites or scratches, licks on broken skinContamination of mucous membrane with saliva (i.e. licks) Severe • Wound management• Rabies immunoglobulin

•Anti-rabies vaccine

 

 

Management:

  • Keep a watch on dog for 10 days if possible.
  • Wound cleaning
  • If needed Rabies Immunoglobulin
  • Anti rabies vaccines (as per protocol)

Not previously vaccinated:

  • Wound cleansing:  All post exposure prophylaxis (PEP) should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent (e.g., povidine-iodine solution) should be used to irrigate the wounds.
  • Human rabies immune globulin (HRIG): Administer 20 IU/kg body weight. If anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered at an anatomical site (intramuscular [IM]) distant from vaccine administration. Also, HRIG should not be administered in the same syringe as vaccine. Because RIG might partially suppress active production of rabies virus antibody, no more than the recommended dose should be administered. The dose of equine rabies immunoglobulin  is 40 IU per kg body weight of patient and is given after testing for sensitivity
  • Vaccine:  Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV)
    • IM (deltoid area): 1ml dose, on days 0, 3, 7, 14, 28.
    • ID (intradermal): 0.1ml in both arms, on 0, 3, 7, 28.

Previously vaccinated:

  • Wound cleansing:  All PEP should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent such as povidine-iodine solution should be used to irrigate the wounds.
  • HRIG: HRIG should not be administered.
  • Vaccine: HDCV or PCECV 1.0 mL, IM (deltoid area†), 1 each on days 0 and 3

For further reading, click on the below link. It will tell you regarding Rabies treatment in details as per govt of India.

http://www.ncdc.gov.in/Rabies_Guidelines.pdf

Or you can get in touch with Maya Clinic or your Child specialist / Pediatrician for queries.

Stay healthy and stay away from stray dogs.

Regards

Dr Rahul varma

 

2 thoughts on “Rabies vaccination after dog bite/monkey bite

  1. Mohd Sharique

    hello sir… i got scratch by monkey yesterday. is there any possibilities of rabies ? what treatment should i take upto what duration????

    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>