Rabies vaccination after dog bite/monkey bite

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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 and 14- 28.
    • 2 site ID (intradermal): 0.1ml in both arms, on 0, 3, 7.

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.

Rabies Latest guidelines from WHO

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

 

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

  1. Jones mwamlima

    Please send me details on rabies more importantly recommendation on monkey vaccine against rabies

    Reply
  2. Jasmine

    Sir,
    Meri mom ko leg par monkey ne kaat liya hai blood bhi nikla hai mom ko 0,3,7 k injection to lag gaye hai but 14 days wale injection k liye doctor ne kaha hai k Wo nahi lagta hai 28 days wala hi lagega 14 wale injection k na lagne se in future koi nuksaan to nahi hoga sir pls tell me
    Kya koi ESA test bhi hai jiske dwara ye pata chale ke vaccine theek se ho gayi hai
    Rabies k bacteria body me nahi hai isko check karne ka bhi koi test hai sir pls tell me as soon as possible
    Thanks & regards

    Reply
  3. 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
      1. Marie-Eve Joly

        Hi if the monkey bites had occurs 10 days ago, do we give all the rabies shot ??
        I dont find nothing on ”late” post-exposure..

        Thank You

        Marie-Eve
        NP Primary care

        Reply
        1. rahulvarma Post author

          Vaccine should be taken as soon as possible… delaying is like risking your life.. remember , rabies is 100% fatal

          Reply
  4. Hitesh

    Dear doctor

    my daughter having age 3.5 years old .wounded by stone or dog she dont knw. But doctor advise us to give dog bite injection and we did it and give her one injection yesterday and three more injection has to be given in next days as suggested by doctor. Now my query is that if its not a dog bite then there is any side effects of these injection

    Reply
    1. rahulvarma Post author

      No, not at all. It will be helpful for future ( it will act like pre exposure prophylaxis). And remember this is 100% fatal disease. So it is always better to go for vaccine , if any doubt. i think your doctor was right in suggesting vaccine.

      Reply
  5. Abhinav sharma

    Monkey bite on my shoulder minor scratches and bleeding . On the day of bite I went to govt hospital he injected a ARV and said no need of further injection. What should I do? Please suggest.

    Reply
    1. rahulvarma Post author

      Better to follow the advise of treating doctor. But if blood was there we need to complete the full course of vaccination schedule for post exposure

      Reply

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