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Should I Need Treatment For Dog Bite Despite Having Booster Vaccines?
Posted on
Mon, 5 May 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Mon, 5 May 2014
Answered on
Mon, 26 May 2014
Last reviewed on
Question : Hi, may I answer your health queries? Please type your queI am fully up to date with my Verorab shots - 3 initial pre-exposure shots over one month, and an on-time booster. My next booster was due next month, XXXXXXX (that would be three years since my last booster as opposed to five). However a couple of weeks back a dog "nipped" me on the lower leg. I live in Cusco city, Peru. I was wearing jeans at the time and there was no visible sign of a break in the skin, it just looked a tiny bit "scraped" and bruised.
I visited a nurse the same day to show him the wound. He told me there was no need to worry and no treatment was required. But I got to worrying and am now concerned that I should have done more. I visited another doctor on day 3 (Assuming the nip was on day 0) who said that given the lack of skin breaking, and the absence of rabies in Cusco city, and the fact that I'd had all my pre exposure jabs, that I there was no need to worry at all. He said I was in fact immune. I had my next booster on the spot just to be sure and was told to keep a look out for the dog in case it showed signs of rabies. I think I saw it yesterday (that would be day 16) and it was fine. But I'm not 100% sure it was the same dog as so many of them look the same here! Should I worry? Are there any further steps I should take? I just want to be 100% sure I am going to be ok so I can stop worrying!ry here...
I visited a nurse the same day to show him the wound. He told me there was no need to worry and no treatment was required. But I got to worrying and am now concerned that I should have done more. I visited another doctor on day 3 (Assuming the nip was on day 0) who said that given the lack of skin breaking, and the absence of rabies in Cusco city, and the fact that I'd had all my pre exposure jabs, that I there was no need to worry at all. He said I was in fact immune. I had my next booster on the spot just to be sure and was told to keep a look out for the dog in case it showed signs of rabies. I think I saw it yesterday (that would be day 16) and it was fine. But I'm not 100% sure it was the same dog as so many of them look the same here! Should I worry? Are there any further steps I should take? I just want to be 100% sure I am going to be ok so I can stop worrying!ry here...
Brief Answer:
you would be immune
Detailed Answer:
Hi, thanks for using healthcare magic
It is understandable to be concerned however, based on the immunisations you have received , you are immune.
Based on research done on the vaccine you received, verorab: (1) pre exposure- Protective serum levels or immune status are achieved by the 3rd dose.
This immunity is maintained by a first booster one year later and subsequent boosters every 5 yrs.
Since you had the 3 pre exposure shots, plus at least 1 booster shot prior to the scrape, you would be protected against rabies.
In addition, you mentioned that there no visible break in the skin, even without the shots, this would have reduced your chance of rabies transmission.
I hope this helps, feel free to ask any other questions
you would be immune
Detailed Answer:
Hi, thanks for using healthcare magic
It is understandable to be concerned however, based on the immunisations you have received , you are immune.
Based on research done on the vaccine you received, verorab: (1) pre exposure- Protective serum levels or immune status are achieved by the 3rd dose.
This immunity is maintained by a first booster one year later and subsequent boosters every 5 yrs.
Since you had the 3 pre exposure shots, plus at least 1 booster shot prior to the scrape, you would be protected against rabies.
In addition, you mentioned that there no visible break in the skin, even without the shots, this would have reduced your chance of rabies transmission.
I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your prompt reply.I have been up and down for two week with so much conflicting information on the internet? My biggest concerns were the following:
1. Some information says that even if the skin is not actually broken - ie there is no bleeding - you should still take immediate action (type of action dependent on whether you have had pre-exposure shots or not and the severity and location of the wound). I guess I really just wanted to know if the skin is not broken is there no risk?
2. A lot of information also says that even with the pre-exposure shots you still need immediate treatment if you are bitten, scratched etc. But the question seems to be the type of treatment and not whether you need it or not.
3. A Friend is just having her 3 pre-exposure jabs prior to a trip to Africa and has been told that even with these 3 jabs she will need further and urgent treatment if bitten. Is my situation different because I've had the booster?
I just am so confused by this as one minute I was delighted I had been vaccinated, and the next it looked like I should have had more treatment in order to cut out all risk. Having had three different health care workers here in Peru tell me three different things didn't help either. As you can tell I have got a little bit paranoid about this and just don't know what to believe any more!
1. Some information says that even if the skin is not actually broken - ie there is no bleeding - you should still take immediate action (type of action dependent on whether you have had pre-exposure shots or not and the severity and location of the wound). I guess I really just wanted to know if the skin is not broken is there no risk?
2. A lot of information also says that even with the pre-exposure shots you still need immediate treatment if you are bitten, scratched etc. But the question seems to be the type of treatment and not whether you need it or not.
3. A Friend is just having her 3 pre-exposure jabs prior to a trip to Africa and has been told that even with these 3 jabs she will need further and urgent treatment if bitten. Is my situation different because I've had the booster?
I just am so confused by this as one minute I was delighted I had been vaccinated, and the next it looked like I should have had more treatment in order to cut out all risk. Having had three different health care workers here in Peru tell me three different things didn't help either. As you can tell I have got a little bit paranoid about this and just don't know what to believe any more!
Brief Answer:
booster at day 3 would have been added protection
Detailed Answer:
Hi
Yes, immediate action is recommended both to prevent tetanus and rabies. This would normally include cleaning the wound wit soap and water, with some disinfectant.
The fact that you had your 1 yr booster would have kept your immunity high.
The vaccines that you would have received would have allowed to have a high level of immunity against rabies.
The fact that you had your booster given on day 3 would have further boosted your immunity.
It is correct to say that some persons, who would have had pre exposure vaccinations, still have shots on day 0 and day 3 to further reduce the slim chance of rabies, you had a day 3 shot which would have been protective.
There are places that are rabies free and the doctor indicated that this was one of these places, you can possibly recheck that with another health official.
Please feel free to ask any other questions
booster at day 3 would have been added protection
Detailed Answer:
Hi
Yes, immediate action is recommended both to prevent tetanus and rabies. This would normally include cleaning the wound wit soap and water, with some disinfectant.
The fact that you had your 1 yr booster would have kept your immunity high.
The vaccines that you would have received would have allowed to have a high level of immunity against rabies.
The fact that you had your booster given on day 3 would have further boosted your immunity.
It is correct to say that some persons, who would have had pre exposure vaccinations, still have shots on day 0 and day 3 to further reduce the slim chance of rabies, you had a day 3 shot which would have been protective.
There are places that are rabies free and the doctor indicated that this was one of these places, you can possibly recheck that with another health official.
Please feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you again for your advice! So for 100% peace of mind, would you say that no further action is necessary or would you advise a further shot just to be on the safe side? Ideally, I would like to know that my risk is zero!
Brief Answer:
you are safe
Detailed Answer:
HI
Sorry about the late reply
When shots are given post exposure in some persons with previous immunisation, they are normally at day 0 and day 3, this means the time has passed.
But you are already immune because you had your first booster as well as a shot on day 3.
Because it is a few weeks past the incident, another shot at this time would not make a difference and impact on immunity.
Though nothing in medicine is 100%, based on your immune level, you are at least 99% chance of not contracting rabies
If anything else remains unclear , feel free to ask
you are safe
Detailed Answer:
HI
Sorry about the late reply
When shots are given post exposure in some persons with previous immunisation, they are normally at day 0 and day 3, this means the time has passed.
But you are already immune because you had your first booster as well as a shot on day 3.
Because it is a few weeks past the incident, another shot at this time would not make a difference and impact on immunity.
Though nothing in medicine is 100%, based on your immune level, you are at least 99% chance of not contracting rabies
If anything else remains unclear , feel free to ask
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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