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Suggest Treatment For Dog Bite

Posted on Tue, 25 Nov 2014

Question: Hello sir. I had a pet dog he was 10 years old. For the first six years he was vaccinated but last four years he was not vaccinated. He became ill for about two months and then he died. 3 days before he died, He scratched me on my leg: within 6 days I took anti rabies vaccine with 0,3,7,14 and 28 doses. Two dats after completing 5 doses, a street dog bitten me on my hand. I again took two doses. But first five doses were rabipur and the last two doses of abhayarab. After the first injection, I was usually taking medicines for gastric and sleep dose. My blood pressure remains high and also I have pain in neck. All I want to know that
1.whether I am secure of rabies ?
2.whether the medicines have obstruct the effect of rabies vaccine ?
3.can change of vaccine will decrease the immunity ?
4.why I have pain in my neck and problem in swallowing ?
5. Should I go for antibody titre test ?

Answered by Dr. Praveen G (38 minutes later)

Brief Answer:
Yes you are safe from rabies

Detailed Answer:
Hello,
Welcome to Healthcare Magic,

I have gone through your history and understand your concern,

1. Yes you are very much safe as you have taken proper and complete anti rabies treatment. As you are were bitten by a stray dog after your first event, you have been identified as Re-Exposure according to WHO categorization and given two dose of anti rabies vaccine as per the recommendation.

2.No the medicines which you have mentioned will not interfere the protective antibody titres.

3. Interchangeability of vaccine will not affect the induction of protective antibody titres. It is acceptable by WHO.

4.The symptoms which you have mentioned is not related to dog bite, it may be due to some other underlying pathology. I would suggest you to subject yourself for physical examination with your doctor.

5.Nothing is required as you have taken complete treatment. You will have adequate rabies virus neutralizing antibody titres (RvNabs).

I hope these answer will help to remove the anxiety with the disease. If you have any further query feel free to post them.
Thank you.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen G (20 hours later)

Thank u sir but still I have some doubt. I want to know that

1. I had not taken the rabies immunoglobulin in my first event or during five doses. Will it cause any problem to me ?

2. Also I have taken two doses very soon after completion of my fifth dose. Will it affect my immunity ? If yes then what to do ?

3. Is there any possibility of rabies exposure in me ?

4. Plz tell me the centres where I can go for the antibody titre test.

Answered by Dr. Praveen G (2 hours later)

Brief Answer:
You are very much free from rabies

Detailed Answer:
Hello,
Welcome back to Healthcare Magic,

Thank you for the query,

1. The rabies immunoglobulins (RIGs) will be advised if there is bleeding from the site of bite. This passive immunization definitely helps to neutralize the rabies virus at the bite site. It is advised in all Cat III bites.

2. No, immune system will be primed for the rabies vaccine antigen, the Re-Exposure dose will induce the anamnestic response and produces adequate antibody titres.

3.I will assure you that you are 100% free from rabies, as you have taken proper and adequate treatment.

4.Rabies virus neutralizing antibody titres (RvNabs) can be done in centers like NIMHANS, XXXXXXX and NCDC, New XXXXXXX
Thank you.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen G (20 hours later)

Thank u sir plz help me more

1. After the first dose I have problem in swallowing food and pain in muscles. Is this due to the effect of vaccine or side effect of the vaccine ?

2. If the vaccines are not stored properly then will it cause any problem like ineffective ?

3. Plz tell me after how many days of vaccination the antibody titre test should be done ?

4. In my first event the dog scratched me and it bleeded but I did not take immunoglobulin. Can I take it now ?

5. What are the side effects of rabies vaccine and how long it remain ?

Answered by Dr. Praveen G (1 hour later)

Brief Answer:
Side effects of vaccine are very minimal

Detailed Answer:
Hello,

Welcome back,
1. These are the side effects of anti rabies vaccine.

2. If the cold chain of anti rabies vaccine is not maintained, it may loose its potency.

3. Protective antibody titres of >0.5 IU/ml will be attained 7 days after the first shot of anti rabies vaccine.

4. There is no point in taking passive immunization with rabies immunoglobulin now. By this time you will have protective antibody titres.

5. The side effects of anti rabies vaccine are very minimal like redness, pain and induration which will not last more than 3 days.

Hope you are satisfied with this, you are more concern about the dog bite. I assure you that you have taken proper treatment for dog bite.

Thank you.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Ashwin Bhandari