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Bitten By Dog. Used Antiseptic Ointment, Shot Of Verorab Injection, Tetanus. Does He Need Anti-Rabies Vaccination?
Hello, Its about my father. He is 59 years old man. He is very healthy and exercise on regular basis. He had no history of any systemic diseases and free from addiction as well. But he is hypertensive and under medication.
On 3rd October 2013 (Thursday), he got bitten by a stray dog/bitch while returning home from work. The injury was not severe and in fact very minor with a very shallow cut/scratch as the dog bit him on the leg(right) over trouser. There was very little blood/lacerated skin(small) indeed.
Within 30 minutes he returned home and immediately washed the wound with soap and applied some antiseptic ointment. He is a pharmacist by profession and knew the severity of this and so, he rushed to the drug store asap and got himself a shot of Verorab Injection (within 1 hour after the incident) along with Tetanus Toxoid shot and now going to receive other 4 shots at 3, 7, 14, 28 days accordingly.
BUT he did not receive any RABIES IMMUNE GLOBULIN (ERIG/HRIG) on the injury spot along with the first shot of Verorab . He never had taken any Anti-Rabies shots in his life before. Today (6th October 2013), he is going to receive the Second shot of Verorab Injection. My concerns are -
1) Are the shots of Verorab Injection enough to fight the chances of Rabies ? or, He needs to have Rabies Immune Globulin(RIG) also?
2) If, Yes then is it late as 3 days have been passed? or it can be taken along with the Second shot of Verorab which has been scheduled for tomorrow evening?
3) Where is the ideal spot for Immunoglobulin injection? Should it be injected subdermally around the injury spot?
He currently lives in a distal part of North-East India, where unfortunately, no specialist doctors are there. He consulted with one but he told him 5 shots of vaccine will work and no RIG shot is required. So, it would be really helpful if you can clear my doubts.
On 3rd October 2013 (Thursday), he got bitten by a stray dog/bitch while returning home from work. The injury was not severe and in fact very minor with a very shallow cut/scratch as the dog bit him on the leg(right) over trouser. There was very little blood/lacerated skin(small) indeed.
Within 30 minutes he returned home and immediately washed the wound with soap and applied some antiseptic ointment. He is a pharmacist by profession and knew the severity of this and so, he rushed to the drug store asap and got himself a shot of Verorab Injection (within 1 hour after the incident) along with Tetanus Toxoid shot and now going to receive other 4 shots at 3, 7, 14, 28 days accordingly.
BUT he did not receive any RABIES IMMUNE GLOBULIN (ERIG/HRIG) on the injury spot along with the first shot of Verorab . He never had taken any Anti-Rabies shots in his life before. Today (6th October 2013), he is going to receive the Second shot of Verorab Injection. My concerns are -
1) Are the shots of Verorab Injection enough to fight the chances of Rabies ? or, He needs to have Rabies Immune Globulin(RIG) also?
2) If, Yes then is it late as 3 days have been passed? or it can be taken along with the Second shot of Verorab which has been scheduled for tomorrow evening?
3) Where is the ideal spot for Immunoglobulin injection? Should it be injected subdermally around the injury spot?
He currently lives in a distal part of North-East India, where unfortunately, no specialist doctors are there. He consulted with one but he told him 5 shots of vaccine will work and no RIG shot is required. So, it would be really helpful if you can clear my doubts.
Wed, 20 Nov 2013
Hi,
Thanks for using Healthcaremagic,
After going through the details following are my comments:
1) This is good that you have received post exposure vaccination of Rabies and please continue it.five injections (Day 0, 3, 7, 14 and 28)
2) Status of dog is unknown.
3) Single or multiple transdermal bites or scratches Contamination of mucous membrane with saliva (i.e. licks) this is category III by WHO and needs to be given Human Rabies Immunoglobulin (HRIG).
4)If immuno globulin was not administered when vaccination was begun, it can be administered up to the seventh day after the administration of the first dose of vaccine.
Beyond the seventh day, Rabies Immunoglobulin (RIG) is not indicated since an antibody response to anti rabies vaccine is presumed to have occurred.
Hope this information helps.
Take care.
Good Luck.
Dr. Akhilesh Dubey M.D.
Thanks for using Healthcaremagic,
After going through the details following are my comments:
1) This is good that you have received post exposure vaccination of Rabies and please continue it.five injections (Day 0, 3, 7, 14 and 28)
2) Status of dog is unknown.
3) Single or multiple transdermal bites or scratches Contamination of mucous membrane with saliva (i.e. licks) this is category III by WHO and needs to be given Human Rabies Immunoglobulin (HRIG).
4)If immuno globulin was not administered when vaccination was begun, it can be administered up to the seventh day after the administration of the first dose of vaccine.
Beyond the seventh day, Rabies Immunoglobulin (RIG) is not indicated since an antibody response to anti rabies vaccine is presumed to have occurred.
Hope this information helps.
Take care.
Good Luck.
Dr. Akhilesh Dubey M.D.
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