
Hi Doctor, I Have Been Scratched By A Dog Yesterday.

I have been scratched by a dog yesterday. I am traveling on a train from Bengaluru to XXXXXXX and will reach XXXXXXX on 8 XXXXXXX Hence, I cannot start the vaccination before 8 XXXXXXX Will it be harmful to me? Please suggest will I get rabies if I start vaccination late?
Rabies prophylaxis.
Detailed Answer:
Hi...
Welcome to Ask a Doctor.
I am Dr Ajeet XXXXXXX
Don't worry.You can get vaccinated at Bengaluru.
Time being,wash the scratch mark with soap and running water.
If the dog can be monitored for next 10 days or had been vaccinated,there is no need of your vaccination.Just let the dog be observed for appearance of any rabid symptoms.
If the dog was unknown,can not be monitored and it's rabies status is not known,that needs a vaccination.All mammalian bites need a rabies vaccination as per internationally accepted policy and protocols because rabies is 100 percent fatal and it's too late till the symptoms appear.
Post exposure prophylaxis should be given as early as possible so as soon as you get down from train,visit a nearby hospital for vaccination.
Your regimen would consist of one dose of immunoglobulin as soon as possible and four doses of rabies vaccine over a 14-day period.
Rabies immunoglobulin (RIG) would provide immediate protection against rabies until your body responds to the vaccine challenge and starts making its own antibodies.
Rabies immunoglobulin and the first dose of rabies vaccine would be given together (Day zero).
Additional doses of rabies vaccine would be given on days 3, 7, and 14 after the first dose(zero dose).
Injection would be given intramuscular in deltoid muscle of arm.
In case,you have been vaccinated previously,you will still need two booster doses of rabies vaccine.The first dose as soon as possible(Day zero) and the second dose three days later(Day 3). Rabies immunoglobulin will NOT be given in that case.
Hope that I have answered your query.
Happy journey and stay blessed.
Regards.


Thank you for your reply. I was bitten by a dog in November 2017 and at that time I had taken full 5 doses of anti-rabies vaccine. The vaccine's name was Vaxirab N. So, in that case, should I take 5 doses on days 0,3,7,14 and 28 or just 2 booster dose that you have recommended?
Also, should I take a tetanus shot? I took my last tetanus shot 6 months ago. Please suggest.
Rabies prophylaxis
Detailed Answer:
Hi...
You have got the Tetanus shot within the last five years (6 months back) and the wound is not deep and severe hence you need not take a tetanus shot again.
As you have been vaccinated against rabies ,one and a half year back,you will need only two booster doses of rabies vaccine for complete protection.
The first dose as soon as possible (Day zero) and the second dose three days later (Day 3).
There is no need of 5 doses (on day 7,14 and 28 in addition to day 0 and day 3) and Rabies immunoglobulin is not indicated.
Regards

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