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What Are The Chances Of Contracting Rabies Despite Taking Full Course Of Vaccination?
Question: Hello Doctor,
My Son is Bitten By Dog. After 2-3 Hours I took him in local Clinic. They Gave Him First Vaccine "VaxiRab(Zydus)" on day Zero On His Right Hand Upper Arm (Deltoid Muscle). And He had Teutnes Vaccine already.
So My Questions are..
1. After Full Course of Vaccination(day 0,3,7,14,28) What Are the Chances of Getting Infected By Rabies?? After Full course My son will have any chance of getting infected by Rabies or he will be 100 percent safe??
2. On the time of second vaccine what should be the place I mean same hand or different hand?
3.Should My son need Rabies Immunoglobin injection?
4. Any Personal Advice?
My Son is Bitten By Dog. After 2-3 Hours I took him in local Clinic. They Gave Him First Vaccine "VaxiRab(Zydus)" on day Zero On His Right Hand Upper Arm (Deltoid Muscle). And He had Teutnes Vaccine already.
So My Questions are..
1. After Full Course of Vaccination(day 0,3,7,14,28) What Are the Chances of Getting Infected By Rabies?? After Full course My son will have any chance of getting infected by Rabies or he will be 100 percent safe??
2. On the time of second vaccine what should be the place I mean same hand or different hand?
3.Should My son need Rabies Immunoglobin injection?
4. Any Personal Advice?
Brief Answer:
Rabies post-exposure immunization
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
If your son is not previously vaccinated against rabies,he should be passively immunized with rabies immune globulin [RIG-(20 IU/kg)]but no later than 7 days after the first vaccine dose.
A fifth dose on day 28 is no longer recommended.
Routine measurement of serum neutralizing antibody titers is not required following primary immunization(0,3,7,14th day).
Deaths from rabies have occurred despite vaccine treatment. These may be attributable to the use of low-potency nervous-tissue vaccines, delay in starting
vaccination, an incomplete vaccine course, omission of passive immunization, failure to infiltrate RIG around the wound, injection of vaccine into the buttock, or decreased immune responsiveness of the vaccinee.
However none of these factors seem applicable to your son. So remain assured about full protection against rabies.
Your son can take the second dose on the same arm unless there is local reactions(pain, erythema, edema, and pruritus) but immunization should
not be discontinued.
Rabies vaccine and RIG should never be administered at the same site (same arm) or with the same syringe.
Administration of RIG will depend upon the class of bite and is to be decided by the treating doctor.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Rabies post-exposure immunization
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
If your son is not previously vaccinated against rabies,he should be passively immunized with rabies immune globulin [RIG-(20 IU/kg)]but no later than 7 days after the first vaccine dose.
A fifth dose on day 28 is no longer recommended.
Routine measurement of serum neutralizing antibody titers is not required following primary immunization(0,3,7,14th day).
Deaths from rabies have occurred despite vaccine treatment. These may be attributable to the use of low-potency nervous-tissue vaccines, delay in starting
vaccination, an incomplete vaccine course, omission of passive immunization, failure to infiltrate RIG around the wound, injection of vaccine into the buttock, or decreased immune responsiveness of the vaccinee.
However none of these factors seem applicable to your son. So remain assured about full protection against rabies.
Your son can take the second dose on the same arm unless there is local reactions(pain, erythema, edema, and pruritus) but immunization should
not be discontinued.
Rabies vaccine and RIG should never be administered at the same site (same arm) or with the same syringe.
Administration of RIG will depend upon the class of bite and is to be decided by the treating doctor.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank You For Your Kind Reply.
1. Is RIG required?? My child is Not Vaccinated By RIG Yet.
2. Its was not a deep wound But a red Scratch By the dog. Can I consider that My child will be fully Protected After the Vaccination Course?? or after vaccination there will be a little bit risk??
3. On Day Zero It was one Dose Of vaxiRab(Zydus) On His Right hand Upper Arm (Deltoid Muscle). One Dose is enough On right hand upper arm on first day?
Thank You Doc.. Your reply was helpful.
1. Is RIG required?? My child is Not Vaccinated By RIG Yet.
2. Its was not a deep wound But a red Scratch By the dog. Can I consider that My child will be fully Protected After the Vaccination Course?? or after vaccination there will be a little bit risk??
3. On Day Zero It was one Dose Of vaxiRab(Zydus) On His Right hand Upper Arm (Deltoid Muscle). One Dose is enough On right hand upper arm on first day?
Thank You Doc.. Your reply was helpful.
Brief Answer:
Rabies post-exposure immunization
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Human RIG (injected intramuscularly into the thigh, not the buttock) should be given particularly if the injury is anywhere in upper limb or neck or head i.e closer to brain or the dog is a stray dog or died or killed or has bitten several other persons unprovoked.You have not mentioned whether the dog is pet or stray,alive or dead.Neither you have mentioned the part of the body bitten.
Rabies immune globulin (RIG) has proved valuable in protection, presumably by neutralizing rabies virus during the first week after initial vaccination, before
neutralizing antibody has appeared,
Purified chick embryo cell vaccine (Rabipur/VaxiRab), is one of the three tissue-culture vaccines of choice and is highly immunogenic.Your son will be fully protected against Rabies after completion of full immunization.Risk is negligible,if not zero.
Four 1-mL doses (on days 0, 3, 7, 14) of rabies vaccine should be given IM in the deltoid area.
Alternate regimen of eight-site intradermal injections of 0.1 ml can be used with vaccines which have an intramuscular dose of 1 ml.It is no longer practiced.
Your son is given the correct dosage and route on day 0.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Rabies post-exposure immunization
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Human RIG (injected intramuscularly into the thigh, not the buttock) should be given particularly if the injury is anywhere in upper limb or neck or head i.e closer to brain or the dog is a stray dog or died or killed or has bitten several other persons unprovoked.You have not mentioned whether the dog is pet or stray,alive or dead.Neither you have mentioned the part of the body bitten.
Rabies immune globulin (RIG) has proved valuable in protection, presumably by neutralizing rabies virus during the first week after initial vaccination, before
neutralizing antibody has appeared,
Purified chick embryo cell vaccine (Rabipur/VaxiRab), is one of the three tissue-culture vaccines of choice and is highly immunogenic.Your son will be fully protected against Rabies after completion of full immunization.Risk is negligible,if not zero.
Four 1-mL doses (on days 0, 3, 7, 14) of rabies vaccine should be given IM in the deltoid area.
Alternate regimen of eight-site intradermal injections of 0.1 ml can be used with vaccines which have an intramuscular dose of 1 ml.It is no longer practiced.
Your son is given the correct dosage and route on day 0.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank you for Your Kind Reply.
1. Dog is of Pomeranian Breed, Pet and 4 month old.
2. Dog Actully Not Bite But His saliva touched a minor Red Scratch of my Son's small finger.
3. Dog Is normal yet not behaving anything weired.
4. Is RIG compulsary as RIG is not availabe in my place?? can i take RIG on my upper arm(deltoid)
5. This Incident Happend on 8 july. whats the time frame in which i can take RIG if needed?
Thank you very much doctor you are very helpful..
1. Dog is of Pomeranian Breed, Pet and 4 month old.
2. Dog Actully Not Bite But His saliva touched a minor Red Scratch of my Son's small finger.
3. Dog Is normal yet not behaving anything weired.
4. Is RIG compulsary as RIG is not availabe in my place?? can i take RIG on my upper arm(deltoid)
5. This Incident Happend on 8 july. whats the time frame in which i can take RIG if needed?
Thank you very much doctor you are very helpful..
Brief Answer:
Rabies immune globulin (RIG)
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
If a dog is rabid it dies within 7 days from becoming symptomatic. It seems the dog is healthy (however dog is to be observed for 10 days from the day of bite).
Dog has only licked a minor red scratch and the type of contact
category II - licks on broken skin.
For category II immediate vaccination and for category III immediate vaccination and administration of rabies immune globulin are recommended (WHO guidelines). Hence RIG is not justified.
The first dose of vaccine should be inoculated at the same time as the immunoglobulin.If RIG is not immediately available, it should
be administered no later than 7 days after the first vaccine dose. After
day 7, endogenous antibodies are being produced, and passive immunization
may actually be counterproductive.
RIG should be injected at an intramuscular site distant from that of vaccine inoculation e.g. into the anterior thigh.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Rabies immune globulin (RIG)
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
If a dog is rabid it dies within 7 days from becoming symptomatic. It seems the dog is healthy (however dog is to be observed for 10 days from the day of bite).
Dog has only licked a minor red scratch and the type of contact
category II - licks on broken skin.
For category II immediate vaccination and for category III immediate vaccination and administration of rabies immune globulin are recommended (WHO guidelines). Hence RIG is not justified.
The first dose of vaccine should be inoculated at the same time as the immunoglobulin.If RIG is not immediately available, it should
be administered no later than 7 days after the first vaccine dose. After
day 7, endogenous antibodies are being produced, and passive immunization
may actually be counterproductive.
RIG should be injected at an intramuscular site distant from that of vaccine inoculation e.g. into the anterior thigh.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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