كتاب
Management of Rabid Dog bites
- Post exposure therapy for previously vaccinated persons
➡️Managing re-exposure following post-exposure treatment with TCV
If re-exposed, persons who have previously received full post-exposure treatment with a potent cell-culture vaccine should be given only two booster doses, intramuscularly on days 0 and 3, but no rabies immunoglobulin.
➡️Managing exposure following pre-exposure prophylaxis with TCV
If after recommended pre-exposure prophylaxis, a vaccinated person is exposed to rabies, a proper wound toileting should be done and two IM doses of Tissue Culture Vaccine be given on days 0 and 3. Treatment with RIG is not necessary.
➡️Approach to a patient requiring rabies immunoglobulins when none is available
In circumstances where no immunoglobulins are available greater emphasis should be given to proper wound toileting followed by Essen schedule of Tissue culture vaccine with double dose on day 0 at 2 different sites intramuscularly (0 day – 2 doses on left and right deltoid, 3, 7, 14 and 28 days).
➡️Management of animal bite exposure to pregnant women and lactating mothers
Post-exposure prophylaxis against rabies takes preference over any other consideration since it is a life-saving procedure. Moreover, rabies vaccine does not have any adverse effect on fetus, mother-to-be and the course of pregnancy. Hence complete post-exposure treatment should be given depending on the category of the exposure.
