Getting bitten by a dog / monkey is a very scary situation for young kids and their parents. In cases of such bites a doctor needs to be consulted immediately, as the treatment has to be started within 24 hours. Dog bites can lead to rabies disease.
Rabies disease can be prevented with vaccination, but if it occurs it is 100% fatal worldwide.
Rabies can occur with dog bite, monkey bite or any other domestic or wild animals.
Specially if dog bite is unprovoked, chances of the dog being rabied is high. The illness is 100% fatal, therefore whenever in doubt, vaccinate the child.
Categories of Bites:
Table 1: Type of contact, exposure and recommended post-exposure prophylaxis:
|Category||Type of contact||Type of exposure||Recommended post-exposure prophylaxis|
|I||Touching or feeding of animals Licks on intact skin||None|
|II||Nibbling on uncovered skin. Minor scratches or abrasions without bleeding.||Minor|
|III||Single or multiple transdermal bites or scratches, licks on broken skin. Contamination of mucous membrane with saliva (i.e. licks).||Severe||• Wound management|
• Rabies immunoglobulin
- Keep a watch on the dog for 10 days if possible.
- Wound cleaning
- If needed Rabies Immunoglobulin
- Anti rabies vaccines (as per protocol)
Not previously vaccinated:
- Wound cleansing: All post exposure prophylaxis (PEP) should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent (e.g., povidine-iodine solution) should be used to irrigate the wounds.
- Human rabies immune globulin (HRIG): Administer 20 IU/kg body weight. If anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered at an anatomical site (intramuscular [IM]) distant from vaccine administration. Also, HRIG should not be administered in the same syringe as vaccine. Because RIG might partially suppress active production of rabies virus antibody, no more than the recommended dose should be administered. The dose of equine rabies immunoglobulin is 40 IU per kg body weight of patient and is given after testing for sensitivity
- Vaccine: Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV)
- IM (deltoid area): 1ml dose, on days 0, 3, 7, 14, 28.
- ID (intradermal): 0.1ml in both arms, on 0, 3, 7, 28.
- Wound cleansing: All PEP should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent such as povidine-iodine solution should be used to irrigate the wounds.
- HRIG: HRIG should not be administered.
- Vaccine: HDCV or PCECV 1.0 mL, IM (deltoid area†), 1 each on days 0 and 3
For further reading, click on the below link. It will tell you regarding Rabies treatment in details as per govt of India.
Stay healthy and stay away from stray dogs.
Dr Rahul Varma