[Question #3376] Rabies

38 months ago

Hi Infectious Disease Specialist, sorry for posting this in STD forum but I believe is  today is day 5 exposure on 20/2 to a friend pet dog as the dog wasn't meant to bite but being playful as it lick my foot but I not used to dog lick my foot so immediately pull off and it leaves a long minor scratches mark(about 10cm) and a very minor visible second small dot mark around the toe area. The dog received 1st rabies vaccination shot in 10/2/2018. I lived in Malaysia Kuching Sarawak since 2017 there about 7 death rabies cases. Immediately I rushed to local hospital after 2 hours I wash with antiseptic hand wash with clean flushing water from a pipe for 20 minutes but there is a pause for few second in between I rub with the antiseptic liquid then flush it again with the pipe clean water and the process repeated for 20 minutes. After 4 hours from the incident I received Verorab 0.5ml and in day 3(23/2) I received a 2nd dose and never vaccinate with rabies vaccine before. 2nd day I experience minor flu and sore throat as I took loratadine,sobenz lozenges and bromhexine 8mg.  

1.  My doctor categorize my scratches as category II so no need for HRIG as only minor scratches without bleeding with limited quantity available and there is no much visible wound for HRIG to inject,

(http://www.who.int/rabies/human/postexp/en/) in (Combined Immunoglobulin-Vaccine) it does mentioned it should be given Immunoglobulin although experience indicated that vaccine alone was sufficient for minor category II. CDC also mentioned HRIG and 4 doses vaccine should be given for both bite and non bite exposure, do I need HRIG?

2.(http://www.who.int/rabies/human/postexp/en/) Depending on vaccine type, the post-exposure schedule prescribes intramuscular doses of 1 ml or 0.5 ml given as four to five doses over four weeks. I received Verorab 0.5ml should be 5 doses or 4 doses? As my vaccination card total only 4 appointment date I noticed.


Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome to the Forum.  I understand your concerns but think that you would be much better asking these questions of someone in your country who has expertise with rabies.  While we are both infectious disease specialists, rabies is no an area of personal expertise for either of us.

We are not comfortable aswering this question.  I suggest you contact the site administrator and request return of your posting fee.  EWH
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