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Forum Name: Other infections

Question: Rabies - Advice Needed


 Goldberg1_21 - Mon Dec 06, 2004 3:49 pm

Hi,

Around 1 year 5 months back i was administered by 5 doses of verorab + one booster
(D90), because of minor scratches by a dog, that dog is still alive and is normal, but the
time he scratched me, he was looking like a rabid animal but laterz we gave him the
vaccine and things were ok then.

The dog was vaccinated then , that was valid for one year only and was not given
through any licensed animal doctor. (even that vallination expired around 5 months back
and i didnt vaccinate him yet)

Now yesterday, i recieved a very small cut from a sharp wooden piece on my hand, a
single drop of blood came out and i washed that with water, that wound was like 1 mm
of size or you can say 5 paper pin points wide and in depth it was like that the layers
of skin was just cut and blood came out along with showing a little redness of the flesh.

After half an hour i went to the dog to give him food, at several occassions my wound
was very close to his mouth, thus recieving his breath and may be saliva vapours.

After 5 minutes of that , i washed my hands again.

I will really appreciate if u can give me an advice, what to do so now, bcuz i was thinking
that even the dog seems to be normal , it may have rabies virus in it's saliva, Which may
enter through the wound of mine, A person i know said that if the dog is normal,
means acting normal and your wound exposed to it, then its no problem bcuz it didnt
have any rabies virus , but if it does have even a single rabies virus , then it will die
within 15 days , no matter it bitted you or not. He also said that after half an hour blood
clots are made in the wound and the virus cant enter the wound, and if even the virus
enters, then the vaccinations of verrorab i took 1.5 years back will be enough to fight
them.

As it is a very serious matter , infact of death and life, therefore i request you to give
me an advice, i will be very thankful of yours.


Thanks
Goldberg
 Dr. Tamer Fouad - Tue Dec 07, 2004 2:34 am

User avatar Hello Goldberg,
Let me go through a few facts about rabies:
Rabies is uncommon in dogs, cats, and ferrets in the United States. Very few bites by these animals carry a risk of rabies. If the cat (or dog or ferret) appeared healthy at the time you were bitten, it can be confined by its owner for 10 days and observed. No anti-rabies prophylaxis is needed. No person in the United States has ever contracted rabies from a dog, cat or ferret held in quarantine for 10 days.

If a dog, cat, or ferret appeared ill at the time it bit you or becomes ill during the 10 day quarantine, it should be evaluated by a veterinarian for signs of rabies and you should seek medical advice about the need for anti-rabies prophylaxis.

The quarantine period is a precaution against the remote possibility that an animal may appear healthy, but actually be sick with rabies. To understand this statement, you have to understand a few things about the pathogenesis of rabies (the way the rabies virus affects the animal it infects). From numerous studies conducted on rabid dogs, cats, and ferrets, we know that rabies virus inoculated into a muscle travels from the site of the inoculation to the brain by moving within nerves. The animal does not appear ill during this time, which is called the incubation period and which may last for weeks to months. A bite by the animal during the incubation period does not carry a risk of rabies because the virus is not in saliva. Only late in the disease, after the virus has reached the brain and multiplied there to cause an encephalitis (or inflammation of the brain), does the virus move from the brain to the salivary glands and saliva. Also at this time, after the virus has multiplied in the brain, almost all animals begin to show the first signs of rabies. Most of these signs are obvious to even an untrained observer, but within a short period of time, usually within 3 to 5 days, the virus has caused enough damage to the brain that the animal begins to show unmistakable signs of rabies. As an added precaution, the quarantine period is lengthened to 10 days.

I hope that has helped to ease your worries.
 Goldberg1_21 - Tue Dec 07, 2004 11:35 am

Hi,

thanks a lot, so i guess , that i should see my dog for 10 days and if its normal then
no vaccine is needed for me ?? right ?

Also , i took 5 or 6 doses of verrorab 1.5 years back , as i mentioned , so would i help
too and are the antibodies still there to fight ?



Again , so much thanks,
Byezz and takecarez
 Dr. Anthony Solomon - Wed Dec 08, 2004 4:44 pm

Hi,

I am very familiar with the VERORAB vaccine, which you should have received in six doses: on Days 0, 3, 7, 14, and 28 with an optional dose on Day 90. This was given to you as a post-exposure treatment because, according to you, the animal was looking very ill then (“like a rabid animal”, according to you).

If the vaccine was correctly refrigerated at 2-8 degrees centigrade and correctly administered, it should provide protection for 2 years. In fact, humans at high risk of contracting rabies (such as veterinarians, gamekeepers, hunters, forest rangers, slaughterhouse personnel, taxidermists) are advised to take a prophylactic dose of Rabies Vaccine on Days 0, 7 and 28 (3 doses only) with booster doses every 2-3 years. This is the recommendation in the British National Formulary, March 2004 Edition. In your own case, you received six doses, which should provide an equally good protection for two years, assuming again that the vaccine’s potency was not affected by poor storage and it was properly administered.

I am very concerned at the statement you made that the dog was not vaccinated by “a licensed animal doctor”. Who supplied or administered the vaccine? Vaccine failure is common if the product is not properly stored or administered.

If, as you claim, your dog is “normal” at the present time, it could not be harbouring rabies virus in the saliva, so there is no possibility of contracting rabies. Are there cases of rabies in Singapore? Post-exposure prophylaxis depends on the level of risk in the country, the nature of exposure and the individual’s immune status. In respect of your cut, I am more concerned about your tetanus immunisation status. Please ensure that this is up-to-date.

The WHO recommendations for rabies prophylaxis are clear and straightforward:

for a live, non-suspect dog or cat, place the animal under veterinary supervision for a minimum of 10 days and postpone rabies post-exposure treatment for the patient;
for a live, suspect dog or cat, place the animal under veterinary supervision for a minimum of 10 days and commence rabies post-exposure treatment for the patient immediately. Treatment is stopped if the supervision invalidates the initial doubts, otherwise treatment is continued.

Thank you for contacting our website. I hope I have answered the questions you raised in your second mail.


Dr Anthony Solomon
MB BS DTM&H DIP.VEN FRSM
Consultant Physician, Tropical & Genitourinary Medicine
 lucy_11 - Tue Jul 05, 2005 6:14 pm

Hi,

A few days ago I was playing with my dog when suddenly she pressed down on my hand with her teeth, I don't know if it was neccessarily a bite, since there was no bleeding, she just left a very very small hole that she had made with one of her teeth. I ignored it since I didn't think it was a big deal. A few minutes after that happened, my hand started feeling numb, but again I let it go. The next day, my hand started feeling even more numb like if I had slept on it for a long time, I even had the tingly "ant" sensation. Also, my right leg started feeling the same as my right hand, which was the hand that my dog had pressed down on. It just felt very numb, and at night I have a hard time sleeping on my right side because I start feeling the tingly sensation on my hand. I did not go to see a doctor because my dog did have her rabies shot and at the time I didn't know if it was significant enough for me to go see a doctor. Please, can you give some advice on what I should do, and why I'm feeling what I'm feeling.
 Dr. Anthony Solomon - Tue Jul 05, 2005 6:53 pm

Did you wash the bite wound immediately with soap and water, and did you apply any antibacterial medication?

Is your Tetanus immunisation up to date? Does the wound appear swollen or infected? Is the dog still under observation and looking well?

Whatever your answers are, the symptoms you have are indications to consult a doctor for an evaluation. This will give you reassurance and prevent any complications.

Dr Anthony Solomon
 huytrankiem - Mon Jan 05, 2009 3:39 am

Do I need to take the vaccine against Rabies in this case?
Dear Experts,

I was exposed to the risk of catching Rabies on June, 2008. I have taken the full dose of the Verorab vaccine from 23, June to 21, July, 2008( 05 shots on the Day 0, 3, 7, 21, and 28). But on November, I was exposed to Rabies again, and my doctor advised me to take 02 shots on the Day 0 and Day 03( in 11th, November and 14th, November)

I would like to know how long does Verorab protect me from catching Rabies if I am at risk again? I am worried because I was licked on the wound by the stray dog some days ago. And I do not want to take the Vaccine again, I think that Verorab could protect me for a certain months or years. Please give me the advice.

During the time of taking shots, I did not have any beer, but I also had some beers after the last shot ( 06 weeks from the last shot), does the beer affect the work of the vaccine?

Thank you,
 justin2k - Wed Mar 25, 2009 1:53 am

Hi
I have taken verorab on June 2007, 3 doses on 0, 3, 7 days. On march 8th i was bitten by a domestic dog. i have taken injection of rabipur on 0,3 days. Should i need to take the 3rd one i have also missed out the date. The animal is seems to be fine now. i am worried about the injection which i have taken will have any effect.?


while i took injection in past and present i feel my nerves get affected. i am taking vitamin tablet. please advise me/
Thanks

Justin

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