Travel Medicine / Vaccination / Immunization Expert Forum
How effective is Rabies vaccine - non US?
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Questions in the Travel Medicine forum are answered by Dr. Philip D Parks, affiliated with Harvard School of Public Health. Topics covered include disease prevention, finding a doctor abroad, food and water safety, illness and injury abroad, mosquito and tick protection, resources for travelers, traveling with children or pets, traveling with special needs, vaccinations and immunizations.

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How effective is Rabies vaccine - non US?

This issue that has been bothering me for the last couple of months. While travelling in India, a puppy licked fresh open wound in my son's toe. He was given 4 doses of Rabies vaccine in India. He was to receive 5th dose and we were hoping to give the 5th dose here in the US. But, we were told the CDC recommendation is for 4 doses. So, he did not receive 5th dose. The puppy died about 20 days after this incident and while it was sick it bit another person trying to give it a bath (probably in an attempt to get away). So, I am wondering if he received adequate protection in case the dog had rabies. There have been cases in India where vaccination was ineffective due to improper storage and such.
- Given the dog died after 20 days and was sick for a while before that, is it possible the dog had Rabies?
- Are 4 dose recommendation only apply to vaccination manufactured in India? The WHO recommendation is still 5 doses.
- Are there are tests to check if he has adequate antibody levels? If so, should I go for it?

Thank you for answering. I have been stressing over this issue for couple of months now and I have tried to get a reasonable answer from a few doctors without luck. I have sent an email to CDC, but they have not replied either.
Avatar_dr_m_tn
Hello,

It is possible that the puppy/dog had rabies.

Did your son receive Rabies immunoglobulin? This is recommended in addition to the four doses of Rabies vaccine.

Please take a look at the link below.

http://www.cdc.gov/rabies/resources/acip_recommendations.html

Yes, there are tests to determine if your son has developed antibodies to the virus.

I am not aware of the ACIP/CDC recommendations applying to only the vaccinations manufactured in India.

~ Dr. Parks

This answer provided to you is not intended as and does not substitute for medical advice. The information presented in this Medhelp.org posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
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Avatar_m_tn
He did not receive the immunoglobulin. The local doctors here think the 4 doses are good enough and immunoglobulin is not going to help. I am at a loss on how best to proceed.They tell me there are no tests either. Where can I find information about the test?

I am stressed out just thinking about the implications. I appreciate any help.
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Avatar_dr_m_tn
Hello,

Here is the CDC link describing Rabies serology.

http://www.cdc.gov/rabies/specific_groups/doctors/serology.html

~ Dr. Parks

This answer provided to you is not intended as and does not substitute for medical advice. The information presented in this Medhelp.org posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
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