Travel Medicine / Vaccination / Immunization Expert Forum
treatment for dog bite
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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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treatment for dog bite

I am living in India. One of my neighbour's dog bit my near the foot (in fact just a grab) No deep pierce or blood.
The immunisation status of the dog is unknown. But I observed the dog for more than 10 days as it is confined to their house. Till date(approx 2 months) the dog is healthy. But three weeks back due to fear created by my friends I consulted a GP who advised me that a shot (rabipur) is not necessary in the background that I took 5 shots 13 years ago when I was bitten by another neighbour's dog as the immunity will be for 15 years. I googled and no where I could find such an information. So I took 4 shots (0, 3,7 and 14) and yet to take 28th. day shot.
   My question are : pls provide the answer as it would be immensely helpful to all the forum users.
1. In CDC and WHO site it was mentioned that when a dog bites a person
             - confine it for 10 days (which I did by observing my neighbour's dog for more that 3 weeks)
Is it true ?
2. If it does not shows signs of rabies No PEP is necessary. (This dog is healthy)
Is it true ?

I consulted another doctor who says that if the dog is contacted with rabies there is no use of taking the rabies shot after 3 weeks. It won't work if u are infected with rabies virus. You should take the shot on the day of bite other wise no use.
I argued with him if that the case (why the guidelines says observe for 10 days and then if any signs of rabies is shown by the dog then go for PEP). A shot on the day of bite seems illogical ? pls explain.
Another thing I argued is if the dog which has bitten my is rabies infected (but yet to show the sign of rabies i.e in the incubation period) then it is not contagious. Is my argument correct.(reference CDC)
          
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Avatar_dr_m_tn
Hello,

1. 10 days observation is sufficient. This allows for the incubation of the virus to occur in the animal and for the animal to begin to demonstrate symptoms. And, if the treating physician and the patient (who was bitten) have decided to defer treatment (not recommended if there is high suspicion that the animal is rabid), then, the person may be treated at the first appearance of symptoms. This is rarely, if ever, recommended because rabies is 100% fatal in humans after an unvaccinated person develops symptoms.

Practice guidelines per CDC (Centers for Disease Control in the U.S.) do not recommend rabies treatment when a person is bitten by a pet that is confirmed or known to be immunized against the rabies virus. If the immunization status of the animal is unknown, then the decision to treat with rabies vaccination and immunoglobulin depends on the estimated risk that the animal is rabid and the nature of the bite.

2. Therefore, administering the immunoglobulin and vaccination after a person is bitten by an "unknown" animal is a VERY logical decision given the certainty of death following a human infection with rabies and the relatively low risk of adverse effects associated with the treatment. The 10 day quarantine period is recommended for the public health benefit of preventing the quarantined animal from biting someone else or from infecting another animal.

3. A dog that appears "asymptomatic" can transmit the rabies virus.

4. I  agree that it is not helpful to get the rabies vaccination 3 weeks after a dog bite. Getting a vaccination 3 weeks later would only help with immunity against future exposures.

5. In your case, if you were previously vaccinated, there is a test that could have been done to confirm prior vaccination and immunity. I am not sure if this test is available where you live.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this 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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