The RDIS

The Rabies Disease Information System


VACCINATION: THE ULTIMATE TREATMENT FOR RABIES

             Vaccination against Rabies includes both preventive or prophylactic vaccination as well as post exposure vaccination. Any alarm of the disease, such as bite from a stray dog, cat or any other mammal including bat is advisable to be prodceeded by a course of preventive vaccination.

Post Bite or Post Exposure Vaccination Schedule

        The indication for post-exposure vaccination with or without Rabies immuneglobulin depends on the type of contact with the Rabid animal. The first dose is administered on the day of the casuality, also regarded as the 0 day. A second dose is administered on the 7th day, and the third dose is administered on the 21st or the 28th day. The site of administeration is usually on the deltoid region or  anterio lateral aspect of the thigh in case of infants



 Postexposure prophylaxis

        Post exposure prophylaxis consists of immediate wound cleansing and disinfection, followed by Rabies vaccination and the administration of Human Rabies Immunoglobulin. The Rabies vaccine is delivered as 5 doses in the U.S., and it is usually administered intramuscularly in the arm. Fewer doses, and no Rabies immunoglobulin are given if the person was previously vaccinated. Post exposure prophylaxis is highly effective if it is begun soon after the exposure.

        In cases of animal bites, dogs and cats in a Rabies endemic area should be isolated for 10 days for observation. If signs develop, they should be killed and their tissue examined in the laboratory. Wild animals are not  usually observed,  but if captured, the animal should be killed and examined. The postexposure prophylaxis in case of Rabies concern, essentially includes, the local treatment of wounds and active as well as passive immunization.

        Wound treatment - Immediate surgical debridement indispensable. The wound should never be sutured up. Experimentally, the incidence of Rabies in any patient can be remarkably reduced by local treatment alone.

       Passive immunization - Application of Human Rabies Immunoglobulin around the wound has to be supplemented with an intramuscular dose to confer short term protection. Convincing evidence suggest that a combined treatment with Rabies immunoglobulin and active immunization is much more effective than active immunization alone. Equine Rabies Immunoglobulin (ERIG) is available in many countries and is considerably cheaper than the HRIG.

        Active immunization - The Human Diploid Cell Vaccine is one of the best preparations available. Various other standard vaccines are available as well. The vaccine is usually administered into the deltoid region, and 3 to 5 doses are usually given, depending upon the part of the body exposed and the severity or intensity of the exposure.

PREVENTION: 

       'Prevention is better than cure' is an old saying. In case of Rabies, Prevention is the only remedy. Till date, no cure has been successively elicited for the fatal disease. Therefore, the primary treatment of the disease relies on its prevention. Investigations have substantiated that profound prevention of the disease is possible through vaccinations.

RABIES VACCINES: 

         Of late, a number of potent and successful Human and animal vaccine preparations have been made available. Discrete vaccines are available for most of the domestic animals. Oral vaccines are also available, which are used especially for the wildlife.

PROGNOSIS:      

         The Prognosis of the disease is grave. Once the symptoms are apparent, the disease runs its course and the patient eventually scummbs to it. 

References:

http://www.who.int/rabies/human/postexp/en/