Dog bite/ Monkey bite is a very scary situation for young kids and their parents. We need to consult a doctor immediately as treatment has to be started within 24 hours. Dog bites can lead to rabies disease.
Rabies disease can be prevented with vaccination, but if it occurs it is 100% fatal worldwide.
Rabies can occur with dog bites, monkey bites,s or any other domestic or wild animals. Especially if the dog bite is unprovoked, the chances of the dog being rabies are high. Besides as we know the illness is 100% fatal, so whenever in doubt it’s better to vaccinate the child.
Management:
- Keep a watch on the dog for 10 days if possible.
- Wound cleaning
- If needed Rabies Immunoglobulin
- Anti rabies vaccines (as per protocol)
Not previously vaccinated:
- Wound cleansing: All post-exposure prophylaxis (PEP) should begin with an immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent (e.g., povidone-iodine solution) should be used to irrigate the wounds.
- Human rabies immune globulin (HRIG): Administer 20 IU/kg body weight. If anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered at an anatomical site (intramuscular [IM]) distant from vaccine administration. Also, HRIG should not be administered in the same syringe as a vaccine. Because RIG might partially suppress the active production of rabies virus antibodies, no more than the recommended dose should be administered. The dose of equine rabies immunoglobulin is 40 IU per kg bodyweight of the patient and is given after testing for sensitivity
- Vaccine: Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV)
- IM (deltoid area): 1ml dose, on days 0, 3, 7 and 14- 28.
- 2 site ID (intradermal): 0.1ml in both arms, on 0, 3, 7.
Previously vaccinated:
- Wound cleansing: All PEP should begin with an immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent such as povidone-iodine solution should be used to irrigate the wounds.
- HRIG: HRIG should not be administered.
- Vaccine: HDCV or PCECV 1.0 mL, IM (deltoid area†), 1 each on days 0 and 3
For further reading, click on the below link. It will tell you regarding Rabies treatment in detail as per govt of India.
Rabies Latest guidelines from WHO
Or you can get in touch with Maya Clinic or your Child specialist / Pediatrician for queries. Stay healthy and stay away from stray dogs.
Regards Dr. Rahul Varma
Child Specialist
