Posted on : December 28, 2018 by Clinic One on Rabies FAQ
Got a stray or street dog bite or an animal scratch in Kathmandu or in your travels around Nepal? Got a monkey scratch when you visited a temple? Are you concerned about animal contact and scratches during your travels in Nepal, Northern India, and Tibet?
Be careful and get a Rabies vaccine immediately. In the extreme case, someone bitten may die.
We offer the Rabies vaccine in our clinic or in the comfort of your home in Kathmandu Nepal. Call Clinic One today at 9861966614 or email us at [email protected].
The rabies vaccine is administered to prevent rabies. It is indicated for active immunization against the rabies virus. Vaccines are effective in humans and other animals. The most effective way to prevent the spread of rabies to humans is to vaccinate dogs.
Route of administration
Pre-Exposure Prophylaxis: Immunization before possible exposure to a case of high-risk professionals. E.g. Veterinarians, doctors, laboratory personnel, and people who are exposed to the risk of rabies.
Post- Exposure Treatment: Rabies vaccination is part of the post-exposure treatment of individuals after contact with animals that are rabid or suspected to be rabid. Vaccination with rabies vaccine should begin immediately after exposure to rabies, which has been confirmed or suspected. Other post-exposure treatment measure includes first aid and local wound, and administration of rabies immunoglobulin, if indicated. The choice of immunization schedule for post-exposure prophylaxis depends on the type of wound or exposure and the status of the animal.
For Intramuscular Vaccination:
Pre-Exposure: 0.5 mL or 1.0 mL of reconstituted vaccine (as per diluent supplied) on days 0,7 and 21 or 28. Only people, whose occupation puts them at continual or frequent risk of exposure, should receive periodic booster doses whenever rabies virus-neutralizing antibody titre drops below 0.5 IU/mL.
– For a new case: 0.5 mL or 1.0 mL of reconstituted vaccine (as per diluent supplied) on days 0, 3, 7, 14, and 28.
– Rabies immunoglobulin should be administered preferably as soon as possible after initiation of post-exposure prophylaxis in case of Category III bites but not beyond 7 days from the first dose of vaccination.
– For previously immunized individuals: One dose (0.5 mL or 1.0 mL, as per diluent supplied) of reconstituted vaccine intramuscularly at one site on day 0 and day 3. The administration of Rabies immunoglobulin is not required in such cases.
– For immunocompromised individuals: They should definitely receive rabies immunoglobulin in addition to a full post-exposure vaccination series as listed above, both in Category II and Category III bites.
For Intradermal Vaccination:
Pre-Exposure: One dose of 0.1 mL of the reconstituted vaccine at one site on days 0, 7 and 21 or 28. Only people, whose occupation puts them at continual or frequent risk of exposure, should receive periodic booster doses whenever rabies virus-neutralizing antibody titre drops below 0.5 IU/mL.
– For a new case: Updated two-site Thai Red Cross Regimen (2-2-2-0-2): 0.1 mL of the reconstituted vaccine at two different intradermal sites on each of days 0, 3, 7 and 28. Vaccine administered intradermally raises a visible and palpable “bleb” in the skin. Intradermal administration must be carried out by staff trained in this technique.
– Rabies immunoglobulin should be administered preferably as soon as possible after initiation of post-exposure prophylaxis in case of Category III bites, but not beyond 7 days from the first dose of vaccination.
– For previously immunized individuals: One dose (0.1 mL) of reconstituted vaccine intradermally at one site on day 0 and day 3. The administration of Rabies immunoglobulin is not required in such cases.
– For immunocompromised individuals: Intradermal administration should not be used for immunocompromised individuals or individuals receiving chloroquine-based antimalarial treatment or long-term corticosteroid or other immunosuppressive therapy.
Immediate wound treatment
Immediate local treatment of all bite wounds and scratches that may be contaminated with rabies virus is important. It is recommended to thoroughly wash the wound with ample water or detergent for 15 minutes and disinfect the site with 70% alcohol or tincture of iodine.
Vaccination of subjects already immunized against rabies
If the vaccine is administered to the subjects within 5 years of previous immunization (cell culture rabies vaccine), two booster doses of vaccine is to be administered via TM route on day 0 and day 3. If the vaccine was administered more than five years ago, vaccination schedule as per Post- Exposure Treatment may be followed.
The wound should not be sutured for seven days and RIG (rabies immunoglobulin) should always be administered before suturing. Prescriptions of antibiotics and the status of tetanus vaccination should be checked as per institutional anti-tetanus procedures.
Drugs interaction and other interaction
Corticosteroids and immunosuppressive treatment may interfere with antibody production and may cause the vaccine to fail. In order to avoid possible drug interaction, any ongoing treatment should be reported to your doctors.
Precaution / Contraindication Pre-exposure
- Febrile infection
- Pregnancy and lactation
- Progressive chronic disease
- Hypersensitivity to any of the ingredients of the vaccine
Post-Exposure: Due to the fatal progression of declared Rabies infection, there are absolutely no contraindications to curative anti- Rabies vaccination.
Local reaction: pain, erythema, edema, pruritus, and induration at the injection site may occur.
Systemic reaction: fever, shivering, fainting, asthenia, headache, dizziness, arthralgia, myalgia, gastrointestinal disorder (nausea, abdominal pain) may occur in some cases.
Exceptional cases: Anaphylactic reactions may be observed
Clinic One has walk-in appointments for all kinds of vaccines available at our clinic. We are open on all weekdays except Saturday from 7:00 am to 7:00 pm.
Additional Information at the Center for Disease Control
Back to Vaccination Page.
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