A history of rabies vaccination in an animal is not always a guarantee that the biting animal is not rabid. Animal vaccine failures may occur because of improper administration or poor quality of the vaccine, poor health status of the animal, and the fact that one vaccine dose does not always provide long-lasting protection against rabies infection in dogs/cats. Hence, appropriate documentation of vaccination status of dog/cat and proper history should be elicited before deciding to defer post-exposure prophylaxis after bite by vaccinated dog/cat.
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| National Centre for Disease Control, 2015 |
A provoked dog bite should also be managed as an exposure and PEP started immediately. A provoked bite does not mean that the biting animal is not rabid. Washing of wound(s) should be carried out as soon as possible with soap and water (for a minimum of 15 min). Since the rabies virus can persist and even multiply at the site of bite for a long time, wound(s) must be washed even if the patient reports late.
After thorough washing and drying the wound(s), any one of the available chemical viricidal agents should be applied, such as povidone iodine, alcohol, etc.
In category III exposures (which result in drawing blood through the skin) rabies immunoglobulin should be infiltrated in the depth and around the wound(s) to neutralize the locally present virus. Suturing of wound(s) should be avoided as far as possible.
Rabies Immunoglobulin should never be administered in the same syringe or at the same anatomical site as vaccine.
A Times of India article mentions that the Rabies Vaccine, administered after a dog bite to prevent infection, works only 14-15 days later. Immunoglobulin, meanwhile, is administered in cases where the victim has grievous injuries accompanied by bleeding.
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