Do I need an extra vaccine after eye exposure post-ARV?

Question

Hello doctor,

I completed eight doses of ARV. Later, I received a booster dose, followed by 1 ml of RIG the next day and the day 3 dose, along with 2 ml of RIG the day after.

About two hours after receiving the RIG and day 3 dose, dog saliva accidentally splashed into my eyes from a distance of around five feet. Do I need any extra vaccine doses?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

You do not need further treatment because you are already under active post-exposure prophylaxis (PEP) and received both a booster dose and RIG (rabies immunoglobulin) before the new saliva exposure.

Saliva contact with intact eyes is low-risk for rabies. Although mucous membranes (like the eye) are considered potential routes, a splash from a five-foot distance is improbable to transmit the virus. Because the rabies virus does not survive in the environment, it deactivates quickly once saliva is exposed to the air, especially at a distance of five feet.

The current WHO (World Health Organization) guidelines suggest that the rabies vaccine or RIG should not be restarted in a person who is already undergoing or recently completed a PEP course, especially when the new exposure is during treatment and low risk (like saliva splashing into the eye).

Here is the list of things for you to do -

Continue your planned rabies booster schedule (if more doses are scheduled).
Rinse the eye thoroughly with clean water or saline (if not already done).
Observe the dog for ten days if possible. If the dog survives for ten days, it will rule out rabies because dogs with rabies cannot survive more than ten days.
If the dog shows signs of rabies (aggression, paralysis, drooling) or dies within ten days, you can visit a hospital just for safety; otherwise, your immunity is boosted.

I hope this helps.

Thank you and take care.

Regards.