Patient's Query
Hello doctor,
Almost 14 to16 days back, Ι was feeding a four to seven months old stray (his owner is actually out of his mind and does not take care of the pup nor its diet, so I consider it a stray) pup, and he innocently actually took both my fingers in his mouth while I was feeding him biscuit.
As a reflex action, I immediately pulled my hand back. I found that because of this, I sustained a small scratch on the skin of the thumb behind my nails. It was so small, and I do not know how to explain it. There was orangish-colored blood on the borders of that scratch, and the blood was just smaller than a drop.
But I was worried, so I immediately came home and washed that area with detergent soap for five minutes by rubbing the detergent on the area twice and then I placed my thumb in concentrated Dettol (since I was worried about rabies).
Due to some circumstances, I could not get the rabies shot on the very day of the exposure and also not within the prescribed time of 24-48 hours. So, I kept observing the puppy for 14 more days.
Considering the nature of its owner, I assumed that the pup would not have been vaccinated. There was nothing unusual in the pup's behavior and when I observed the pup on the 14th day, he tried to bite and lick the concrete paver block (though not very furiously). To be on the safer side, I somehow managed to get the rabies vaccine on the 14th day.
The doctor said it was too late, but he gave me an IndiRab vaccine injection on the 14th day after the exposure and set the dosage as 0,7,28, 1 year, and 5 years which is the dosage of pre-exposure and not post-exposure. But today, it is almost 16-17 days after the exposure, and I found the dog eating and drinking normally. He is listening, eating biscuits, sitting, standing, and walking normally. He does not bark or act furious, and there is no foaming, no salivation, and no mandibular malfunction.
He just behaves very slowly. I have had no symptoms of rabies till today. I just had a mild fever, body ache (joint ache), and pain in the injected arm which came and went away, and I assume these symptoms to be due to the vaccine that I took yesterday.
However, I have no fever or joint aches at present. I am a microbiology student, and I know the insights and effects of viruses which freaks me a lot. Please let me know the following:
I must tell you that I had the rabies vaccine when I was about two to three years old and I was scratched by a kitten. Two more stray dogs play with this suspected pup, but they have not shown any symptoms either in the course of the last 16 to17 days.
Please help me.
I am much worried and freaked and do not know what to do.
Thank you.
Hello,
Welcome to icliniq.com.
I am here to extend a helping hand to you.
Being a microbiology student yourself, you might know things well. The answers to your questions are as follows:
1. Whether I need to change the doctor because of his incorrect dosage schedule and is giving pre-exposure dosage for a post-exposure case? If so, do I need to change him before the dosage for day seven or change the doctor immediately to get the dosage on day three instead?
My suggestion is that choosing a doctor is your personal choice.
2. Am I still at risk because I started the vaccine after the 14th day of exposure though the dog is still fine till the 17th day, and I have no clinical symptoms either?
There is no 100 percent in medical science. As per the literature, if the dog is healthy by the 10th day, PEP (post-exposure prophylaxis) 'may' be discontinued. But literature does not strongly say that it must be discontinued.
3. Are the vaccines that I am taking now, ineffective and will not protect me because it is too late?
No test is available for this. But you are still healthy.
4. Do I need to have rabies immunoglobulins because it is too late?
There is no need to have the immunoglobulin now.
For more information, you can refer the World Health Organization (WHO) guidelines.
I hope this helps.
Thank you.
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