A 10-year boy with dog bite unprovoked comes to you. Appropriate action is:
(A) Give cell culture derived vaccine (B) Withhold vaccine and observe dog for 10 days (C) Kill dog and send brain for biopsy (D) No fuher action is necessary
(A) Ans: A. Give cell culture derived vaccine(Ref Park's 24/e p297, 23/e p279, 22/e p253)Most appropriate action - Give post-exposure prophylaxis with cell-culture derived vaccine.Post-Exposure Prophylaxis:Aim: To neutralize inoculated virus before entry to nervous system. Prevention:Effective & safe in preventing rabies:Concentrated & purified cell-culture vaccine (CCV).Embryonated egg-based vaccine (EEV).Uses:Intended for pre-exposure & post-exposure prophylaxis.Discontinuation point:Discontinued if suspected animal is proved by appropriate examination is rabies-free.Domestic dogs, cats or ferrets remain healthy throughout 10-days observation period staing from date of bite. Categories of contact with suspected Rabid animalPost-exposure prophylaxis measuresI. Touching or feeding animalsLicks on intact skinNoneII. Nibbling of uncovered skinMinor scratches or abrasions without bleedingImmediate vaccination & local treatment of wound.III. Single or multiple transdermal bites or scratchesLicks on broken skinContamination of mucous membrane with saliva from licksContact with batsImmediate vaccination and administration of rabies immunoglobulin and local treatment of the wound.