Open AccessRe-exposure animal bite management among incident animal bite cases in a secondary care Hospital in Delhi, India
Author(s) -
Saurav Basu,
Warisha Mariam,
Sahadev Santra,
Suneela Garg,
Rajiv Singhal
Publication year - 2020
Publication title -
indian journal of public health/indian journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 26
eISSN - 2229-7693
pISSN - 0019-557X
DOI - 10.4103/ijph.ijph_37_19
Subject(s) - rabies , animal bites , medicine , vaccination , post exposure prophylaxis , rabies vaccine , dog bite , pediatrics , veterinary medicine , family medicine , rabies virus , immunology , virology
Complete postexposure prophylaxis with 4 doses of anti-rabies vaccine (ARV) in a previously vaccinated (nonnaïve) individual results in administration of two extra ARV doses resulting in wastages of precious resources comprising vaccine logistics, human resources, physician, and patient time. This cross-sectional study conducted in a secondary care hospital in Delhi among 175 incident animal bite cases observed 39 (22.3%) had an animal-bite history within the previous 5 years. A total of 19 (10.8%) cases reported a history of complete ARV vaccination during a previous animal-bite exposure. However, in the absence of supportive patient medical documentation, all the animal bite cases without exception were prescribed a full course of ARV irrespective of their previous exposure status. Rabies immunoglobulins (anti rabies serum) were also re-administered in 13 (81.2%) cases. National guidelines for rabies prophylaxis should, therefore, consider the inclusion of an explicit decision-making algorithmic mechanism when the health-care provider is confronted with this situation carrying the potential for hidden vaccine wastage.