CHENNAI: After a couple of rabies deaths in Kerala recently, the Directorate of Public Health and Preventive Medicine (DPH) instructed the district health officers to train health care workers to identify the category of bites and administer rabies immunoglobulin correctly.
In his circular, the director of Public Health and Preventive Medicine, Dr T S Selvavinayagam, said rabies post exposure prophylaxis (PEP) is life saving only if done properly with correct wound care, timely and complete vaccination, and rabies immunoglobulin, with storage of vaccines at the proper temperatures recommended by the manufacturer are all crucial.
All the district health officers, and city health officers have been instructed to follow the scientific guidelines.
The DPH said a five-year-old boy in Kerala who was bitten by a stray dog last month died despite being vaccinated. Similarly, another boy, who was also vaccinated, died after being bitten by a stray dog.
Assess the bite
Category I Touching, feeding animals, licks on intact skin – No PEP needed
Category II Minor scratches, abrasions without bleeding – Vaccine only.
Category III Transdermal bites or scratches, licks on broken skin-Vaccine and rabies immunoglobulin should be given
Immediate first aid
Wash the wound thoroughly with soap and water for at least 15 minutes. Apply antiseptics like povidone-iodine or alcohol to reduce viral load
Inadequate washing allows the virus to remain at the bite site and enter the body
Doses should be administered on the 1st day, 3rd day, 7th day and 28th day