BENGALURU: In the first-of-its-kind advisory in India, The Association for Prevention and Control of Rabies in India (APCRI), based in Bengaluru has issued an advisory of rabies prophylaxis during COVID-19 pandemic. It states that post-stray animal bite cases, anti-rabies vaccines and rabies immunoglobulins/ rabies monoclonal antibodies (Post Exposure Prophylaxis) must be administered, even if the person has received any dose of COVID-19 vaccine.
They can even both be given on the same day at different sites, as they are both essential and life-saving. "When a person suffers a dog bite, the saliva contains the rabies virus which enters the brain through the peripheral nerves. Once it enters the nerves, it is the end of the person. Therefore to neutralise, kill or inactivate the virus, immunoglobulins or rabies monoclonal antibodies must be injected into the wound. Then the vaccine must be given over a period of a month, multiple times; the antibodies from which form after 2 weeks," said Dr. Ashwath Narayan, President, APCRI which is registered at Department of Community Medicine, Kempegowda Institute of Medical Sciences.
"If the person is exposed to the animal after the first dose of the COVID vaccine, the second dose of the same vaccine should be scheduled at a minimum gap of two weeks after completing the last dose of rabies vaccine," an excerpt of the guidelines stated.
Dr. MK Sudarshan, founder president and mentor of APCRI said that rabies is a 100 percent fatal disease, with few survivors and is hence more dangerous than COVID. Apart from those suffering from animal bites getting the vaccine, animal handlers, veterinarians and dog catchers take the rabies vaccine as a form of prevention, he said.
The first dose of COVID-19 vaccination shall be given after a minimum gap of two weeks following the last dose of rabies vaccine. If a COVID-19 patient in home isolation is exposed to pet animals and the pet is completely immunized and healthy, Post Exposure Prophylaxis (treatment post the bite) can be deferred and the pet has to be observed for 10 days. If the pet is not immunized, the rabies treatment must be followed by a health professional by following COVID-19 protocol like wearing N95 mask, PPE kit, gloves, face shield, etc.
The course of rabies vaccination can be continued along with antiviral drugs a COVID-19 patient is taking such as Oseltamivir, Favipiravir, Remdesivir, Interferon alpha 2B, etc. PEP must be administered to the patient exposed to animals, even if they are on steroids, antiplatelets and anticoagulants.
The rabies vaccine can also be given even to lactating mothers exposed to an animal, even if they have received COVID-19 vaccine. The advisory includes 25 FAQs and was released on June 5.