Friday, April 10, 2009

Rabies, Wildlife, Equine, Human Exposure - USA (02) : (North Carolina, Georgia)

RABIES, WILDLIFE, EQUINE, HUMAN EXPOSURE - USA (02): (NORTH CAROLINA, GEORGIA)
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Fri 10 Apr 2009
From: David Dassey


This is regarding the moderator's comment on
Rabies, wildlife, equine, human exposure - USA: (NC, GA) 20090409.1364
on the statement, "[The patient] received 5 [vaccine] shots for rabies and
said he must have 5 more [This must be a mistake; only 5 shots are
needed, spread over 28 days, not just a week -- see below - Mod.CP/JW]."

The patient was probably referring to the number of needle insertions
to administer rabies immune globulin (RIG) in addition to vaccine
dose number 1. This is a common finding when interviewing bite
victims who present to a different healthcare provider for completion
of the PEP series. Many patients are unable to tell what was
administered, only how many sticks they received (a good reason for
giving the patient the package inserts and a written treatment
record). The other clue is the site of the multiple injections -- if
the needles infiltrated the bite wound(s), the substance delivered
was certainly RIG.

David Dassey


[The writer from LA County Public Health is almost certainly correct.
The patient only spoke of shots, not specifically of vaccine shots. I
made the mistake of inserting the word [vaccine] and extrapolated
incorrectly from that. - Mod.JW]

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