DOG BITE:

DOG BITE

Good morning folks had come up with a few cases of Dog bite off late so thought would be helpful enough to write a few words about what are the Do’s and Don’ts in case of a dog bite:

Do’s:

-Wash well with soap and water immediately.

-Splinting of the limb is advisable.

-Keep the dog under observation in isolation if possible.

-Take the victim to nearest medical facility at the earliest.

- Vaccination with/ without immunoglobulin should be given at the earliest.

-Tetanus toxoid if not taken within last 5years.

-Antibiotics, Analgesics and local dressing.

-Leave the wound open with a dressing and regular follow-up.

-Immunization schedule to be completed.

-Pets should be immunized for Rabies.

-Not just Dogs- Any warm blooded animal should be considered as source of Rabies and immunization to be taken.

Don’ts:

-Trying for home remedies and local healing practices.

-Primary suturing of wound should be avoided.

-Discontinuation of immunization schedule after 1st week.

-Pets bites are not serious and not require immunization.

-Pets not getting immunized since they are mainly indoors only.

Table 2:- Immunization schedule for subjects with no or inadequate immunity
Schedule A	Schedule B	Schedule C
Prophylactic immunization prior to exposure.	Immunization after exposure.	Concomitant prophylaxis after exposure.
One injection IM on days 0,7,28 and 365	One injection IM on days 0,3,7,14,30 & if necessary on day 90.	Rabipur® as in SCHEDULE B + 1 X 20 I.V./kg body wt. human rabies immunoglobulin concomitantly with injection of Rabipur or on day 7 after the first injection of Rabipur® at the latest.

The Category of bite and Schedule to be followed is laid down in the below columns for easy reference:

Grade of exposure	Type of exposure		Immunization schedule
	Contact with a rabid or suspected rabid animal	Contact with an inoculated animal
I	Touching/feeding animal, but no contact with saliva; and skin undamaged prior to and during contact	Touching inoculated lure, skin intact	No immunization necessary If uncertainty exists than SCHEDULE B is to be followed.
II	a) Animal has nibbled or licked exposed skin. b) Contact with saliva c) Superficial, non- bleeding scratches made by the animal	Touching inoculated lure, skin damaged.	Immediate immunization according to SCHEDULE B. In case of uncertainty concomitant prophylaxis as specified in SCHEDULE C. If animal is examined & found to be non-rabid then continue as in SCHEDULE A
III	a) All bites b) Bleeding scratches c) All scratches on the head, neck, scapular region, arm & hands d) Contact of animal saliva with mucous membrane of patient	Contact of inoculated lure with mucous membrane or fresh skin wound	Immediate concomitant prophylaxis per SCHEDULE C. If animal is proved non-rabid it is adjustable to continue treatment as in SCHEDULE A.