The death of a 50-year-old man in Chennai as a result of rabies, despite the fact that both immunoglobulin and a complete course of the vaccine after a dog bite have received questions about vaccinals and gaps in care after exposure. Experts underline that although rabies is almost always fatal as soon as the symptoms develop, it can also be prevented if the right steps are taken quickly.
Immediate wound care
“The very first step after a bite is thoroughly washing the wound with soap and running water for at least 15 minutes. Only this can wash away most of the virus,” said C. Ananthakrishnan, senior consultant in internal medicine, Prashanth Hospitals, Chennai. He described wound cleaning as ‘as gold as the vaccine itself’, and emphasized that the first hour after a bite was crucial. Sindhuja L., neuro-doctor, versus hospitals, Chennai added that many failures occur because people miss or delay this step. “If the virus comes in before the vaccine starts to work, the outcome can be fatal,” she said.
The location and depth of the wound play a decisive role in determining the results. “Beten on the head, face, neck and upper limbs ensure that the virus can travel to the brain quickly. These require an aggressive approach,” Surendrn R., consultant, infectious diseases and hospital infection control, Sims Hospital, Chennai explained.
Category 3 wounds – Deep bites with bleeding, contamination of mucous membranes or multiple injuries require immunoglobulin next to the vaccine, he said.
Dr. Sindhuja remembered that he had treated a child on the face that Rabies developed despite receiving the vaccine, which emphasizes how the proximity of the bite of the brain accelerates disease progression.
Correct use of vaccine
The regime after exposure Rabies Vaccine (PEP) contains five doses given on days 0, 3, 7, 14 and 28 after a possible exposure. For category 3 category 3, rabies immunoglobulin is also given, ideally infiltrated in and around the wound to neutralize the virus locally.
Errors in the administration of vaccine or immunoglobulin remain a considerable care. “Immunoglobulin must be thoroughly infiltrated in and around the wound, not only intramuscularly. Missing areas, especially on the face and neck, raise the risk,” Dr. Ananthakrishnan. Completing the vaccine schedule is equally critical, doctors noted. “It is not enough to get only two shots. If the full course is not completed per schedule, the protection drops considerably,” he said.
Ajay Christopher, associate consultant in Emergency Medicine, Rela Hospital, Chennai, point out that starting the vaccine or immunoglobulin leaves the intervention ineffective more than a day or two after the bite.
Tackle systemic gaps
Timely initiation, correct administration site (usually the deltoid), compliance with the entire diagram and the maintenance of the cold chain are crucial to guarantee complete protection. Experts pointed to maintenance of a cold chain as a weak link in the system. “Rabies -vaccines are sensitive organic products. If they are frozen or not stored between 2 ° C and 8 ° C, their effectiveness drops drastically,” Dr. Christopher.
Dr. Surendran added that incorrect treatment during transport and storage disruptions in hospitals can lead to ineffective doses being administered.
The underlying health problems can also influence the vaccine response. “Patients who are immunocomromitated, patients with diabetes, on transplantation medicines or heavy alcohol consumption, may not respond so well to vaccines,” Dr. said. Ananthakrishnan.
Systemic problems also continue to exist. “In smaller cities, immunoglobulin is not always available, and the public consciousness about immediately waxing is still very low,” said Dr. Sindhuja.
Dr. Surendran emphasized the need for strict protocols about vaccine storage and treatment, regular monitoring and training of health care staff.
Focus on prevention
Despite these gaps, experts emphasized that Rabies remains one of the most diseases to be prevented. “Rabies has no healing as soon as the symptoms begin, but if it is treated well, it is 100% prevented,” said Dr. Ananthakrishnan.
Doctors also said that no animal bite would never be ignored. “Even a scratch from a stray dog ​​or cat can be dangerous. Was immediately, seek medical care and SLA or never delay vaccindoses,” said Dr. Sindhuja.
For those with a high risk, such as people who often deal with animal vaccination before exposure can also be considered, Dr. Surendran.
“The take-home message according to experts: death of rabies can be avoided if wound care, vaccine and immunoglobulin are administered correctly and on time.”
Published – September 20, 2025 12:17 pm is
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