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Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
Hi doctors, i'm badly in need of help from you. I hope someone answers my question straight forward with 100% surity with right facts. Almost a month back on july 2nd i thought i'd an exposure with a rabid dog. It jumped on me on bites and scratches but i felt it had saliva and which fell into my mouth and eyes. So i went and took 5 rabipur post exposure vaccines with 28 day course. My last vaccination was on 31st of july. I experienced minor symptoms like rash, body pain, due to my anxiety i again went and took one rabipur shot at august 15th morning. Now i'm suffering from muscle pain, neck pain after one day. Feeling weird in my throat.
1. What are my symptoms? Is it because the extra dose i took or anything else? 2. What are the effects of extra dose of rabipur i took? Will it increase my immunity level or this extra dose will create any health problem?
3. Considering my last exposure was not an exposure, can i stop further vaccinations and stay rabies free?
4. Worst case if last one was actually an exposure, will my previous vaccination is able to fight it or should i go for new course of 2 extra booster doses?
5. Can extra dose of rabipur i took cause me rabies instead of preventing it? 6. I also heard rabipur vaccine itself can cause rabies? Is that TRUE? If yes how? What are the chances in my case?
Posted Mon, 17 Sep 2012 in Infections
Answered by Dr. Hema Yadav 45 minutes later
Thanks for posting your query.
Answer 1. Your symptoms are most probably mild sideffects of the rabies vaccine which are not always seen in all recipients but can occasionally occurr in some especially after booster dose. So yes it could be due to the extra dose you took but nevertheless it's not a health hazard it's just a immune reaction of your body and should soon resolve on its own.You have achieved adequate immunity with even five doses to be more than 98% sure that you are safe from rabies . So please do not worry.

Answer 2.Yes considering the last exposure was not a risk you can stop further vaccination . You can consider yourself rabies free in such case.

Answer 3. Even if it was a sure shot rabies exposure only two doses of vaccine 3 days apart would be necessary .Though your time interval between exposures is less and most likely the first vaccination effects are still protective , 2 doses at 3 days apart is recommended if its surely a rabid animal exposure .

Answer 4. No, the newer vaccines developed for rabies do not cause any encephalitis or rabies in humans and in your case there is no such risk for sure.
Even the extra dose can cause some immune hyper responsiveness but not rabies.
As of now your symptoms should soon resolve ( within a week or so) .
So please do not worry.

Hope I have answered your queries.
Kindly accept my answer if you have no further queries .
Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 1 hour later
Hi doctor, thanks for your help. I still have few questions and hope you answer them too
1. If my second exposure was not rabies exposure, i can stop further vaccinations and can be rabies free with 100% certain?
2. If my second one was exposure, i need to have another booster vaccine at 3rd day and stop vaccination. Can i be 100% sure that i'm rabies free?
3. If first and second one were not exposure and since i finished 6 rabipur injections, i can stop now with sure i'm rabies free. I will also have immunity to future exposure?
4. I was confused regarding vaccine because i saw someone telling in the same forum that rabipur or any vaccination can sometime cause disease in people with low immunity and all. Is that TRUE? How can you say it will not happen in my case. Not challenging your knowledge but wanted to be sure. Please don't mind.
5. Also if someone drinks water from a bottle where dog was licked the outer surface and little drop of saliva fallen into water, after 5 minutes if someone drinks that, can they get rabies? How long it lives outside the host in water or wet surface? Kindly answer one by one. Thanks in advance. You are doing a great job here.
Answered by Dr. Hema Yadav 7 hours later
Thanks for the follow up.
In medicine or diseases no one can assure you of 100% since rare incidents do occur , hence I mentioned that as per statistics it's very highly ( say 98% ) you are safe . I can say that practically it does mean a 100% certainty but in theory and in research studies there is usually a range given rather than absolute values.
That said , I would like to assure you that rabies vaccine are very effective vaccines almost 100% protective against rabies even if the animal was rabid .so let me now answer your queries one by one .
Answer 1. Yes you can be almost 100% sure of protection and can stop vaccination if you are 100% sure that there was no rabies exposure .

Answer 2. Yes , even if you are 100% sure that it was a rabies exposure you need only two doses 3 days apart to be almost 100% rabies free.

Answer 3. Any vaccine works depending on the immunity of an individual and in cancer , HIV or other immunocompromised patients the effect of vaccine can be unpredictable and live vaccines can cause diseases. Yes the older rabies vaccine did cause many cases of encephalitis however there are no such reports with the newer rabipur vaccines . But if you have any immunocompromised condition then the sideffects of vaccine or vaccine associated encephalitis might be a risk though the chances are very less. Since you didn't mention any such medical history and I assumed you were a healthy individual , there are no chances of such effect in your case.

Answer 4. Yes the rabies virus can be transmitted by a rabid dogs saliva . It is destroyed in dry conditions but in wet or moist conditions the virus may survive for few hours. However if the dog is watched for 10 days and shows no sign of rabies then it's not likely to cause rabies . Remember that not all dog bites are XXXXXXX only rabid dog bites or licks or saliva are XXXXXXX .

Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 28 minutes later
Hi doctor, thanks for the response.
1. Yes all this 26yrs, i've been healthy enough with proper food diet and physical activities. I have never admitted to hospital all this while and i have not suffered any major illness. When i took first five doses, i was all fine and able to go to office as normal apart from minor joint pain and headache. With these can i be sure that i'm a healthy person with no such disorder?

2. I was not able to find that dog from 3 days. So i can't observe that for next 10 days. Thats why i choose to go for vaccine.

3. I absolutely had no problem from first 5 doses of rabipur. But my worry is since as of now i've already taken 6 doses in last 45 days and if i take another total of 7 dose in 48 days, which i feel like a over dose, i'm worried that may cause me the disease.

4. Considering all the above scenarios, practically if i go for another vaccine (7th), can i be sure that i'll not catch rabies due to rabipur vaccines? Also my 2nd exposure was non bite exposure.

5. From your knowledge and experience, incident of rabies happened with older vaccine with immuno compermised people,has it ever happened with healthy people who has adequate immune system? Are you aware of any health people getting rabies from vaccination?

Please assess my risk, possibility of getting the 7th vaccine considering the above facts. Thanks in advance.
Answered by Dr. Hema Yadav 38 minutes later
Thanks for follow up.
First of all I apologies that I could not answer one of your last queries by mistake .
The answer to your previous query subset 3 is that since you have already had 6 doses of rabipur vaccine you have adequate immunity and which usually lasts till 2 years but the effect may decrease gradually over this time period.

Answer 1.Yes you seem to be healthy and not immunocompromised .
The rest of your queries can be answered satisfactorily if I know the exact details of your second exposure .

Wether you can watch the dog or no the vaccine should be taken after considering the exposure you had . Since your second exposure was just within 15 days of the last booster dose I would not have advised a repeat dose since you already possess the immunity required to fight the virus.
If it was a wound I would have suggested taking immunoglobulin injection which provides passive immunity immediately and temporarily .
But you mention it's a non bite exposure and you are not very sure of the dog being rabid . Hence weighing the risk benefit ratio you neednot take any further doses of the vaccine.
That doesnot mean that overdose of vaccine will cause rabies because the virus used in vaccines are non virulent in nature . It's not the risk of rabies but the occurrence of sideffects and allergic or immune responses that I am more worried about .

The best option is to consult a infectious disease specialist or any physician and get yourself evaluated ( including complete history of second exposure).
If you can furnish me with the details too I would be glad to guide you.
As far as the present scenario is , there is no need for you to take any further doses or worry about rabies unless your second exposure was from a significant rabid dog .
Considering the small time period , your body dies have immunity against rabies and it would protect you from the second exposure too.
If you still feel anxious and take the 7 th dose you wouldn't have rabies but there is a risk of a immune reaction or increased sideffects .

In my knowledge there arent healthy individuals who got rabies after vaccination but there are rarest of cases of hidden genetic susceptibility etc where encephalitis is a possible rare risk .
Hope I have answered your query.
Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 12 hours later
Okay doctor. Here is my details. 26 yr old healthy without any major illness. Last time when my body temperature reached 100 f was in 2009. Sometimes i easily catch cold more than 3 to 4 times a yr. My first exposure was on july 02nd 2012. A dog scratched me blood came out. I took 5 rabipur vaccine and my last one was on july 31st. I watched that dog after 15 days also it was all fine. But i thought i'll complete the course and so completed. During my first vaccination i experienced headache, muscle pain, pain at injection site and small pimple like rashes. Everythin went of after few days. During the 5th vaccination i was all fine. My second exposure was on august 13th. Exactly 13 days after my last vaccination. I kept my water bottle outside my home for some other work. When i came back i saw a dog with saliva in mouth was licking the bottle which was open. It was during night. I clearly noticed saliva in it's mouth. Some amount must have fallen inside the bottle on water as well. I just made that dog to run and stood there for sometime but i don't know why i was out of mind, exactly after 3 to 4 min i drunk the water which was there. I completely drank and later realised this and got shocked. I didn't see that again till today. I went and got the first overall 6th dose on 15th morning which was almost 36 hours. That night i felt muscle pain and joint pain. Weird sensation in throat. Today i'm feeling okay better without any muscle pain but little itchy throat. I hope i have given you some details which you had asked. Here in my place many dogs are there and doctor was also telling that she's seeing more rabies patients now a days.

Please access my risk in detail and let me know if i can skip or take next dose which is at tomorrow.
Answered by Dr. Hema Yadav 44 minutes later
Thanks for the follow up.
Yes you can take the next dose of vaccine tomorrow for the following reasons.
1. Two doses are the recommended protection ( 100%) for any previously immunized person which you are .
2. Additional dose of rabies vaccine won't cause rabies.
3. The second exposure cannot be confirmed as non risky as the dog cannot be watched and there was a definite contamination with the dogs saliva.
4. Since it was not a wound no precaution like washing the wound etc could be taken .
So I still feel that you are completely safe due to your previous vaccination last month ( the immunity last for 1-2 years) but weighing the risk benefit ratio and the recommended guidelines you can go ahead with the second dose which won't cause any harm .I understand your dilemma but this would be the safest thing to do .

Hope I have answered your query.
Kindly accept my answer if you have no further queries.
Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 5 hours later
Hi doctor, thanks for the advice. Yes as suggested by you i'll go ahead and take the 2nd and last vaccination. I hope it will not put me in any trouble. I really hope. Please let me know if i need to follow any food diet or whatso ever. I didn't follow anything during my first vaccine except i avoided eating egg and too much non veg
Answered by Dr. Hema Yadav 3 hours later
Thanks for the follow up.
Please do not worry.
You will not regret your decision and I hope if you keep up a positive attitude you will not have any trouble this time .
Yes do refrain from eggs , non vegetarian food and nuts ( groundnut etc ) . Also minimize dairy products if feasible . Basically any allergogenic foodstuff like the above mentioned are best avoided.
Drink lots of water and be Optimistic .
Wishing you good health.
Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 9 days later
Hi Doctor,
As suggested by you, i took my seocnd rabipur vaccination on august 18th
when i had first vaccine, i was having little elevated temp (max was 99 F)
and tiredness, muacle and joint pain.
it vanished after a day.

when i took second vaccine, i did not experience any symptom such has muscle pain or headache or fever. still feeling little discomfort in my thoat
like a on and off pull in throat muscle. not severe but can easily eat and drink and swallow.

1. Is it really required that someone should experinence symptoms like fever and all. when you get fever after vaccination, does that mean that body started responding and started creating antibodies? if you dont experience does that mean you have weak immune system and body is not fighting against virus?

2. What is the reason for my throat pain?

3. Atleast now can i be sure that i 100% out of danger after 2 vaccinations and i dont get rabies by these extra dosage of rabipur?

4. I also had chicken during these days but avoided dairy products, ground nuts and othet allergic products. I am a non vegetarian and dont have any
allergy to chicken or egg in last 26 years? will it put me to trouble since
rabipur is derived from chick embryo cells, will it increase the chance of rabies or encephalitis in me now?

5. Wherever i search, it says rabipur can cause encephalitis. i already had
5 doses and now 2 again. never experienced any fever except little rash and small headache and joint pain. So can i be sure that vaccine recated normally
to me and i dont catch encepahalitis?

6. If at all someone is suscepatable to encephalitis, how soon he'll catch that disease? is that curable??

7. Now from yesterday, i am having on and off headache not severe though but can really feel it? any chances of me being the victim?
Answered by Dr. Hema Yadav 17 hours later
Thanks for the follow up.
Answer 1. No it's not mandatory to have fever after successful vaccination.Fever is not related to the efficacy of vaccine or the amount of immunity it generates.
Some may get fever, some may not like in your case you got fever after first dose but not after second.
Answer 2. I cannot comment on your throat pain without assessing it . However minor flu like symptoms say sore throat and fever are known to occur with rabipur and are harmless as such.
Answer 3. Yes you can be termed almost 100% safe.
Answer 4. No you are not at increased chances of getting allergic reaction to rabies unless you have known history of allergy or current symptoms of allergy ( which your symptoms don't suggest ).
Answer 5. Rabipur rarely causes encephalitis but even if it does it's not as life threatening like rabies . Yes your reaction to the vaccine seems appropriate.
Answer 6. Post vaccination encephalitis usually occurs within 1-3 weeks of the vaccination and usually presents as severe symptoms like neurological weakness , seizures , vision defects etc. In most cases with proper treatment , full recovery is possible ( 70-90 %)
Answer 7. Mild headache is termed as one of the usual post vaccination effects however if it progresses severely within hours to couple of days you can consult your doctor for confirmation .
No just mild post vaccination effects like yours do not make you more likely to be a victim of encephalitis .
In any case if you still persist to have such symptoms after a week to ten days then you can get yourself examined and investigated .
At present it doesn't seem worrisome .
Hope I have answered all your queries.
Kindly accept my answer in case you have no further queries.

Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 20 hours later
Hi doctor, thanks for the reply. Kind of happy news for me today because i observed both the dogs from which i was bitten and from i got exposure second time. It's been more than 17 days since my second exposure and dog is all healthy and it's not a street dog. It's taken care by a family. They also assured that dog is vaccinated. Now i can tell you with 200% certainty that both of my exposure were non rabies exposure. Without having any exposures, now i have received 5 post exposure rabipur vaccination and 2 doses of rabipur booster doses. Now i would like to summarise and ask few questions to you. I hope this will be my last set of questions.

1. In your medical experience, have you ever seen person (healthy) who never had exposure, receives post exposure vaccination like mine and a booster doses, caught rabies just due to vaccination? Has it ever happened anywhere?

2. You said encephalitis can occur 1 to 3 weeks after vaccination. If i don't experience any headache and other symptoms can i move on with 100% certainty that i don't catch It?

3. It's been 15 days since my first dose and 12 days since my second booster dose and 30 days since i finished my first set of post exposure 5th vaccine. I'm feeling fine, there is a mild headache Which comes and goes not severe. What's you though on this. Am i Clear with all worries?

4. I'm slightly having pain in my right palm and wrist,which comes and goes. Has it anythin to do with rabies or encephalitis. I work all day with mouse in my right hand. I hope that's the Reason.

5. Last question. You said encephalitis can occur with rabipur very rarely. Does it occur in healthy people or only in immunocompermised? If in healthy How frequently? What makes them to catch this? Thanks for spending your time and answer my question.
Answered by Dr. Hema Yadav 3 hours later
Thanks for the follow up.
Well , Congratulations ! Now I can assure you 100% that you won't catch rabies.
Please note that it's my pleasure to be helpful to you by answering your queries and never hesitate to ask any further queries.
Answer 1.No never has it happened anywhere with the newer vaccines ( Rabipur etc) to the best of my knowledge and experience .
Answer 2. Yes , almost 100% you are not likely to catch it.
Answer 3. Yes you need not worry . Mostly this headache too should resolve completely within the coming week . Infact stress could precipitate headaches so try relaxing !
Answer 4. No the pain in your hand doesn't seem anyhow related . Yes it could be due to overuse of the mouse ( pressure)
Answer 5. It has been reported in immunocompromised or genetically or neurologically susceptible people not in healthy and asymptomatic people yet the odds could be 1 in millions.
The cause for post vaccination encephalitis is very complex and related to the reaction of the persons immune system especially nervous system ( brain and spinal cord ) to the vaccine antigens or the medium in which it has been cultured . Hence it mostly causes seizures or neurological deficits.

Hope I have answered all your queries.
Kindly press the accept button to close the query in case you have no further queries.
Above answer was peer-reviewed by
Follow-up: Bitten by rabid dog, taken Rabipur vaccine. Have muscle and neck pain, throat discomfort. What are my symptoms? 38 minutes later
Hi doctor, thanks for the answers. Both the dogs were healthy and local municipal also confirmed that there are no rabid dogs and rabies case in my place from past 5 yrs.

I'm pretty healthy and i hardly been to hospital. Whenever i have fever or cold, it goes itself in a day or two. Never took any medicines.

I also think if i had to catch encephalitis, i would have experienced symptoms in my first 5 vaccination only. Nothing happened that time and till today i didn't have fever, seizure.. So i hope i have crossed the hurdle.

I also heard that rabipur is from purified chick embryo cells. Is it a nerve tissue vaccine? Because i heard nerve tissue vaccines are XXXXXXX and mostly cause encephalitis.

It's been 12 day after my second vaccine and i feel comfort and get tensed only if i think about this. Is 12 days without any symptoms is quite good indication isn't It? Has alcohol (in moderate level) has any impact on the vaccination and can cause encephalitis or it has nothing to do with any food and alcohol?

I really thank you for your time and answers. I will accept once i get the answers for above. You are doing a great job here. God bless you.
Answered by Dr. Hema Yadav 49 minutes later
Thanks for the follow up.
Yes you are absolutely safe . Please do not worry.
Rabipur is Cell culture derived vaccine ( purified chick embryo vaccine ) and not nerve cell vaccines ( the older vaccines not used now).
Yes alcohol is not related to any of the post vaccination effects .
Yes you have almost finished two weeks ( 12 days ) and are asymptomatic as such so don't worry .
Wishing you good health.
Above answer was peer-reviewed by
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