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    Is repetition of anti-rabies vaccination required for a cat scratch?

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Posted on Fri, 3 Jun 2016 in Medicines and Side Effects
Question: Dear Doctor,

I need your advice regarding a doubt about rabis. I am residing in the Middle East.

There is a fully grown cat in our compound. I think it is a female, neutered cat but I am not too sure. The only reason I am saying that the cat maybe neutered is because its left ear is tipped. I think it belongs to my landlord or the previous owner of the house. It just comes to the compound on and off, and seems very friendly and used to humans being around.

The other day it came to my apartment, so i gave him some food, after eating, it was playing with me and its paw brushed my finger and I got a scratch. There was a little blood, I washed the finger immediately with soap, and Detol (anti-bacterial solution). I saw the cat the next day, it was in my apartment for food again, and I didn't notice anything different.

But I am worried because I don't see the cat every day. Even before this encounter, the cat wouldn't come to my apartment every day. Should I be worried Doctor about rabis transmission? Please I appreciate your quick response, this happened 5 days ago.

I got the 5 doses of anti rabis vaccine on a previous occasion in 2014 March, as I encountered a similar situation with a kitten, however it turned out that there was nothing wrong with the kitten. This happened when I was based in Asia. Should this have any protection for me from further animal contact?

Thank you very much
SNZ
doctor
Answered by Dr. Divakara 2 hours later
Brief Answer:
Need to get 2 dose rabies vaccine.

Detailed Answer:
Hi

Greetings from Dr Divakara P.
Thanks for posting your query.

Well if you can observe the cat for 5 more days and cat is normal in these 5 days then no need to take vaccine.

But if you can't observe the cat then it would be better you take the vaccine . Since you have previously taken one full course of rabies vaccine before now only two dose vaccine is sufficient.

Hope this information was useful to you.
Any clarification feel free to ask.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara 2 hours later
Dear Doctor,

Thank you very much for the response.

Are 2 doses as you have recommended sufficient only if post-exposure vaccination with rabies immune globulin was given?

I am not sure if I received rabies immune globulin with the post-exposure vaccination? Is there a way to find this out? The vaccination course (on D0, D3, D7, D14, D28) I was given was Verorab. The sticker on the vial says the below.

"prepared on cell cultures (inactivated) vacuna antirabica. I dose/dosis (≥2.5UI/IU), Via IM"


Isn't there a danger in waiting for another 5 days?
doctor
Answered by Dr. Divakara 31 hours later
Brief Answer:
2 dose course is irrespective of Immunoglobulin intake.

Detailed Answer:
HI

The 2 dose of Rabies vaccine can be taken even if you have taken only Rabies Vaccine and not Anti rabies Immunoglobulin . So there is no need for testing whether you have been given any Immunoglobulins.

What you have taken is Rabies Vaccine and not Immunoglobulin. Well Rabies Vaccine is better if given early but every vaccine comes with risk of serious side effects , so if there is a chance that a vaccine can be safely avoided then why not !!.

If you can observe the cat then you can wait else start it immediately.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara 47 minutes later
Thank you Doctor.

I was very worried because as I mentioned before, i usually don't see the at everyday. I got confirmation that it's not owned by the landlord. Last night I was having a little fever and could not sleep well. I visited the health center today and the doctor also told me to wait for a few more days. He told me that I am just being paranoid. He said symptoms in humans appear after 7 weeks, so the fever was unrelated. When I told him of my history of taking Verorab and that I'm concerned bcoz I don't usually see the cat everyday, he prescribed 2 doses with a tetanus booster.

What are the side effects associated? Should I be worried? I thought the vaccine is anyway given to ppl when they travel to high risk countries as a precaution even when they have no exposure to an animal, therefore would a vaccine be prescribed this way if there were high risks involved?
doctor
Answered by Dr. Divakara 21 hours later
Brief Answer:
No need to worry.

Detailed Answer:
HI

Your doctor is right , fever is unrelated to Rabies as it takes 4 weeks to 3 months to develoop symptoms . So just relax. No need to worry.

Yes Rabies vaccine is given before animal bite also ( called as Pre exposure prophylaxis ) and also given after animal bite ( called as Post exposure prophylaxis )

So don't be worried , in my opinion if you can't observe the cat then better get the 2 dose Rabies shot.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara 4 minutes later
Dear Doctor, thank you very much for all the information and assistance. I am a bit of an anxious type, runs in the family.
doctor
Answered by Dr. Divakara 2 hours later
Brief Answer:
Welcome.

Detailed Answer:
HI

You are welcome .

Relax again .
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Divakara

Internal Medicine Specialist

Practicing since :2006

Answered : 2358 Questions

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