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Taken Rabipur Vaccine. What Are The Chances Of Rabies Through Non-bite Exposure? Have Pimples And Mouth Ulcers

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Posted on Thu, 4 Oct 2012
Question: dear sir

i want ask question regarding rabies vaccine .

1)i had taken 5 doses of rabipur vaccine in month of april 2012 as per WHO schedule day 0,3,7,14,28 . my question is that i travelling too much on highways and in india highways so many dogs died on roads some times we walking near dead body of dog its a normal scene in india .what are chances of rabies through non bite exposure to the person who take 5 doses of rabies vaccine one month before ? i asking this question because sometime person have small pimples on any part of body or any small cut on skin or sometimes mouth ulcers .my question is that if a person who take 5 doses of rabipur vaccine(WHO P.E.P SCHEDULE) one month before traveling too much on highways where so many dogs died on road with mouth ulcer or anycut in skin have take vaccine again ?
doctor
Answered by Dr. Neelam Ashish Vanjari (8 hours later)
Hi XXXXXXX,
Thanks for writing in
The exact risk of getting infected from dead animals is not known, as extensive studies have not been done on it.
But there are chances of getting infected with rabies, even if person comes in contact with dead animals through their body secretions and saliva, even aerosol exposure is possible.

So you have to consider rabies pre-exposure prophylaxis. Part of it, you have completed i.e 5 doses of rabipur vaccine ( which you had taken last month)

As of now, you need to continue doing serological testing every year. This means that you need to get your anti-rabies antibody levels tested each year. You need to take booster vaccination if antibody titre falls below acceptable level i.e. 0.5 IU/ml.

Booster immunization consists of 1 dose of human diploid cell (rabies) vaccine or purified chick embryo cell vaccine, 1.0-mL dose, intramuscular (deltoid area).

Remember, you do not need booster dose now. Take booster only if antibody level falls below 0.5 IU/ml. At present, you are adequately protected and you dont need to worry about this aspect.

I hope I have answered your query. In case of doubt, I will be happy to help you.

Best regards,
Dr. Neelam.


Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Neelam Ashish Vanjari (39 hours later)
hi doctor

my follow up questions

1) i take last dose(5th) of rabipur vaccine on 9th April 2012 . my question is am i safe i travelled too much in first week of may 2012 on highway where so many dogs dead (normal scene on indian roads )with small mouth ulcer and pimples ? am i safe ?

2) is there any restriction on any medicine or food after taking rabipur vaccine ?

3) name of serological test for checking antibodies ?

4)if serological test facility not available can i take rabipur booster dose after one year for continious protection ?
5)i taken last dose |(5th dose ) on 9th april 2012 when booster is due for continious protection

according to your answer at present no need of serological test or rabipur booster dose am i right ?
6) my all above question 1,2,3,4,5 are regarding non -bite exposure


7) is there any safe period after taking 5 doses of rabipur vaccine if re-exposure(non -bite ) occurs again ?
doctor
Answered by Dr. Neelam Ashish Vanjari (3 hours later)
Hi XXXXXXX,
Thanks for writing back.
The first thing that I would like to tell is that you do not need to worry.

1] As you have taken five doses of rabipur vaccine, you are safe to move on highways.

2] There is no restriction on food or medicine after taking rabipur.

3] Serological test for antibodies is - rapid fluorescent focus inhibition test.

4] Do not take unnecessary booster without doing serological test.

5] Your next booster due will be on 9 April 2013, if SEROLOGICAL TEST IS POSITIVE.

6] Presently you do not need booster or serological testing.

7] The fact that you have gotten yourself vaccinated, treatment is simplified in case you are exposed. You no longer need rabies immune globulin and decreases the number of doses of vaccine needed after an exposure. This is important because many people at high risk may be working in areas where they may not be able to get immediate medical attention, or where immunizing products are not readily available.

No specific time duration is documented as safe. But this vaccination decreases risk as mentioned in point no.7.

I hope I have clarified your doubt. Revert back in case of other doubts, I will be happy to help.

Wish you good health.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Neelam Ashish Vanjari (19 hours later)
Thanks Dr XXXXXXX

i am very satisfied by your answers .i have few question in my mind can you clear my doubts

1)if any bite exposure occurs to me in future e.g after 8 month or 9 month or 1 yr .how many doses of rabies vaccine(rabipur ) required that time ?that time if rabipur is not available can i go for other brand like rabivax (HDCV)? i m asking this question because i take 5 doses of rabipur if in future rabipur((PCECV) is not available than booster dose of HDCV is effective ?

2)my question is that when i am taken 5 doses of rabipur i see empty vaccine bottle remains 1or 2 small drops of vaccine left in bottle every time because after trying so much these drops not come out ? is this affect antibodies ?am i safe ?

3)can i donate blood now or any restriction on blood donation ?

4)i want to take vaccination of hepatitis A,B ? can i take now ? if your answer is no after how much i take hepatitis vaccine?

these are final doubts in my mind
really thankful to you

XXXXXXX
doctor
Answered by Dr. Neelam Ashish Vanjari (26 hours later)
Hi XXXXXXX,

Thanks for writing back.

1) If any bite occurs in future, you need to take 2 doses of rabipur. If rabipur is not available, you may go for rabivax.

2) It is fine if you lose out 2 to 3 drops of the vaccine. You are still safe. It does not affect the antibodies.

3) Yes, you can donate blood now. There is no restriction to it.

4) You can take the vaccines for Hepatitis A and B now. There is no harm in it.

All the best.

Regards,
Dr. Neelam

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Neelam Ashish Vanjari (3 days later)
HI Dr XXXXXXX

thanks for your answer little confusion in my mind

1) As u told me before( Your next booster due will be on 9 April 2013, if SEROLOGICAL TEST IS POSITIVE) but if my SEROLOGOCAL TEST IS NOT POSITIVE than what i do ?when next serologiocal test due if my test is not positive ?after one year or six months ?

2) When i was go to hosiptal to take 5 doses of Rabipur vaccine . i see nurse take out vaccine from Refrigerator and after taking out vaccine and before reconstitution(freeze-dried powder that must be mixed with a liquid – a process known as 'reconstitution) vaccine is out of Refrigerator 5 to 7 mintues at a room temprature in which air conditinor is working but they administered vaccine immediate after reconstitution . my question is this vaccine is out of refrigerator 5 to 7 minutes before reconstitution . is vaccine effective?.when i asked nurse she say 5 to 7 minutes are normal time there is no need to worry ? what you thinking about that ?

3) Is rabipur vaccine is safe ?can rabipur vaccine cause rabies in any circumstances ?

thanks

XXXXXXX
doctor
Answered by Dr. Neelam Ashish Vanjari (25 minutes later)
Hi XXXXXXX,

Thanks for writing your doubt.

1] If your serological test comes out negative, do not take booster dose.
Your next serological test comes after 1 year i.e. 9 April 2014.
Keep in mind test has to be repeated after 1 year.

2] Leaving vaccine at room temp for 5-7 minutes will not affect its effectivity. Vaccine will still be effective.

3] Yes, Rabipur vaccine is safe. Vaccine will not cause rabies in any circumstances. Vaccine contains inactivated virus which will create antibodies in our body but will not be able to produce disease. So you are safe.
All the best.


Regards,
Dr. Neelam

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Neelam Ashish Vanjari (28 hours later)
hi Dr XXXXXXX

1)as you told me before if any person who received 5 doses of rabipur vaccine and after 6 months again bite exposure occurs . you told me 2 doses of rabipur vaccine on day( 0 and 3) required but if any person take again 5 doses of rabipur instead of 2 doses for re-exposure is he /she is safe ? is over doses effect antibodies in that person ?is that person safe from rabies ?is that person have enough antibodies ? i am asking that question because that person take 5 doses instesd of 2 ?

XXXXXXX
doctor
Answered by Dr. Neelam Ashish Vanjari (22 minutes later)
Hi XXXXXXX,

Thanks again.

In above mentioned condition, person is supposed to take only 2 doses of vaccine.
However in India, sometimes we do find cases we do find cases where doses are missed or received extra doses. But don't worry. Usually vaccine in any circumstances will not cause Rabies.

I would like to ask when that person has received rabies vaccine 5 doses.
Did he experience any symptom after that?

I may be able to assist you better if you can provide me with this information.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Neelam Ashish Vanjari (1 hour later)
Hi Dr XXXXXXX

The person who taken 5 doses(rabipur ) intead of 2 doses(rabipur) he did not experince any special symptoms after that . he is normal .is that person safe from rabies ?is sufficient antibodies against rabies in that person ?

1)i am asking this question to know person who take 5 doses of rabipur again instead of 2 doses had sufficient antibodies ?

2) can over doses taken by him reduce rabies antibodies ?

3) what is overall effect of 3 extra doses of rabipur vaccine taken by him ?
XXXXXXX
doctor
Answered by Dr. Neelam Ashish Vanjari (5 hours later)
Hi XXXXXXX,
Thanks for writing back.
The person who had taken extra doses of vaccine will also be safe from the rabies.
Let me explain the basis behind vaccination. When vaccine is given, inactivated viruses though are not able to produce disease, will provoke immune response in body i.e they enable the body to produce antibodies.
So those extra doses of vaccine too will provoke immune response and antibody number will go up but will never come down.

So answers to above your query are-

1] Person with extra doses of vaccine will be safe with sufficient amount of antibodies.

2] Those extra doses will not reduce antibody number.

3] Overall effect of extra doses will be protection against rabies.

I hope I have answered your query and all your doubts. If you have no more concerns, please close this discussion.

Best regards,
Dr. Neelam.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
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Dr. Neelam Ashish Vanjari

General & Family Physician

Practicing since :2007

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Taken Rabipur Vaccine. What Are The Chances Of Rabies Through Non-bite Exposure? Have Pimples And Mouth Ulcers

Hi XXXXXXX,
Thanks for writing in
The exact risk of getting infected from dead animals is not known, as extensive studies have not been done on it.
But there are chances of getting infected with rabies, even if person comes in contact with dead animals through their body secretions and saliva, even aerosol exposure is possible.

So you have to consider rabies pre-exposure prophylaxis. Part of it, you have completed i.e 5 doses of rabipur vaccine ( which you had taken last month)

As of now, you need to continue doing serological testing every year. This means that you need to get your anti-rabies antibody levels tested each year. You need to take booster vaccination if antibody titre falls below acceptable level i.e. 0.5 IU/ml.

Booster immunization consists of 1 dose of human diploid cell (rabies) vaccine or purified chick embryo cell vaccine, 1.0-mL dose, intramuscular (deltoid area).

Remember, you do not need booster dose now. Take booster only if antibody level falls below 0.5 IU/ml. At present, you are adequately protected and you dont need to worry about this aspect.

I hope I have answered your query. In case of doubt, I will be happy to help you.

Best regards,
Dr. Neelam.