Respuesta del Experto a …
Inmunoprofilaxis antirrábica tras mordedura de perro.
Pregunta
7-year-old boy was bitten by a dog in Ethiopia on 15/9/12 am.
Dog has full rabies vaccination and the doctors here are telling me that my son does not need rabies shots. Please, could you confirm this or do you recommend vaccination for the boy anyway? Thanks in advance, Markus C.
Respuesta de José Antonio Navarro (18 de septiembre de 2012)
Generally speaking a dog, cat, or ferret with a history of continuously current vaccination (i.e., no substantial gaps in vaccination coverage) is unlikely to become infected with rabies (1) but a history of rabies vaccination in an animal is not always a guarantee that the biting animal is not rabid. Animal vaccine failures may occur because of improper administration or poor quality of the vaccine, poor health status of the animal, and the fact that one vaccine dose does not always provide long-lasting protection against infection in dogs (2). In most situations in developing countries, the vaccination status of the implicated animal alone should not be considered when deciding whether to give or withhold prophylaxis (3).
Therefore with the limited data provided, my personal opinion is to proceed with a full course of postexposure prophylaxis (vaccine plus specific immunoglobulin).
References
1. Centers for Disease Control and Prevention. Human Rabies Prevention — United States, 2008 Recommendations of the Advisory Committee on Immunization Practices. MMWR Early Release 2008;57
2. WHO expert consultation on rabies. First Report.WHO Technical Report Series 931. Available on: http://www.who.int/rabies/trs931_%2006_05.pdf
3. World Health Organization. Rabies Vaccine: WHO Position paper. Wkly Epidemiol Rec 2010;85:309-320
