Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 2;17(12):5355-5360.
doi: 10.1080/21645515.2021.2013079. Epub 2022 Jan 21.

Defining the volume of rabies immunoglobulins/ rabies monoclonal antibodies requirement for wound infiltration of category III animal exposures - an exploratory study

Ravish S Haradanhalli  1 , Nitu Kumari  2 , Mysore K Sudarshan  1 , D H Ashwath Narayana  1 , Ramya M Prashanth  3 , Jithin Surendran  1
Affiliations

Defining the volume of rabies immunoglobulins/ rabies monoclonal antibodies requirement for wound infiltration of category III animal exposures - an exploratory study

Ravish S Haradanhalli et al. Hum Vaccin Immunother. .

Abstract

WHO recommends infiltration of rabies immunoglobulins/rabies monoclonal antibodies as anatomically possible, into or close to all category III animal bite wound(s)/exposures for post exposure prophylaxis. The volume required for wound infiltration depending upon the site/size/severity of wound is yet to be defined for guiding the treating physicians. This study aimed to determine the volume of rabies immunoglobulin/rabies monoclonal antibody required for wound infiltration depending upon the site, size, and severity. A prospective cohort study was conducted including category III animal exposures at the anti-rabies clinic, KIMS hospital and Research Center, Bangalore, India. The volume of rabies immunoglobulins/rabies monoclonal antibodies required for wound infiltration, depending on site, severity, and size was determined. All the subjects were followed for 6 months to demonstrate the safety and clinical efficacy of post exposure prophylaxis. The present study included 717 subjects having 1428 bite wounds. There was a significant difference in the median volume required for wound infiltration based on site, size, and severity of bite wounds. However, on pairwise comparison; the median volume among all the pairs for only wound size was found to be statistically significant. Supportively, a strong positive correlation was seen with the size of wound and volume infiltrated. The volume of rabies immunoglobulin/rabies monoclonal antibodies required for wound infiltration shall be determined according to size of wounds, i.e. 1 ml for <1 cm wound, 3 ml for 1-5 cm wound, and 5 ml for >5 cm wound.

Keywords: post exposure prophylaxis; rabies immunoglobulins; rabies monoclonal antibodies; volume; wound infiltration.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Graph 1.
Graph 1.
Correlation between size of wound and volume of RIG/RMAb required.
Picture 1.
Picture 1.
Wound infiltration of RIG/ RMAb in difficult areas.
See this image and copyright information in PMC

References

    1. Weekly Epidemiological Record . Rabies Vaccines: WHO Position Paper No 16. World Health Organization; 2018. Vol. 93, p. 201–20.
    1. Tarantola A. Four thousand years of concepts relating to rabies in animals and humans, its prevention and its cure. Trop Med Infect Dis. 2017; 2:E5. doi:10.3390/tropicalmed2020005. - DOI - PMC - PubMed
    1. World Health Organization . WHO South East Asia region strategic framework for elimination of human rabies transmitted by dogs in the South-East Asia region. Geneva (Switzerland): World Health Organization, Regional office for South East Asia; 2012.
    1. Wilde H, Khawplod P, Khamoltham T, Hemachudha T, Tepsumethanon V, Lumlerdacha B, et al., Rabies control in South and Southeast Asia. Vaccine. 2005;23:2284–89. doi:10.1016/j.vaccine.2005.01.030. - DOI - PubMed
    1. Gongal G. Introduction of intradermal rabies vaccination–a paradigm shift in improving post-exposure prophylaxis in Asia. Vaccine. 2018;37(1):94–98. doi:10.1016/j.vaccine.2018.08.034. - DOI - PubMed