Dog bite is first washed under running water for 10-15 minutes with soap without scrubbing hard. Bleeding is controlled with a sterile bandage. Betadine type antiseptic is applied. The wound is protected till medical attention is given.
Since a bite can get secondary infection, doctors usually prescribe amoxicillin-clavunate antibiotic.
The treatment consists of rabies vaccine and rabies immunoglobins. Rabies vaccine (IM) can be given in deltoid muscle on day 0, 3, 7 14 and 28 — in all five doses. Another regimen is intradermal on day 0, 3, 7, 28 (4 visits). Two small doses are given in each arm at each visit.
Rabies immunoglobin can be derived from humans. They are called HRIG. They can be derived from horses. They are called ERIG. HRIG is given in a dose of 20 IU per kg of body weight. ERIG is given in a dose of 40 IU per kg of body weight. Immunoglobins are given directly into and around the bite wound.
If tetanus booster has not been taken in the last five years, one can be given a tetanus booster.
Anti-rabies vaccines are available in approximately 80 per cent of public health facilities across India. RIG is not widely available — available to the extant 20 per cent public sector facilities. RIG is available at tertiary and secondary health care facilities. In private sector, hospitals which stock rabies vaccines also stock RIG.
Sassoon experiences shortages of both the vaccine and RIG. PMC facilities maintain adequate supplies, say Naidu, Kamla Nehru, Sonwane. They offer 24×7 dog-bite treatment in Pune.
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