A 30-year-old man is bitten by a stray dog in rural Maharashtra. The dog was not available for observation. The patient has a deep laceration on the leg. Regarding rabies post-exposure prophylaxis, which schedule is recommended by WHO for a previously unvaccinated individual?
- A Rabies vaccine on days 0, 3, 7, 14, and 28 plus rabies immunoglobulin infiltrated into the wound ✓
- B Single dose of rabies vaccine on day 0
- C Rabies immunoglobulin alone infiltrated into the wound
- D Rabies vaccine on days 0, 7, and 21 without immunoglobulin
Correct answer: A. Rabies vaccine on days 0, 3, 7, 14, and 28 plus rabies immunoglobulin infiltrated into the wound
Explanation
For category III exposure (deep laceration, bite) in an unvaccinated person, WHO recommends both rabies vaccine (Essen regimen: days 0, 3, 7, 14, 28) and rabies immunoglobulin (RIG) infiltrated into the wound. RIG provides immediate passive immunity while the vaccine induces active immunity. Vaccine alone is insufficient for severe exposures.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.