A 6-year-old boy is bitten on the forearm by a stray dog that cannot be traced. The wound is deep and bleeding. He received complete pre-exposure rabies vaccination two years ago after an earlier animal bite. What is the correct management now?

• A Wound washing and tetanus prophylaxis only, since he was previously vaccinated against rabies
• B Wound washing, full five-dose vaccine course, and human rabies immunoglobulin infiltrated into the wound
• C Wound suturing immediately, then observation of the dog for 10 days
• D Wound washing, rabies vaccine booster doses, no immunoglobulin needed ✓

Explanation

D person with documented complete pre-exposure or prior post-exposure vaccination needs only wound care and two booster vaccine doses on days 0 and 2. Rabies immunoglobulin is NOT given to previously vaccinated individuals because it can blunt the active immune response, and their primed immune system responds rapidly to boosters. Full course plus RIG applies only to Category III exposure in unvaccinated persons.

Reference: National Rabies Control Programme Guidelines, NCDC India, 2019 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.