A 5-year-old boy was bitten on the forearm by a stray dog; the wound is bleeding and more than skin deep. After thorough washing with soap and water for 15 minutes, what additional post-exposure prophylaxis is required?

• A Rabies immunoglobulin infiltrated into the wound plus a full vaccine course ✓
• B Intradermal rabies vaccine alone on days 0, 3, 7 and 28
• C Tetanus toxoid alone, with observation of the dog for 10 days
• D Oral doxycycline for 5 days and wound dressing only

Explanation

B transdermal bite that draws blood is a Category III exposure under national rabies guidelines, requiring immediate wound washing, rabies immunoglobulin infiltrated into and around the wound, and a complete vaccine series. Immunoglobulin provides passive protection during the window before active antibody develops. Vaccine alone without immunoglobulin is inadequate for Category III wounds, which rules out option B.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.