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LETTER TO THE EDITOR Table of Contents   
Year : 2014  |  Volume : 11  |  Issue : 4  |  Page : 371
Dog bite injuries of genitalia and rabies immunisation


Department of Pediatric Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, S. Andrea delle Fratte, Perugia, Italy

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Date of Web Publication17-Oct-2014
 

How to cite this article:
Bertozzi M, Appignani A. Dog bite injuries of genitalia and rabies immunisation. Afr J Paediatr Surg 2014;11:371

How to cite this URL:
Bertozzi M, Appignani A. Dog bite injuries of genitalia and rabies immunisation. Afr J Paediatr Surg [serial online] 2014 [cited 2019 Dec 12];11:371. Available from: http://www.afrjpaedsurg.org/text.asp?2014/11/4/371/143183
Sir,

We read with interest the letter "Dog bite injuries of genitalia." [1] We can understand the concern of the authors regarding the administration of immunoglobulin reported in our previous manuscripts. [2]

We agree that the use of immunoglobulin should be based on the severity of the wound, but how can we measure the danger of a wound if a true exposure to rabies was defined as a bite or contamination of a person's mucous membranes or open wounds with saliva from a laboratory-confirmed or clinically rabid animal?

Of course, postexposure vaccination is not necessary in case of checked family dog. [3]

In the case of need, human rabies can be prevented by postexposure vaccination with or without immunoglobulin injection even if a dramatic reduction of human rabies deaths in Thailand was achieved largely by the provision of expensive World Health Organisation standard postexposure treatment, utilising modern tissue culture vaccines and immunoglobulins. [4]

The real problems with postexposure prophylaxis are the cost of the vaccine and immunoglobulin as well as the availability of the immunoglobulin. For this reason, preexposure prophylaxis has played a role in decreasing the need for immunoglobulin injection, especially in developing countries where rabies is endemic. [5] We think that in all countries where rabies is endemic, preexposure prophylaxis should be advocated to avoid the need of post-exposure prophylaxis with or without immunoglobulins.

 
   References Top

1.
Pokee N, Wiwanitkit V. Dog bite injuries of genitalia. Afr J Paediatr Surg 2014;11:200.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Bertozzi M, Appignani A. The management of dog bite injuries of genitalia in paediatric age. Afr J Paediatr Surg 2013;10:205-10.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Bertozzi M, Prestipino M, Nardi N, Falcone F, Appignani A. Scrotal dog bite: Unusual case and review of pediatric literature. Urology 2009;74:595-7.  Back to cited text no. 3
    
4.
Sriaroon C, Sriaroon P, Daviratanasilpa S, Khawplod P, Wilde H. Retrospective: Animal attacks and rabies exposures in Thai children. Travel Med Infect Dis 2006;4:270-4.  Back to cited text no. 4
    
5.
Permpalung N, Wongrakpanich S, Korpaisarn S, Tanratana P, Angsanakul J. Trend of human rabies prophylaxis in developing countries: Toward optimal rabies immunization. Vaccine 2013;31:4079-83.  Back to cited text no. 5
    

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Correspondence Address:
Dr. Mirko Bertozzi
S.C. Di Clinica Chirurgica Pediatrica, Università Degli, Studi Di Perugia, Ospedale S. Maria della Misericordia, S. Andrea delle Fratte, 06100 Perugia
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0189-6725.143183

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