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| Year : 2014 | Volume
: 11
| Issue : 4 | Page : 371 |
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| Dog bite injuries of genitalia and rabies immunisation |
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Mirko Bertozzi, Antonino Appignani
Department of Pediatric Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, S. Andrea delle Fratte, Perugia, Italy
Click here for correspondence address and email
| Date of Web Publication | 17-Oct-2014 |
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How to cite this article:
Bertozzi M, Appignani A. Dog bite injuries of genitalia and rabies immunisation. Afr J Paediatr Surg 2014;11:371 |
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 | |  |
| 1. | Pokee N, Wiwanitkit V. Dog bite injuries of genitalia. Afr J Paediatr Surg 2014;11:200.  [ PUBMED]  |
| 2. | Bertozzi M, Appignani A. The management of dog bite injuries of genitalia in paediatric age. Afr J Paediatr Surg 2013;10:205-10. [ PUBMED] |
| 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. |
| 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. |
| 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. |
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
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0189-6725.143183
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