African Journal of Paediatric Surgery

LETTER TO THE EDITOR
Year
: 2017  |  Volume : 14  |  Issue : 1  |  Page : 18-

Pre-exposure and Post-exposure prophylaxis for dog bites


Beuy Joob1, Viroj Wiwanitkit2,  
1 Sanitation 1 Medical Academic Center, Bangkok, Thailand
2 Department of Medical Science, Faculty of Medicine, University of Nis, Nis, Serbia

Correspondence Address:
Dr. Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok
Thailand




How to cite this article:
Joob B, Wiwanitkit V. Pre-exposure and Post-exposure prophylaxis for dog bites.Afr J Paediatr Surg 2017;14:18-18


How to cite this URL:
Joob B, Wiwanitkit V. Pre-exposure and Post-exposure prophylaxis for dog bites. Afr J Paediatr Surg [serial online] 2017 [cited 2020 Oct 27 ];14:18-18
Available from: https://www.afrjpaedsurg.org/text.asp?2017/14/1/18/226198


Full Text



Sir,

The recent report on 'pre-exposure and post-exposure prophylaxis for dog bites' is very interesting.[1] Bertozzi et al. suggested that 'monoclonal antibodies represent a promising alternative to traditionally used polyclonal products, and countries with chronic shortages of human rabies immunoglobulin (HRIG) and equine rabies immunoglobulin (ERIG) would benefit greatly from replacement of these scarce and expensive polyclonal preparations'.[1] Bertozzi et al. also proposed for special attention to foreign traveller and paediatric patient.[1] We agree for the usefulness of the rabies Ig in preventive role. However, as noted in the previous publication by Pokee and Wiwanitkit, the cost-effectiveness has to be evaluated and reassessed.[2] The very high cost of human-derived type Ig is very expensive and limitedly used in Thailand, where the rabies is highly prevalent. It is confirmed that 'ERIG is a safe and underutilised essential biological when HRIG is not affordable or available'.[3] Furthermore, the safety and side effect of unnecessary Igadministration should be concerned.[4] Unnecessary use should be avoided. Not only the foreign traveller and paediatric patient but also any local patient has to be considered in the same rule since it is no doubt that there can be no natural protective antibody to rabies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Bertozzi M, Rinaldi VE, Cara GD, Appignani A. A glance at rabies pre-exposure and post-exposure prophylaxis for dog bites. Afr J Paediatr Surg 2016;13:107-8.
2Pokee N, Wiwanitkit V. Dog bite, immunoglobulin, and preexposure vaccination. Afr J Paediatr Surg 2015;12:100.
3Wilde H, Chutivongse S. Equine rabies immune globulin: A product with an undeserved poor reputation. Am J Trop Med Hyg 1990;42:175-8.
4Aoki FY, Rubin ME, Friesen AD, Bowman JM, Saunders JR. Intravenous human rabies immunoglobulin for post-exposure prophylaxis: Serum rabies neutralizing antibody concentrations and side-effects. J Biol Stand 1989;17:91-104.