A sustained government community awareness campaign also needs to be mounted, which informs the public on what to do in case of an animal bite. Most are unaware of the immediate precautions which need to be taken. The ‘WHO Guide for Rabies Pre- and Post-exposure Treatment in Humans’ advocates that the general consideration in rabies post-exposure treatment requires administration of purified immunoglobulin and modern vaccine in what are defined as category III exposures. Dramatic decreases in rabies cases among humans have been achieved recently in China, Thailand, Sri Lanka and Latin America, following the implementation of programmes for post-exposure treatment. As per the WHO, category III exposure is defined as single or multiple transdermal bites, scratches of contamination of mucous membrane with saliva.

It is a well-established fact that vaccine administration alone cannot prevent rabies. The rabies immunoglobulin (RIG) also needs to be administered. This is because the vaccine only gives protection after 10-14 days. Thus, for a minimum period of 10-14 days that it takes the vaccine to seroconvert, the victim has no protection from rabies. It is thus essential that the rabies immunoglobulin be administered to any victims who have had category III exposure, as the rabies immunoglobulin, which contains ready antibodies to the deadly rabies virus, provides immediate protection against rabies in this window period.

The administration of RIG would give protection to the victim even if bitten by a rabid animal. When the rabies immunoglobulin is not given in such a case, it leads to a typical case of a ‘vaccine failure’ and death. To understand better how the vaccine and immunoglobulin work, it is useful to look at what is done in the case of a snake bite. In case one is bitten by a snake, the anti-snake venom serum is administered. This contains ready anti-bodies to the specific snake venom, and thus saves the life of the victim, even if the snake is poisonous. No vaccine is administered in the case of a snake bite. The rabies immunoglobulin works exactly as do these anti-venom serums.

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