Resolved question:
Our daughter arrived in India four weeks ago for a 5 month stay. Approximately two months before she left home (Portland OR), she received the rabies vaccination series. She received the last of the three shots in the series on July 16 (about 6 weeks ago). Recently she discovered a live bat in her apartment and two days later she found it dead there. She is wondering if she could have been bitten by the bat during the night and not known it. There doesn't seem to be any place where she lives to get a bat tested for rabies (and and her colleagues say not to be concerned about it). She has questions about the quality of the health care in her area. How important would it be if she were bitten to get additional treatment from a local health provider?
Thanks in advance for your reply.
Submitted:
4 Days
Category:
Family Physician-GP
Hello,
Thank you for asking your query at DoctorSpring.
Since your daughter has completed all the three courses of pre exposure prophylaxis with a time interval of 6 weeks, she should be adequately protected against rabies by now under normal circumstances. However it is not advisable to take chances in cases of Rabies, especially since you are in a high risk country.
The issue here is whether she had a real contact with bat resulting in a bite or scratch. Although some bat bites can go unnoticed, this is not the norm. She should look out for any new bite marks and abrasions.
Testing the bat for rabies won’t be easy in India. And even if there is facility for testing chances that the results might be delayed. Rabies antibody levels of your Daughter can be tested (to see how well she is protected), but again there could be unavailability and/or delay. If there is a strong suspicion of bite, contact and/or if there are visible bite marks I recommend a “Post exposure prophylaxis” for immunised person. This includes two doses of Rabies vaccine – Day 0 and Day 3. This is a safe and easily available option.
The good thing is that since Rabies prophylaxis is commonly given in India, vaccines are easily available and Doctors are experienced in this regard. If you could give your Daughter’s current location in India, I will see whether I can offer any further assistance.
Hope this helps
Please feel free to ask followup questions.
Thank you
Dear Dr. Sebastian,
Thanks so much for your very helpful reply. I will forward the information to my daughter. She is a Fulbright Scholar who is working and living near Maharaja Sayajirao University in Baroda (Vadodara) in the state of Gujarat for about 5 months. Thank you in advance for any additional assistance you might be able to provide.
Sincerely,
John Buntin
buntin.john@gmail.com
Hello Buntin,
The quality of care is acceptable in Vadodara. If a consultation is required, she can choose any of the hospitals like Global Baroda Hospital or the Apollo clinic. There are no 'Family Physicians' in India. So I recommend a consultation with a Specialist in Internal Medicine (MBBS, MD) or a specialist in Social and Preventive Medicine (MD community medicine)
You can get same day appointments with most of the Doctors if needed. Phone is the preferred method.
Hope this helps
Please feel free to ask followup questions.