Hi, I am very familiar with the VERORAB vaccine, which you should have received in six doses: on Days 0, 3, 7, 14, and 28 with an optional dose on Day 90. This was given to you as a post-exposure treatment because, according to you, the animal was looking very ill then (“like a rabid animal”, according to you). If the vaccine was correctly refrigerated at 2-8 degrees centigrade and correctly administered, it should provide protection for 2 years. In fact, humans at high risk of contracting rabies (such as veterinarians, gamekeepers, hunters, forest rangers, slaughterhouse personnel, taxidermists) are advised to take a prophylactic dose of Rabies Vaccine on Days 0, 7 and 28 (3 doses only) with booster doses every 2-3 years. This is the recommendation in the British National Formulary, March 2004 Edition. In your own case, you received six doses, which should provide an equally good protection for two years, assuming again that the vaccine’s potency was not affected by poor storage and it was properly administered. I am very concerned at the statement you made that the dog was not vaccinated by “a licensed animal doctor”. Who supplied or administered the vaccine? Vaccine failure is common if the product is not properly stored or administered. If, as you claim, your dog is “normal” at the present time, it could not be harbouring rabies virus in the saliva, so there is no possibility of contracting rabies. Are there cases of rabies in Singapore? Post-exposure prophylaxis depends on the level of risk in the country, the nature of exposure and the individual’s immune status. In respect of your cut, I am more concerned about your tetanus immunisation status. Please ensure that this is up-to-date. The WHO recommendations for rabies prophylaxis are clear and straightforward: for a live, non-suspect dog or cat, place the animal under veterinary supervision for a minimum of 10 days and postpone rabies post-exposure treatment for the patient; for a live, suspect dog or cat, place the animal under veterinary supervision for a minimum of 10 days and commence rabies post-exposure treatment for the patient immediately. Treatment is stopped if the supervision invalidates the initial doubts, otherwise treatment is continued. Thank you for contacting our website. I hope I have answered the questions you raised in your second mail. Dr Anthony Solomon MB BS DTM&H DIP.VEN FRSM Consultant Physician, Tropical & Genitourinary Medicine
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