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Rabies — SCE Infectious Diseases MCQ

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ModerateTravel Medicine & VaccinationRabiesSCE Infectious Diseases

A 45-year-old woman is bitten by a dog in Bali, Indonesia. She did not receive pre-exposure rabies vaccination. The wound is on her hand. She presents to a local clinic 6 hours after the bite. What is the most appropriate post-exposure prophylaxis?

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Correct answer: B — Wound cleaning plus rabies immunoglobulin infiltrated around wound plus rabies vaccine (days 0, 3, 7, 14)

A dog bite in a rabies-endemic country (Indonesia) is a WHO Category III exposure requiring urgent post-exposure prophylaxis: thorough wound cleaning (soap and water for 15 minutes, then povidone-iodine), rabies immunoglobulin (RIG) infiltrated around the wound, and intramuscular rabies vaccine course (Essen regimen: days 0, 3, 7, 14; some schedules include day 28). RIG is essential for Category III exposures in unvaccinated individuals as it provides immediate passive immunity while the vaccine generates active immunity. Previously vaccinated individuals do not need RIG.

Reference: WHO 2024 – Rabies post-exposure prophylaxis; UKHSA 2024 – Rabies post-exposure guidelines