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Am. J. Trop. Med. Hyg., 75(2), 2006, pp. 363-364
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


IS INJECTING A FINGER WITH RABIES IMMUNOGLOBULIN DANGEROUS?

KANITTA SUWANSRINON*, WIPAPORN JAIJAROENSUP, HENRY WILDE, AND VISITH SITPRIJA
Queen Saovabha Memorial Institute, Thai Red Cross Society (WHO Collaborating Center for Research in Rabies), Bangkok, Thailand

 

ABSTRACT

Treating potentially rabies virus infected wounds requires the injection of rabies immunoglobulin into and around the wounds, followed by vaccination with an approved tissue culture rabies vaccine. A significant number of such bite wounds involves fingers where there is little space for expansion. Injecting immunoglobulin into such areas under pressure may induce a compartment syndrome caused by compromising circulation. We carried out a retrospective review and a prospective study of patients seen with digital bite injuries and found that it is a safe procedure if carried out with care by experienced staff.

Received February 22, 2006. Accepted for publication April 30, 2006.

Acknowledgments: The authors thank the nurses and house officers at our animal bite clinic for their enthusiastic help. The American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.

Financial support: This study was supported by the Thai Red Cross Society and was largely carried out at the request of the US Communicable Diseases Centers Rabies Division and WHO. They encountered inquiries regarding the safety of injecting fingers and toes with immunoglobulin. Dr. K. Suwansrinon is a research fellow at the Queen Saovabha Memorial Institute, Mrs. W. Jaijaroensup is a nurse practitioner, and Prof. H. Wilde is a consultant physician at the same institution. Dr. Wilde has been the recipient of travel support from Sanofi-Pasteur, the Swiss Serum and Vaccine Institute, Chiron Corporation, Thai BIOTECH Fund and WHO.

Disclosure: None of the authors have any conflicts of interest to declare.

* Address correspondence to Kanitta Suwansrinon, MD, Queen Saovabha Memorial Institute, Thai Red Cross Society, 1871 Rama IV Road, Bangkok 10330, Thailand. E-mail: sukanitta{at}yahoo.com

Authors’ addresses: Kanitta Suwansrinon, Wipaporn Jaijaroensup, Henry Wilde, and Visith Sitprija, Queen Saovabha Memorial Institute, 1871 Rama IV Rd, Pathumwan, Bangkok 10330, Thailand, E-mail: sukanitta{at}yahoo.com.






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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.