Address correspondence to Kanitta Suwansrinon, MD, Queen Saovabha Memorial Institute, Thai Red Cross Society, 1871 Rama IV Road, Bangkok 10330, Thailand. E-mail:
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.
Expert World Health Organization Committee on Rabies, 1992. Eith Report. Geneva: World Health Organization.
Hemachudha T, Laothamatas J, Rupprecht CE, 2002. Human rabies: A disease of complex neuropathogenic mechanisms and diagnostic challenges. Lancet Neurol 1 :101–119.
Del Pinal F, Herrero F, Jado E, Fuente M, 2001. Acute thumb ischemia secondary to high-pressure injection injury. J Trauma 50 :571–574.
World Health Organization, 1996. Recommendations on Post-Exposure Treatment and the Correct Technique of Intradermal Immunization Against Rabies. Geneva: World Health Organization.
Wilde H, Sirikawin S, Subcharoen A, Kingnate D. Tantawichien T,Harischandra PA, Chaiyabutr N, de Silva DG, Fernando L, Liyanage JB, Sitprija V, 1996. Failure of postexposure treatment of rabies in children. Clin Infect Dis 22 :228–232.
Wilde H, Bhanganada K, Chutivongse S, Siakasem A, Boonchai W, Supich C, 1992. Is injection of contaminated animal bite wounds with rabies immune globulin a safe practice? Trans R Soc Trop Med Hyg 86 :86–88.