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[indices] rabies vaccination


  • From: "Beverley Snell" <bev@burnet.edu.au>
  • Date: Sat, 28 May 2005 14:32:14 +1000

Dear e-drug friends, kindly send me some supporting document/ your
advise regarding following case.

A buffalo was bitten by a rabid dog. The milk from this infected
buffalo was consumed by some of the people in the village. We wanted
to know whether we have to vaccinate these people or not? Is there a
chance of virus getting transferred through milk?

Waiting for your early reply.

Lakshmi
Drug Information Center
Karnataka State Pharmacy Council
Bangalore
Karnataka,India
kspcdic@blr.vsnl.net.in
--

Note from moderator: Dear Lakshmi - Do you know if the buffalo developed rabies or has been confirmed rabid? Rabies is transmitted to other animals and humans through close contacts with saliva from infected animals (i.e. bites, scratches, licks on broken skin and mucous membranes). (http://www.who.int/zoonoses/diseases/rabies/en/). The rabies virus usually travels along nerves to the spinal cord and then the brain where it replicates (http://www.cdc.gov/ncidod/dvrd/rabies/natural_history/nathist.htm). It is unlikely that the virus would be present in the milk - it is also usually not present in blood.

We had a similar case in Kwa-Zulu Natal, South Africa, where people had consumed the meat of a cow found to be rabid. No post exposure prophylaxis (PEP) was administered.

However, I did a MEDLINE search and found reports of PEP being given to people who had consumed unpasteurised milk from a cow subsequently diagnosed as rabid (MMWR March 26 1999; 48(11): 228-229 (http://www.cdc.gov/mmwr/preview/mmwrhtml/00056759.htm). This is in accordance with recommendations of The National Association of State Public Health Veterinarians (in the United States). However, since rabies virus is inactivated by temperatures below those used for cooking and pasteurization, eating cooked meat or drinking pasteurized milk from a rabid animal is not an indication for PEP. There are anecdotal reports of the presence of rabies virus in milk and this could only really be confirmed if samples of milk are collected and assayed.

>From this information and given that rabies is invariably fatal, these cases should probably be treated as category III exposures and receive full PEP with both rabies immunoglobulin (if it is available) and rabies vaccine.