Safety and Non-Suppressive Effect of a Puri(cid:976)ied F(ab’)2 Equine Rabies Immunoglobulin in WHO Category III Rabies Exposed Patients
Jatuporn Sirikun MD1, Ploypailin Ratanachinakorn MD1, Somphon Roeksomtawin MD1, Athiwat Primsirikunawut DVM2
Affiliation : 1 Division of Trauma Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand 2 National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
Background : Early management of rabies post-exposure patients with rabies immunoglobulin [RIG] is highly recommended in
WHO category III of rabies exposure. Equine rabies immunoglobulin [ERIG] is as economical and effective as compared to human
rabies immunoglobulin [HRIG] but more affordable to patients in developing countries.
Objective : To evaluate safety and suppressive effect of a F(ab’)2 ERIG (VINRAB®) in WHO category III rabies exposed patients.
Materials and Methods : Eligible patients received wound treatment, single dose ERIG around the wound and intramuscularly
[IM], and 5-dose puri(cid:976)ied chick embryo cell [PCEC] rabies vaccine (Essen regimen, 1.0 ml IM on days 0, 3, 7, 14, and 28). Sera
before immunization were tested for rabies viral neutralizing antibodies by RFFIT on days 0, 7, 14, and 28. The adverse reaction
was monitored for 60 days.
Results : The results showed on day 14, 100% of the patients had seroconverted without suppressive effect. No serious adverse
reactions or immediate reaction were observed.
Conclusion : The puri(cid:976)ied F(ab’)2 ERIG is considered well tolerated and can be utilized in parallel with standard IM dose of the
PCEC rabies vaccine.
Keywords : Rabies, Safety, Non-suppressive effect, ERIG, Post-exposure prophylaxis, Rabies antibodies, RFFIT
