ATTENTION is called to pages 53 and 54 of the 1951 report of the above committee (the Red Book). The recommended antirabies serum (Sheep-Lederle) has been withheld by the manufacturers because of allergic reactions accompanying the use of this product. Unfortunately no other rabies antiserum is commercially available at present. Active immunization with rabies vaccine (the Pasteur treatment) remains the sole biologic weapon in rabies prophylaxis in addition to the highly important care of the wound.
The indications for the use of phenolized (Semple type) vaccine are given in the summary. Furthermore, in view of the fact that an antiserum is not now commercially available, an additional indication must be mentioned.
When a child who has had rabies vaccine in the past is re-exposed, the danger of rabies must be balanced against the great risk of inducing treatment paralysis with a second course of vaccine. Sensitization to brain tissue proteins is very likely to exist in such individuals and the rate of neuroparalytic accidents is high. Therefore (in the absence of available antiserum) when a re-exposure with a head, neck, or hand bite occurs a recall series of vaccine injections not to exceed six doses is recommended. The appearance of any sign of a systemic reaction, such as tingling of the extremities, girdle pains, headache, nausea, sphincter disturbances or fever, is a signal for discontinuing vaccine injections.
It should also he noted (page 54) that whereas antirabies serum was recommended in instances of salivary contamination of abraded skin in the absence of teeth marks, Pasteur treatment is not recommended in this situation. Here the risks of treatment outweigh the risks of rabies.
- Copyright © 1952 by the American Academy of Pediatrics