Allergic Manifestations to Equine Rabies Immunoglobulin: A Case Series

Saramma Abraham; Rahul Suresh; Teny George Pallippadan; Soumya Gopakumar; Anuja U

Saramma Abraham Junior Resident, Department of Community Medicine, Government Medical College, Thiruvananthapuram
Rahul Suresh Junior Resident, Department of Community Medicine, Government Medical College, Thiruvananthapuram.
Teny George Pallippadan Junior Resident, Department of Community Medicine, Government Medical College, Thiruvananthapuram.
Soumya Gopakumar Assistant Professor, Department of Community Medicine, Government Medical College, Thiruvananthapuram.
Anuja U Professor and Head, Department of Community Medicine, Government Medical College, Thiruvananthapuram.

Keywords: Rabies, ERIG, skin test, test dose hypersensitivity

Abstract

Introduction: Rabies is a vaccine preventable zoonotic disease, however, if not prevented in time, it may become 100% fatal. Combining vaccine- immunoglobulin therapy with proper wound care is advised for effective rabies prevention. Equine rabies immunoglobulin is cheaper than human rabies immunoglobulin, but there is an increased chance of hypersensitivity reaction following its administration.
Method: A case series study has been presented in this article consisting of three different presentations of hypersensitivity reactions after the administration of equine rabies immunoglobulin.
Results: Two cases developed an immediate allergic reaction after desensitization. The third case showed a delayed local reaction and did not develop any allergy during the skin test before administering the full dose.
Conclusion: In a poor resource setting like India, skin sensitivity testing may be continued to identify high risk patients, and provide desentization, but still allergic reactions may be anticipated for them.

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