Safety of equine rabies immunoglobulin injection into fingers and toes

Background: International guidelines recommend infiltration of Rabies Immunoglobulin (RIG) into and around animal bite wounds in category III potential rabies exposures. This is followed by vaccination with an approved tissue culture rabies vaccine.

Objective: We assessed the feasibility and safety of injecting Equine Rabies Immunoglobulin (ERIG) into anatomical sites with less space for expansion. Methods: A prospective study on 195 patients having category III animal bites over fingers, toes, nose, ear lobule, and eyelids was carried out at the Anti-Rabies Clinic of Maharaja Krushna Chandra Gajapati Medical College, Berhampur, Orissa, India. All patients received Equine Rabies Immunoglobulin (ERIG).

Results: No major side effects were observed. Minor side effects included induration (67.1%), pain (53.8%), and pruritus (29.2%). No compartment syndrome was seen.

Conclusion: Injecting ERIG into and around bite wounds following WHO and US-CDC guidelines in areas where no ample space is available, such as fingers, is a safe procedure.