Date: Mon 31 Dec 2018
Source: Outbreak News [edited]
A 5-year-old boy died Saturday [29 Dec 2018] in a Santo Domingo hospital from rabies, the 4th such case of the year  in the Dominican Republic, according to an El Comercio report (computer translated).
The child, who entered the Robert Reid Cabral Children's Hospital 10 days ago, remained in an induced coma, and yesterday his condition began to worsen, presenting respiratory, cerebral, and cardiac failures, according to a hospital spokesman.
The boy was bitten by a dog on 19 Nov 2018 in Pedernales, in the southwest of the Dominican Republic, and 10 days later he was subjected to an anti-rabies vaccination scheme, receiving 4 doses.
This death follows a 6-year-old child who died on 14 Dec 2018.
[We do not know what kind of wound care this child received prior to getting the post exposure prophylaxis (PEP). Neither does this article tell us the location of the bite on the body. This article also does not mention rabies immunoglobulin (RIG).
We are sorry for the family and the loss of this child. Sadly, this is an example of the urgency and necessity to get medical attention very quickly.
According to the US Center for Disease Control (CDC),
- The rabies virus is transmitted through saliva or brain/nervous system tissue. You can only get rabies by coming in contact with these specific bodily excretions and tissues.
- It's important to remember that rabies is a medical urgency but not an emergency. Decisions should not be delayed.
- Wash any wounds immediately. One of the most effective ways to decrease the chance for infection is to wash the wound thoroughly with soap and water.
- See your doctor for attention for any trauma due to an animal attack before considering the need for rabies vaccination.
- Your doctor, possibly in consultation with your state or local health department, will decide if you need a rabies vaccination. Decisions to start vaccination, known as post exposure prophylaxis (PEP), will be based on your type of exposure and the animal you were exposed to, as well as laboratory and surveillance information for the geographic area where the exposure occurred.
- In the USA, post exposure prophylaxis consists of a regimen of one dose of immune globulin and 4 doses of rabies vaccine over a 14-day period. Rabies immune globulin and the 1st dose of rabies vaccine should be given by your healthcare provider as soon as possible after exposure. Additional doses or rabies vaccine should be given on days 3, 7, and 14 after the 1st vaccination. Current vaccines are relatively painless and are given in your arm, like a flu or tetanus vaccine (<https://www.cdc.gov/rabies/exposure/index.html
>). - ProMED Mod.TG]
Pedernales, Pedernales, Dominican Republic: