Sex: M
Vaccine: RAB
Symptoms: Death, Inappropriate schedule of product administration, Rabies
Clinical narrative: This case was reported in a literature article and described the occurrence of rabies in a 6-year-old male subject who received Rabies Vaccine for prophylaxis. Co-suspect products included equine rabies immune globulin vaccine for prophylaxis. Concurrent medical conditions included dog bite (bitten on the head area (category 3 exposure) by a sick dog). On an unknown date, less than a year after receiving Rabies Vaccine, the subject developed rabies. Serious criteria included death and GSK medically significant. Additional event(s) included inappropriate schedule of vaccine administered. The outcome of rabies was fatal in June 2014. The outcome(s) of the additional event(s) included inappropriate schedule of vaccine administered (unknown). The subject died in June 2014. The reported cause of death was rabies. The investigator considered that there was a reasonable possibility that the rabies may have been caused by Rabies Vaccine. Additional information was provided. This case was reported in a literature article and described the occurrence of rabies in a 6-year-old male who was vaccinated with unspecified rabies vaccine (manufacturer unknown) for prophylaxis. This case corresponds to discussion section in this literature article. The patient was a part of the study to determine the epidemiologic characteristics of patients associated with delays in the initiation and completion of post-exposure prophylaxis (PEP). In this study, a retrospective review of all patients seen at the ten provinces between January 1, 2014-December 31, 2016 was performed. The patient had an unknown rabies vaccination history. On unspecified date in May 2014, the patient was bitten on the head area (comprised of bites to the head, face and neck area) by a sick dog. The exposure was defied as category 3 exposure (includes single or multiple transdermal bites or scratches, licks on broken skin). [In this study, "Sick" category refers to animals showing signs of weakness and inability to eat]. No information on patient's family history or concomitant medication was provided. On unspecified date between May 2014 and June 2014, 2 days after the exposure, the patient received one dose of unspecified rabies vaccine (administration site and route unspecified; batch number not provided) instead of the World Health Organisation (WHO) recommended 1st dose of vaccination on the day of rabies exposure (Day 0). The patient additionally received Equine rabies immune globulin (eRIG). [In this study, based on WHO guidelines, patients receiving five doses of intramuscular vaccine and eight doses of intradermal vaccine were considered fully vaccinated. Patients receiving at least one dose were classified as vaccinated.]. The age of vaccination was either 6 or 7 years. On unspecified date between May 2014 and June 2014, an unknown period after vaccination, the patient developed unspecified symptoms of rabies and subsequently died about 6 days later in June 2014. The cause of death was rabies. It was unknown if autopsy was performed. This case has been considered serious due to death. Treatment was unknown. The authors did not comment on the relationship of rabies with unspecified rabies vaccine. The authors concluded, "Country has made tremendous progress towards reducing the burden of rabies. However, despite the wide availability of PEP, we found relatively low rates of vaccine completion. Our findings suggest provider training and patient education is needed to ensure appropriate treatment is completed. Moreover, our data suggest changes to information reported through the national surveillance system for monitoring good clinical practice for rabies prevention and control. This is 1 of the 3 valid cases reported in the same literature article.; Reported Cause(s) of Death: rabies.