Concepción Ladrón de Guevara García
A patient returned from Algeria showing a grade III wound (WHO standard) produced by a dog bite, was treated with rabies nerve tissue vaccines (NTVs) lacked the rabies immunoglobin, and developed a visible local reaction to the vaccine.
The last WHO position paper (2010) recommends replacing nerve-tissue vaccines with CCVs. The nerve tissue vaccines induce more-severe adverse reaction sand are less immunogenic than CCVs.
It should be assessed in travellers to areas of risk, pre-exposure vaccination, and eliminated the need to the use of rabies globulin post exposition, and avoid as much as possible the use of of nerve-tissue vaccines.