When should immunoglobulin be given after a tick bite? - briefly
Rabies immune globulin should be administered promptly after a potentially rabid tick bite, preferably within 24 hours and before the first dose of rabies vaccine. It is injected both around the wound and intramuscularly to provide immediate passive immunity.
When should immunoglobulin be given after a tick bite? - in detail
Immunoglobulin administration after a tick attachment is reserved for situations in which rabies exposure is plausible. The decision rests on three criteria: the tick species is known to feed on rabid mammals, the bite occurred in a region with confirmed rabies circulation, and the animal source cannot be observed or tested. When these conditions are met, passive‑immunisation must be initiated promptly.
The first dose of rabies‑specific immunoglobulin should be infiltrated into and around the bite wound as soon as possible after exposure, ideally within the first 24 hours. If immediate infiltration is not feasible, the product may still be given up to seven days post‑exposure, but efficacy declines with delay. Simultaneous administration of the first rabies vaccine dose is required; the immunoglobulin provides immediate neutralising antibodies, while the vaccine induces active immunity.
Key points for proper use:
- Clean the wound thoroughly with soap and water; irrigate with antiseptic solution.
- Calculate immunoglobulin dose based on body weight (20 IU/kg for human rabies immune globulin, 40 IU/kg for equine preparations).
- Inject the calculated volume into the wound site(s); any remaining volume is administered intramuscularly at a site distant from the vaccine injection.
- Begin the vaccine schedule on day 0, then on days 3, 7, 14, and 28 (or as per updated WHO recommendations).
- Document the exposure details, product batch number, and administration times for follow‑up.
If the bite does not satisfy the rabies risk criteria, immunoglobulin is not indicated; prophylactic antibiotics for bacterial tick‑borne infections may be considered instead. Continuous monitoring of the wound and observation of the tick’s host, when possible, support appropriate post‑exposure management.