Vinrab Special Precautions

Despite the high degrees of purification of the serum, it is recommended to perform a skin test before administering ERIG. The skin test consists of an intradermal injection with a 1:10 dilution of ERIG (0.1 mL) on the outside of the forearm so as to obtain an orange ring type appearance (3 mm diameter in duration).
An equivalent intradermal injection of physiological saline solution is used as control. The observations made 15 minutes after intradermal injection is considered to be positive if erythema (>6 mm), local edema or a systemic reaction is observed and this control shows no such dermal reaction. Purified equine rabies immunoglobulin (the active constituent of rabies immunoserum) has been reported to be safe and affordable alternative to human rabies immunoglobulin. (Bulletin WHO 1989, 67 (731-732). A positive test result is not a format contraindication for the use of serotherapy, but it should be considered as a warning. In such cases ERIG should be administered only after ensuring the facility to overcome the anaphylactic shock. A negative test is not an absolute guarantee for the absence of an immediate allergic type reaction.