Can anti-rabies injection be given in case of cat bite?

Q: My 23 years old daughter has been bitten by a cat on the hand about 26 days back. There was no cut mark on the skin, although a blue mark was visible below her thumb. She washed her hands thoroughly and applied an anti-bacterial lotion. The doctor gave her a tetanus injection and nothing more. Another doctor now told us that an anti-rabies injection should have been given and that it is too late now to do anything. The cat was seen moving around about 3 days back. Can anti-rabies injection be given to her?

A:There are no clear guidelines about prophylactic vaccination against rabies for cat bites or scratches. According to a committee report of the experts by the Indian Academy of Pediatrics (IAPCOI), observation of the biting animal is one of the important steps of prevention. They recommend that "the treatment may be modified if animal observed (dog or cat) healthy throughout an observation period of 10 days by converting post-exposure prophylaxis (PEP) to pre-exposure prophylaxis by skipping the vaccine dose on day 14 by administering on day 28." As per this schedule, rabies vaccination is necessary. The recommended pre-exposure vaccination includes three doses of a cell culture vaccine (CCV) administered on days 0, 7 and 21 or 28. There are no recommendations for missed prophylaxis.