436 Section 13/ Miscellaneoushumans. The virus usually spreads by
contact with infected individuals via the
water borne route, though mouth-to-mouth
transmission is also possible. The disease
typically affects very young children, with
80 to 90 percent of cases occurring in
children under three years of age.
Polio is a highly contagious disease. By the
time first case is detected in a family, all family
members may have probably been infected
due to the rapidity of viral spread. Viral spread
is enhanced by crowding and poor sanitation.
The most prominent example of the
effectiveness of OPV is the success of theContd....Table 13.1.3: Immunoglobulins for passive immunization.
Product Dosage Use
Immune globulin Preexposure prophylaxis: 0.02 mL/kg IM for anticipated Hepatitis A
(intramuscular) risk of <3 months, 0.06 mL/kg for anticipated risk of >3
months, repeated every 4 to 6 months for continued
exposure.
Postexposure: 0.02 mL/kg IM immediately after exposure
up to 2 weeks.
Hepatitis B 0.06 mL/kg IM immediately after exposure up to 1 week for Hepatitis B
immune globulin percutaneous exposure or 2 weeks for sexual exposure.
(HBIG) 0.5 mL IM within 12 hours after birth for perinatal exposure.
Immune globulin 400 mg/kg IV daily for 2 to 5 consecutive days, depending Idiopathic thrombocyto-
(intravenous) on platelet count and clinical response or 1 g/kg once daily penic purpura
for 1 day or 2 consecutive days.
Immune globulin 400 mg/kg IV daily for 4 consecutive days within 4 days Kawasaki disease
(intravenous) after the onset of illness. A single dose of 2 g/kg IV over
10 hours is also effective.
Immune globulin Normal hosts: 0.25 mL/kg IM Measles
(intramuscular) Immunocompromised hosts: 0.5 mL/kg IM (maximum
dose of 15 mL).
Immune globulin Minimum effective dosage is 150 mg/kg every 3 to 4 weeks Primary immunodefici-
(intravenous) (serum IgG concentration ≥ 400 mg/dL). ency disorders
Rabies immune 20 IU/kg. Rabies
globulin
RhO (D) immune The usual dose (1 vial) administered IM within 72 Rh isoimmunization
globulin hours after delivery or termination of pregnancy.
Immune globulin 0.55 mL/kg IM Rubella
(intramuscular)
Antivenin At least 3 to 5 vials (30-50 mL) IV initially within 4 hours Snake bite (coral snake)
(Micrurus after the bite. Additional doses may be required.
fulvius), equine
Antivenin The entire dose should be given within 4 hours after Snake bite (pit vipers)
(Crotalidae) the bite by the IV or IM route (1 vial = 10 mL); upto 15
polyvalent, equine vials can be used depending upon the degree of
envenomation.