Practical rabies
Download as PPTX, PDF4 likes1,776 views
The document provides essential information about rabies transmission, symptoms, and post-exposure prophylaxis. Rabies is spread through the saliva of infected animals, with symptoms typically appearing 30 to 90 days after exposure. It also details proper wound treatment, vaccination schedules, and recommendations based on the type of exposure to potentially rabid animals.
Practical rabies
- 1. PRACTICAL RABIES NEHAL VAIDYA MBBS, DCH. POOJAN HOSPITAL BHUJ
- 2. RAPID FIRE
- 3. 1 • The rabies virus is passed on by contact with what part of an infected animal? • A. Skin • B. Saliva • C. Blood • D. Claws • E. B and C
- 4. ANSWER • The correct answer is B. Saliva . • The rabies virus is transmitted to others through the saliva of the infected animal. All mammals can carry the virus. Humans can contract the virus through a bite from the infected animal, or from a scratch, scrape, open wound, or mucous membrane that comes in contact with the saliva. It is not possible to contract the virus by petting a rabid animal or through contact with the blood, urine, or feces of a rabid animal, the CDC says.
- 5. 2 • How soon do symptoms typically appear after a person is infected with the rabies virus? • A. 48 hours • B. 1 week • C. 1 month • D. 1 year
- 6. A • The correct answer is C. 1 month . • Symptoms usually appear 30 to 90 days after exposure. Depending on the severity of the bite and the place on the body that was bitten, symptoms may appear more quickly. In rare cases, however, a person may not develop symptoms until a year or more after exposure.
- 7. 3 • SUTURING WOUND PROTECTS • -TRUE • - FALSE
- 8. A • FALSE • The wound should be cleaned with plenty of soap and water and should be kept open • Suturing or bandaging can help virus replication
- 9. 4 Recently instead of five doses a one dose vaccination schedule is available. - True - False
- 10. A • False • The vaccination schedule for post exposure is 0,3,7,14,28.
- 11. 5 • In non serious cases, you can give anti rabies serum and wait for 7 days before starting vaccination • True • false
- 12. A • False • Both should be started
- 13. HOW RABIES REACHES BRAIN
- 14. Event symptoms Clinical phase Duration Pathogenesis Exposure Bite or scratch from, or mucosal contact with, a rabid animal Fever, malaise, chills, fatigue, insomnia, anorexia, headache, anxiety, irritability Incubation 20–90 days 1. Virus inoculation 2. Virus replicates in the muscle 3. Virus binds to nicotinic acetylcholine receptors Paralytic rabies Flaccid muscle weakness Furious rabies Pain, paraesthesia or pruritus at the wound site Non-specific prodromal phase 2–10 days Ascending spread of flaccid muscle weakness, muscle fasciculations, bilateral weakness of facial muscles, sphincter Involvement Arousal, hyper excitability periods of confusion, hallucinations, agitation and hydrophobia First neurological signs > 10 days 4. Virus travels within the axons in peripheral nerves Onset of coma Acute neurological phase 2–7 days 5. Infection of the brain neurons causing neuronal dysfunction 6. Centrifugal spread along nerves to salivary glands, skin, corneas and other organs Death Coma 0–14 days*
- 15. RAPID LEARNING Category Type of contact with a suspect or confirmed rabid domestic or wild animal, or animal unavailable for testing Recommended post-exposure prophylaxis I Touching or feeding animals, licks on intact skin (i.e. no exposure) No prophylaxis II Nibbling of uncovered skin, minor scratches or abrasions without bleeding • Anti-rabies vaccine immediately • Stop treatment if animal remains healthy throughout an observation period of 10 days III Single or multiple transdermal bites or scratches, licks on broken skin, contamination of mucous membrane with saliva from licks, exposures to bats • Anti-rabies immunoglobulin immediately • Anti-rabies vaccine immediately. • Stop treatment if animal remains healthy throughout an observation period of 10 days*
- 16. RAPID LEARNING • Observation Period, should depend on availability of animal for observation and laboratory testing. • In developing countries like India, the vaccination status of the implicated animal alone should not be considered when deciding whether to give or withhold PEP eg: Stray or Pet dog exposure • Treatment may be modified if animal involved (dog or cat) remains healthy throughout the observation period of 10 days by converting post-exposure prophylaxis to pre-exposure vaccination by skipping the vaccine dose on day 14 and administering it on day 21 or 28 while using Essen Schedule
- 17. DON’Ts AND DOs Magical , religious practices do not help (e.g. witchcraft, turmeric powder etc.) Wash the wound thoroughly with plenty of water and soap Apply an antiseptic (povidone iodine) or alcoholDo not cover or Suture the wound DON’T AT HOME or CLINIC AT CLINIC Cat II & III Cat III
- 18. RAPID LEARNING WHO recommended Essen (5-dose) intramuscular regimen Injected into deltoid (adults) or anterolateral area of thigh (children <2 years)
- 19. PEP: Passive Immunization for Category III exposure RIG administration is must for category III exposure • RIG infiltrated in & around wound/s • Two types of RIG – Human RIG – dose 20 IU/kg of body weight – Equine RIG – dose 40 IU/kg of body weight • RIG provides passive immunity – Immediate access to rabies virus- neutralizing antibodies (RVNA) – Provides protection until active immunity begins – 7-10 days post-vaccination Source: 1. WHO Rabies Report 2010; 2. NCDC Rabies report 2007, Govt. of India
- 20. 20 Re-exposure prophylaxis Only 2 doses to be given to pre-vaccinated (PrEP or PEP) victims x1 x1 Day 0 3 One dose (IM) is administered on Days 0 & 3 No RIG is required • In instances where the biting dog or cat is healthy, vaccinated and available for an observation period of 10 days, one may ensure a proper wound management and defer booster vaccination if the PrEP or previous PEP was completed in the last 3 months. Source: 1. WHO 2004. Rabies Technical Report Series 931; 2. WHO Rabies Report 2010; 3. NCDC Rabies report 2007, Govt. of India; 4. Rabipur PI Injected into deltoid (adults) or anterolateral area of thigh (children <2 years)
- 21. PRE EXPOSURE PROPHYLAXIS • COURSE • 0, 7, 28. • BOOSTERS EVERY 3 YRS
- 22. CATEGORY?
- 23. CATEGORY?
- 24. HOW TO FACE AN ATTACKING DOG?
- 25. ATTACK IF YOU ARE ATTACKED
- 26. THANK YOU