Rabies is a viral disease that causes acute encephalitis
(inflammation of the brain) in warm blooded animals. Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus
3. Definition
Rabies is a viral disease that causes
acute encephalitis
(inflammation of the brain) in warm
blooded animals.
Rabies is a zoonotic disease (a
disease that is transmitted to
humans from animals) that is caused
by a virus
4.
5. INTRODUCTION
The disease infects domestic and wild animals,and is
spread to people through close contact with infected
saliva via bites or scratches.
Dogs are the source of 99% of human rabies deaths
Once symptoms of the disease of the disease develop,
rabies is nearly always fatal
6. SOURCE OF INFECTION
The source of infection to manis the saliva of rabid
animals.
In dogs and cats ,the virus may be present in the saliva
for 3-4 days before the clinical onset and during the
course of illness till death.
7.
8. INCUBATION PERIOD
It is highly variable in man,commonly3-8 weeks
following exposure.
The closure the bite to the brain,the shorter the
incubation.
Rabies virus travels one centimeters per day
12. SIGN & SYMPTOMS
Bizarre behavior
Agitation
Seizures
Difficulty in drinking
Patients will be able to eat solids
Afraid of water – Hydrophobia
Even sight or sound of water disturb the
patient
But suffer with intense thrist
Spasms of pharynx produces choking
Death in 1-6 days
Respiratory arrest/death/some may survive.
13. Continued..
Headache, fever, sorethroat
Nervousness, confusion
Pain and tingling at the site of bite
Hallucinations
Paralysis
16. PRE EXPOSURE PROPHYLAXIS
Provided to subjects at the risk before occupational or
vocational exposure to rabies.
Subject include diagnosticians laboratory and vaccine
workers, vatenarians, cavers.
Simplifies post exposure management.
Only vaccine used.
17. POST EXPOSURE PROPHYLAXIS
Provided to subjects after rabies exposure.
Consist of wound care, rabies immune globulin, and vaccine
Cleansing.
Chemical treatment.
Suturing.
Anti-rabies serum.
Antibiotics and anti-tetanus measure.
Observe the animal for 10 days.
Wash lesions well with soap and water.
Infiltrate rabies immune globulin (20 IU/kg) into and around
the margin of bites.
Administer vaccine around 90 days.
18. RABIES IMMUNOGLOBULIN
Two Human Rabies Immunoglobulin are available;
Both supplied in vials at– 150 IU/ml
19.
20.
21. WOUND CLEANING & TREATMENT
Wash the area of an animal bite thoroughly
22. Initial treatment for an animal bite should include
through cleansing however all animal bite should be
seen by Physician.
24. TREATMENT
POST EXPOSURE TREATMENT
A. LOCAL WOUND TREATMENT
Wash with soap/detergent and warter preferably for 10
minutes.
Apply alcohol, povidone iodine/ any antiseptic.
Anti-tetanus
Avoid suturing wounds.
Do not apply oinment, creams/ wound dressing
26. VACCINE ADMINISTRATION
1. Intra muscular schedule
6 dosage schedule
Reduced multisite intra mascular
regime (2-1-1)
2. Intradermal schedule
2 site intradermal schedule(2-2-2-
0-1-1)
8 site intraderal schedule (8-0-4-
0-1-1)
27. Vaccination
INTRADERMAL SCHEDULE
Day of Immunization PVRV/PCECV Site
DAY 0 0.1 ml L & R deltoids/
anterolateral thighs of
infants
DAY 3 0.1 ml L & R deltoids/
anterolateral thighs of
infants
DAY 7 0.1 ml L & R deltoids/
anterolateral thighs of
infants
DAY 28/30 0.1 ml L & R deltoids/
anterolateral thighs of
infants
28. MANAGEMENT OF RABIES PATIENT
Once symptoms start, treatment should centre on comfort
care, using sedation and avoidance of intubation and life
support measures once diagnosis is certain.
MEDICATIONS
Diazepam
Midazolam
Haloperidol + Dipenhydramine
29. 2. SUPPORTIVE CARE
Confirmed rabies should receive adequate sedation and
comfort care in an appropriate medical facility
once rabies diagnosis has been confirnmed invasive
procedure must be avoided
Provide suitable emotional and physical support
Discussion and provide important information to relative
concerning tranmission of disease and indication for PET of
contacts.
Honest, gentle communication should be provided to
relatives of patients.
30. 3. INFECTION CONTROL
Patient should be admitted in a quiet, draft-free
isolation room.
HLCR workers and relatives in contact with patients
should wear proper personal protective equipment.
4. DISPOSAL OF DEAD BODY