rabies report
TRANSCRIPT
Report by: Norvin L. Adlawan
RABIES
• a ZOONOTIC DISEASE (a disease that is
transmitted from animals to humans) that
is caused by the
RABIES
Rabies Virus
Source: WHO
THE RABIES VIRUS
Rabies virus belongs to the order Mononegavirales, viruses with a nonsegmented, negative-stranded RNA genomes. Within this group, viruses with a distinct "bullet" shape are classified in the Rhabdoviridae family. The genus Lyssavirus includes rabies virus, Lagos bat, Mokola virus, Duvenhage virus, European bat virus 1 & 2 and Australian bat virus.
Source: Center for Disease Control & Prevention
MAIN HOSTS
DOGS
1 Dogs are the main host and transmitter of rabies. They are the source of infection in all of the estimated 55,000 human rabies deaths annually in Asia and Africa.
BATS
2 Bats are the source of most human rabies deaths in the United States of America and Canada. Bat rabies has also recently emerged as a public health threat in Australia, Latin America and western Europe.
CATS & OTHERS
3 Cats are the most common domestic animals with rabies in the United States.
Almost any wild or domestic animal can potentially get rabies, but it is very rare in small rodents (rats, squirrels, chipmunks) and lagomorphs (rabbits and hares).
TRANSMISSION
You can get rabies only by coming in contact with:
• Saliva
• Brain/Nervous Tissue
Source: Center for Disease Control & Prevention
TYPE OF EXPOSURE
Templates
1
BITE
1 Any penetration of the skin by teeth constitutes a bite exposure. All bites, regardless of body site, represent a potential risk of rabies transmission, but that risk varies with the species of biting animal, the anatomic site of the bite, and the severity of the wound.
NON-BITE
The contamination of open wounds, abrasions, mucous membranes, or theoretically, scratches (potentially contaminated with infectious material from a rabid animal) constitutes a nonbite exposure.
2
• The incubation period for rabies is typically
1–3 months, but may vary from less than 1
week to more than 1 year.
INCUBATION PERIOD
• Fever
• Pain or an unusual or unexplained tingling,
pricking or burning sensation (paresthesia)
at the wound site.
INITIAL SYMPTOMS
FORMS OF THE DISEASE
Templates
1
CLASSIC RABIES
People with classic (furious) rabies exhibit signs of hyperactivity, excited behaviour, hydrophobia and sometimes aerophobia. After a few days, death occurs by cardio-respiratory arrest.
PARALYTIC RABIES
A rarer form of rabies, paralytic rabies, has been linked to vampire bats. This form of rabies runs a less dramatic and usually longer course than the furious form. The muscles gradually become paralyzed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs.
PATHOPYSIOLOGY
1
RABIES VIRUS
Entry into break in skin(bites, abrasions, mucusa)
Incubation Period (1 month – more
than 1 year)
Invasion Phase
Pain Fever Malaise Anorexia Headache
Sore Throat
Increased Sensitivity
Excitement Phase
Imminent thoracho-lumbar involvement (PNS): Pupillary dilatation, Lacrimation
Increased thick saliva/foaming of the mouth. Excessive sweat
Anxiety and fear Hydrophobia Mania and hallucinations
with lucid intervals Pronounced muscular
stimulation and general tremor
ConvulsionsNext Slide…
Templates
1
DEATH
COMA
Gradual weakness of muscle groups; muscle spasms cease, ocular palsy, vertigo
(+) Babinski (lesions at pyramidal tract)
HR shifting from tachycardia (100-120) to bradycardia (40-60)
Cheyne-Stokes breathing Local sensation diminished (pain,
heat, cold) Bladder and intestinal retention
(damage to the innervation of the musculature of bladder and intestine
Hydrophobia disappear Slight difficulty wallowing Ascending paralysis, flaccid
paralysis of extremities until it reaches respiratory muscles
Apathy, Stupor
PARALYTIC PHASE
(Depression Phase)
Continuation…
• Several tests are necessary to diagnose rabies ante-mortem (before
death) in humans; no single test is sufficient.
• Tests are performed on samples of saliva, serum, spinal fluid, and
skin biopsies of hair follicles at the nape of the neck.
• Reverse transcription polymerase chain reaction (RT-PCR).
• Serum and spinal fluid are tested for antibodies to rabies virus.
• Skin biopsy specimens are examined for rabies antigen in the
cutaneous nerves at the base of hair follicles.
DIAGNOSTIC EXAMS
• Responsible pet ownership (Immunization)
• Thoroughly clean ALL BITES AND SCRATCHES made by animal
with strong medicinal soap or solution
• Report immediately rabid or suggestive of rabies domestic or wild
animals to proper authorities
• Pre-exposure to high-risk individuals
PREVENTION
• If dog is apparently healthy, observe the dog for 14 days. If it dies or
shows signs suggestive of rabies, consult a physician
• If the dog shows signs suggestive of rabies, kill the dog immediately
and bring head for lab exam. Submit for immunization while awaiting
for results
• If the dog is not available for observation (killed, died, or stray)
submit for immunization
DOH PROTOCOLS
POST-EXPOSURE PROPHYLAXIS
CATEGORY I: touching or feeding animals, licks on intact skin.
POST-EXPORSURE MEASURES: None
CATEGORY II: nibbling of uncovered skin, minor scratches or abrasions without bleeding.
POST-EXPOSURE MEASURES: Immediate vaccination and local treatment of the wound
Category III: single or multiple transdermal bites or scratches, licks on broken skin; contamination of mucous membrane with saliva from licks, exposures to bats.
POST-EXPOSURE MEASURES: Immediate vaccination and administration of rabies immunoglobulin; local treatment of the wound
• Local wound treatment. Wash with soap and water. Use iodine or
other disinfectants
• Antibiotics and Anti-tetanus as prescribed by Physician
• Rabies-specific treatment. Active immunization (Human Diploid Cell
Rabies Vaccine) and passive immunization (Rabies Immune
Globulin)
MEDICAL INTERVENTIONS
THANK YOU!
Your Logo