2. * Rabies is a zoonotic disease (a disease that is
transmitted from animals to humans) that is caused
by a virus.
* Nearly half of those bitten by suspect rabid animals
are children under 15 years of age.
* Rabies is spread to people through close contact with
infected saliva via bites or scratches.
* Most of the deaths occur in the absence of post-
exposure prophylaxis
9. *Rabies is caused by RNA
virus of genus Lyssavirus
*Family-Rhabdoviridae
*Bullet shape
*Neurotropic virus
*New species discovered in
bats
10. Virus is transmitted through saliva of infected
animal
*Bites
*scratch
*Licks on injured skin
*Licks on mucous membranes
*Aerosols (bats in caves)
Uncommon routes
*Transplants of infected organs
*Bite of a rabid human being
11. Incubation period
Varies from few days
to years
Average 30-90 days
Depends upon site,
degree and virus load,
number of wounds
Provides opportunity
to start treatment
12. Sr. No District/Area No. of
Rabies
Patients
Treatment Time between bite
and rabies
1. Lahore 01 Not received One month
2. Lahore 01 Not received 20 days
3. Lahore 01 Not received one and a half month
4. Lahore 01 Not received 3 months
5. Shakargarh (Narowal) 01 Not received one and a half month
6. Chakwal 01 Not received one and a half month
7. Rahim Yar Khan 01 Not received 3 months
8. Khushab 01 Not received one and a half month
9. Shraqpur Sharif 01 Not received 2 months
10. Okara 01 Not received 5 months
11. Muridke 01 Partly received One month
12. Daska 01 Not received 2 and half month
13 Sialkot 01 Not received 3 months
14. Qadirabad 01 Not received One year
15. Sargodha 01 Not received 3 months
16. DG gkan 01 Not received 2.5 years
15. Prodromal Phase (2-10 days)
Fever, flu like symptoms, headache, anorexia,
lethargy, itching or abnormal sensation at the
site of wound
Acute Neurological Phase (2-7 days)
Anxiety, confusion, aggression or lack of
aggression, hyper salivation, muscular spasm,
difficulty in swallowing leading to hydrophobia,
photophobia, aerophobia
16.
17. Coma and Death
Symptoms progress towards paralysis and coma
in both furious and dumb rabies
Death usually occurs from respiratory paralysis
within days after onset of symptoms
18. *Wounds should be washed/flushed and disinfected immediately.
Vaccine and immunoglobulin therapy (when required for the
latter) instituted as soon as possible,
* If rabies immunoglobulin is not available on first visit its use
can be delayed by a maximum of 7 days from date of first
vaccine injection,
*Initiation of PEP should not await the results of laboratory
diagnosis or be delayed by dog observation when rabies is
suspected,
*Pregnancy and infancy are never contraindications to PEP,
*Persons who present for evaluation and rabies post-exposure
prophylaxis even months after having been bitten should be
dealt with in the same manner as if the contact occurred
recently.
19. *Category I :
touching, feeding of animals or licks on intact skin no
exposure
therefore no prophylaxis if history reliable
*Category II:-
minor scratches or abrasions without bleeding or and
nibbling of uncovered skin
use vaccine alone
*Category III:
single or multiple transdermal bites or scratches, licks on
broken skin, contamination of mucous membrane with saliva
(i.e. licks) and suspect contacts with bats:
use immunoglobulin plus vaccine
20. * Should be immediate
* Is essential even if the person presents long after exposure
Consists of:
*Immediate washing and flushing for 15 minutes
with soap and water, or water alone,
*disinfection with ethanol (700ml/l) or iodine
(tincture or aqueous solution).
21. * The 5 dose intramuscular regime: one dose of the
vaccine should be administered on days 0, 3, 7, 14
and 28 in deltoid region or, in small children, into the
antero-lateral area of the thigh muscle;
* The 2-1-1 regimen may also be used. Two doses are
given on day 0 in the deltoid muscle, right and left
arm. In addition one dose in the deltoid muscle on
day 7 and one on day 21.
* Vaccines should not be injected into the gluteal
region;
22. *This vaccine is of sufficient potency to allow
its safe use in one of the WHO recommended
intradermal post-exposure regimens
23. *Immediate Case Notification.
*Availability of Anti-Rabies Vaccine.
*Special Dog killing campaigns launched by the
districts.
* Behavioural Change Campaigns.
*World Rabies Day- 28th
September.
Editor's Notes
Rabies is an acute progressive encephalomyelitis transmitted through bite of a rabid or suspected rabid animal
Infectious disease with highest mortality rate ( almost 100%) yet it is a preventable disease
The leading viral zoonosis of global public
health significance
Dog is the most common animal, more than 90% cases pertain to dogs , both stray and unvaccinated pet dogs can be responsible. 5-10% cases belong to other domestic and farm animal such as cats, cows horeses mules . donkey, Majority animals present with furious rabies in which rabid animal becomes aggressive attacks without provoking,tries to eat abnormal things like wood, stones. Grass. Saliva dribbles from the mouth , attacks many people a ta time and can bite other animals
