Chapter 158: Rabies

Question 1

accounts for greater than 99% of human rabies cases

Answer 1

dog bite

Question 2

Regions with no rabies

Answer 2

Hawaii, UK, Australasia, Antartica

Question 3

are eosinophilic intracellular lesions found within cerebral neurons and are highly specific for rabies

Answer 3

Negri bodies

Question 4

TRUE OR FALSE: The distinction between a “provoked” and “nonprovoked” attack can be used for risk assessment

Answer 4

FALSE

Question 5

Indications for evaluation for post exposure prophylaxis

Answer 5

persons: bitten by, scratched by, or exposed to saliva from a wild or domestic animal that could be rabid

Question 6

Rabies pre exposure prophylaxis

Answer 6

Primary: IM 0.1mL deltoid area, one dose on days 0,7 and 21 or 28; human diploid cell vaccine (HDCV) or purified chick embryo cell culture vaccine (PCECV)

Booster: IM 0.1mL deltoid area one dose on day 0 ONLY

Question 7

TRUE or FALSE: Healthcare personnel with nonintact skin or mucous membrane exposure to infective saliva or neural tissue from patients with rabies should receive postexposure prophylaxis

Answer 7

TRUE

Question 8

TRUE OR FALSE: immunocompromised persons should receive a four- dose series of vaccine over a 14-day period

Answer 8

FALSE: five-dose series of vaccine over a 28-day period

Question 9

True or False: If HRIG was not administered when vaccination was begun, it cannot be given anymore

Answer 9

FALSE: HRIG and the first dose of rabies vaccine should be given as soon as possible after exposure, preferably within 24 hours. If HRIG was not administered when vaccination was begun, it can be administered up to 7 days after administration of the first dose of the vaccine

*Beyond the seventh day after vaccination is begun, HRIG is not indicated,

Question 10

True or False: Severe egg allergy is a contraindication to the use of purified chick embryo cell culture vaccine

Answer 10

TRUE

Question 11

Category I

Answer 11

touching or feeding animals, licks on intact skin (i.e., no exposure)

*NO PROPHYLAXIS REQUIRED

Question 12

Category II

Answer 12

nibbling of uncovered skin, minor scratches or abrasions without bleeding

Question 13

Category III

Answer 13

single or multiple transdermal bites or scratches, contamination of mucous membrane with saliva from licks, licks on broken skin, exposure to bats

Question 14

The five-dose schedule consists of one dose on each of ____

Answer 14

Days 0, 3, 7, 14 and 28

1 mL or 0.5 mL

Question 15

four doses schedule

Answer 15

two doses on day 0 then one dose on days 7 and 21

1 mL or 0.5 mL

Question 16

Intradermal administration post exposure regimen

Answer 16

0.1 mL at two sites on days 0, 3, 7, and 28

Question 17

define “Previously vaccinated”

Answer 17

refers to persons who have received one of the recommended preexposure or postexposure prophylaxis regimens of human diploid cell vaccine or purified chick embryo cell culture vaccine, or those who have received another vaccine and had a documented acceptable rabies antibody titer

Question 18

Vaccine in Persons with Prior Rabies Immunization

Answer 18

two intramuscular doses (1 mL each) of vaccine, one immediately and one 3 days later

*HRIG is unnecessary

Question 19

define severely immunocompromised

Answer 19

• congenital immunodeficiency
• human immunodeficiency virus infection
• leukemia or lymphoma
• aplastic anemia, or generalized malignancy, or who are being treated with alkylating agents, antimetabolites, radiation, or large amounts of corticosteroids

Question 20

True or False: Immunosuppressive agents should not be administered during postexposure prophylaxis, unless they are essential for the treatment of other conditions

Answer 20

TRUE

Question 21

two clinical forms if rabies

Answer 21

an encephalitic form in 80% and a paralytic form in 20%