L27: Spotlight on rabies as an occupational zoonosis

Question 1

How many people die annually from rabies?

Answer 1

59,000, esp childen

Question 2

How much of the global population is at risk of rabies?

Answer 2

Half

Question 3

Where is rabies mostly found?

Answer 3

Africa and Indian sub-continent

Question 4

What kind of virus is rabies?

Answer 4

Lyssavirus (subgroup of Rhabdoviruses)

Question 5

Which species are endemically infected with rabies in the USA?

Answer 5

American bats

Question 6

Which virus has been found in two bat species in the UK?

Answer 6

EBLV-2

Question 7

How does rabies spread to the salivary glands?

Answer 7

Through axons to the brain, then through the PNS to the salivary glands

Question 8

Why is there lots of saliva in rabies?

Answer 8

Unable to swallow

Question 9

Where does the rabies virus replicate?

Answer 9

Locally in the muscle around the bite

Question 10

How long is rabies incubation?

Answer 10

20-60 days, occasionally 5-6 days

Question 11

What are the two forms of rabies?

Answer 11

Paralytic (dumb) or Furious

Question 12

How does Furious disease progress?

Answer 12

Into dumb (flaccid paralysis)

Question 13

What is the end condition in rabies?

Answer 13

Acute fatal encephalitis

Question 14

What are symptoms of rabies?

Answer 14

Anxiety, confusion, delirium, hallucinations, water phobia

Question 15

Why do you get change in tone of voice with rabies?

Answer 15

Vocal cord paralysis

Question 16

How soon do rabies victims die?

Answer 16

3-4 days

Question 17

What is rabies often misdiagnosed as?

Answer 17

Malaria

Question 18

What is the most effective treatment for rabies?

Answer 18

Washing wound with surgical disinfectant (60-80% cases)

Question 19

What should you never do to a rabies wound?

Answer 19

Suture

Question 20

What do you do after you have washed the wound?

Answer 20

Passive immunoglobulin

Question 21

How can you control wildlife rabies?

Answer 21

Oral baited vaccination

Question 22

What is the required population threshold for the rabies vaccination?

Answer 22

Little evidence

Question 23

What is rabies seroprevalence in old bats?

Answer 23

Over 60%

Question 24

What is the significance of a high seroprevalence in old bats?

Answer 24

Clear evidence it is not always fatal

Question 25

What is the most cost-effective way of preventing malaria?

Answer 25

Vaccinating dogs

Question 26

Which rabies vaccination has high rates of complication?

Answer 26

Inactivated fixed rabies virus nerve tissue

Question 27

Which rabies vaccines are safer?

Answer 27

Continuous cell line culture and embryonated egg vaccine

Question 28

What happens during the prodromal stage?

Answer 28

Behavioural change, pyrexia, dilated pupils, nictitating membrane, salivation

Question 29

What happens to cats with rabies?

Answer 29

Dead-end host, irritability and aggression

Question 30

Why do horses present with choke?

Answer 30

Laryngeal paralysis

Question 31

What kind of host are horses with rabies?

Answer 31

Dead-end

Question 32

How much aggression do cattle and sheep show?

Answer 32

High %

Question 33

Where do most human rabies cases come from?

Answer 33

Domestic dogs

Question 34

Which cycles are common and important?

Answer 34

Sylvatic cycles

Question 35

Which scheme allows freer movement from low risk countries?

Answer 35

PETS Scheme

Question 36

When do you give the vaccinations?

Answer 36

3 months then 2-3 years

Question 37

Which age animals do you vaccinate in the field?

Answer 37

All, inc under 3 months

Question 38

What % must you vaccinate to reduce risk of epidemic by 90%?

Answer 38

At least 70%