Rabies

Question 1

T/F: Rabies is a fatal infection

Answer 1

Tru

Question 2

Infections can be prevented by:

Answer 2

• Immunization of animals
• Pre exposure immunizations for people
• Routine for vet & others at high risk of exposure (dept pf wildlife)
• Post exposure rabies prophylaxis

Question 3

Main animal reservoir for rabies?

Answer 3

Bats

Up to 70% of bats have rabies

Question 4

Is picking up a dead animal an exposure?

Answer 4

Yes

Question 5

How is rabies spread?

Answer 5

bites of infected animals

saliva scratch

Question 6

How is rabies classified?

Where does it attack?

Answer 6

Rhabdovirus

Attacks the brain

Question 7

Incubation period?

Answer 7

wks-months

10-14d avg

Question 8

first initial sx

Answer 8

FLS

Question 9

Sx progress to:

Answer 9

Confusion
Hydrophobia

Then Fever

Then coma

Question 10

If sx develop in human, fatality is nearly __%?

Answer 10

100%

Question 11

How to “treat” rabies? Not PEP

Answer 11

ART (only 30% successful)

Milwaukee Protocol

Question 12

Have ART Rx been replicated successfully for rabies tx?

Answer 12

No

Question 13

What is Milwaukee Protocol?

Answer 13

ART Tx for Rabies

Question 14

For PANCE: How many doses of PrEP?

Name of Rx?

Answer 14

3 shot series

Imovax or Rabavert

Question 15

For PANCE: When is Imovax/Rabavert given? which days?

Answer 15

Day 0, 7, 21 OR 28

PrEP

Question 16

Who gets PrEP

Answer 16

Vet students
People at high risk (ie a bat rehabilitation specialist…)
Center for Wildlife
Animal control

Question 17

For PANCE: When is Imovax/Rabavert given if exposure to rabies occurs?
if pt is already immunized

Answer 17

Need 2 shots

Day 0 and 3

Question 18

New Guidelines: When is Imovax/Rabavert given? which days? How many doses?

Answer 18

2 shots

Given on day 0 and 7

Question 19

Any change to PEP in New Guidelines?

Answer 19

No changes

Question 20

Why doesn’t the general public get immunized for rabies?

Answer 20

The risk is not very high for general public.

Too expensive to create new doses vs. risk of getting rabies.

Question 21

When to give PEP?

Answer 21

ASAP

Question 22

What is the PEP regiment?

Answer 22

HRIg (Human Rabies Immune Globulin)

& SERIES of rabies Vaccines

Question 23

What is HRIg?

Answer 23

“Ready to go AB”

Question 24

What does the vaccine do?

Answer 24

Induces AB PRODUCTION

Question 25

How londg does AB induction take?

Answer 25

WEEKS

Question 26

What is the dose for HRIg?

Answer 26

20 units/kg

Question 27

How much HRIg per vial?

Answer 27

150units/mL

or 300units/mL

Question 28

HRIg Dose for 180lb person

Answer 28

180lbs/2.2 kg /lb=81.8 kg
ok to round to 82kg

82 kg x 20 units/kg=1640 units divided by 150 units/ml=10.9 mls
okay to round to 11 mls

Question 29

T/F: HRIg is more effective if injected at bite site

Answer 29

True

Otherwise, give IM

Question 30

What day to give HRIg

Answer 30

Day 0

Question 31

T/F: Monkeys carry rabies

Answer 31

True

Question 32

T/F:Rabies vaccine is poorly tolerated

Answer 32

FALSE

rabies vaccine is well tolerated

Question 33

What days do you give Rabies Vaccine PEP?

Answer 33

Day 0, 3, 7 AND 14.

Question 34

How much is HRIg?

Answer 34

10-20k!!!!

Question 35

Is HRIg rare?

Answer 35

yes

Question 36

Does a squirrel or rabbit bite constitute PEP?

Answer 36

No. they do not carry rabies

Question 37

Does handling a dead animal constitute PEP?

Answer 37

Yes

Question 38

If you see a nocturnal animal out in the middle of the day- what do you think?

Answer 38

RABIES

Question 39

Good disinfectant?

Answer 39

10% bleach

Question 40

What is a silent bat bite?

Answer 40

Bats can be in the house and bite you while you are sleeping when you don’t even know it.

Question 41

If someone has already had PrEP, what is the PEP protocol?

Answer 41

2 doses of Rabies Vaccine (day 0 & 3)

No HBIg