Rabies Flashcards
T/F: Rabies is a fatal infection
Tru
Infections can be prevented by:
- Immunization of animals
- Pre exposure immunizations for people
- Routine for vet & others at high risk of exposure (dept pf wildlife)
- Post exposure rabies prophylaxis
Main animal reservoir for rabies?
Bats
Up to 70% of bats have rabies
Is picking up a dead animal an exposure?
Yes
How is rabies spread?
bites of infected animals
saliva scratch
How is rabies classified?
Where does it attack?
Rhabdovirus
Attacks the brain
Incubation period?
wks-months
10-14d avg
first initial sx
FLS
Sx progress to:
Confusion
Hydrophobia
Then Fever
Then coma
If sx develop in human, fatality is nearly __%?
100%
How to “treat” rabies? Not PEP
ART (only 30% successful)
Milwaukee Protocol
Have ART Rx been replicated successfully for rabies tx?
No
What is Milwaukee Protocol?
ART Tx for Rabies
For PANCE: How many doses of PrEP?
Name of Rx?
3 shot series
Imovax or Rabavert
For PANCE: When is Imovax/Rabavert given? which days?
Day 0, 7, 21 OR 28
PrEP
Who gets PrEP
Vet students
People at high risk (ie a bat rehabilitation specialist…)
Center for Wildlife
Animal control
For PANCE: When is Imovax/Rabavert given if exposure to rabies occurs?
if pt is already immunized
Need 2 shots
Day 0 and 3
New Guidelines: When is Imovax/Rabavert given? which days? How many doses?
2 shots
Given on day 0 and 7
Any change to PEP in New Guidelines?
No changes
Why doesn’t the general public get immunized for rabies?
The risk is not very high for general public.
Too expensive to create new doses vs. risk of getting rabies.
When to give PEP?
ASAP
What is the PEP regiment?
HRIg (Human Rabies Immune Globulin)
& SERIES of rabies Vaccines
What is HRIg?
“Ready to go AB”
What does the vaccine do?
Induces AB PRODUCTION
How londg does AB induction take?
WEEKS
What is the dose for HRIg?
20 units/kg
How much HRIg per vial?
150units/mL
or 300units/mL
HRIg Dose for 180lb person
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
T/F: HRIg is more effective if injected at bite site
True
Otherwise, give IM
What day to give HRIg
Day 0
T/F: Monkeys carry rabies
True
T/F:Rabies vaccine is poorly tolerated
FALSE
rabies vaccine is well tolerated
What days do you give Rabies Vaccine PEP?
Day 0, 3, 7 AND 14.
How much is HRIg?
10-20k!!!!
Is HRIg rare?
yes
Does a squirrel or rabbit bite constitute PEP?
No. they do not carry rabies
Does handling a dead animal constitute PEP?
Yes
If you see a nocturnal animal out in the middle of the day- what do you think?
RABIES
Good disinfectant?
10% bleach
What is a silent bat bite?
Bats can be in the house and bite you while you are sleeping when you don’t even know it.
If someone has already had PrEP, what is the PEP protocol?
2 doses of Rabies Vaccine (day 0 & 3)
No HBIg
