Rabies Flashcards
Genus of rabies virus?
Lyssavirus
Prodromal feature of rabies?
Itch at bite site
Incubation period for rabies?
usually 1-2 months, can be longer (up to 20 yrs)
Presentation of rabies?
Prodrome non specific symptoms
Furious rabies- hydrophobic spasms - autonomic over activity, jerking spasms
Paralytic rabies - ascending flaccid paralysis
LP results in rabies
Raised WCC lymphocytes
Raised protein, normal glucose
Tests for rabies?
PCR of saliva, CSF, tears, skin Bx
Antigen detection
Not used any more:Negri bodies in cells
When should you attempt ICU for rabies?
Attempt intensive care only if:
1-American bat virus implicated
2-Some vaccine was given before onset of
encephalitis
3-Early appearance of antibody
Post exposure prophylaxis for rabies?
Passive immunisation (rabies immune globulin - RIG) infiltrated around wound - if break around skin - only if not vaccinated
Active immunisation
Tetanus
Who needs PEP?
Bites or scratches from dog/mammal
ANY direct contact with a bat
PEP in immunosuppressed patient?
Treat as unvaccinated
5 imms plus RIG on day 0
PEP if vaccinated?
2 imms
Day 0 and day 3
OR
4 site intradermal on 1 day!
PEP for unvaccinated?
5 imms and RIG
Other regimes available for low resource settings
