Rabies

Question 1

What is the virus associate with rabies?

Answer 1

Neurotropic Rhabdoviridae Lyssavirus

Question 2

What are the top 5 species associated with rabies in Canada?

Answer 2

Fox
Skunk
Bat (#1)
Dog 
Racoon

Question 3

How does rabies transmission occur?

Answer 3

Bites
Mucous membrane contact with virus
Scratches
Infection of prior wound with saliva
Transplant

Question 4

What are 1. Acute and 2. Subacute clinical features of rabies

Answer 4

1. Prodrome: neuropathic pain, paresthesias at site of innoculation with nonspecific flu like symptoms
2. Subacute: encephalopathy
   A. Encephalitic/Furious (80%) hydrophobia, hyperactivity, hypersalivation, pharyngeal spasms
   B. Paralytic/Dumb (20%) paralysis

Question 5

How do you make the gold standard diagnosis of rabies?

Answer 5

Nuchal skin punch biopsy and pathology

Question 6

Who to call if suspicious of clinical rabies?

Answer 6

Medical officer of health

Question 7

What are the 3 treatment priorities in clinical rabies

Answer 7

1. Wound care (clean deeply with soap and water)
2. Active immunization (rabies immunoglobulin)
3. Passive immunization (vaccine)

Question 8

Post exposure prophylaxis guidelines for rabies?

Answer 8

Unimmunized: full rabies vaccine (1 mL IM on days 0, 3, 7, 14, 28) post exposure PLUS rabies immunoglobulin (20 IU/kg, 50% around wound, rest is IM)

Immunized: rabies vaccine booster at days 0., 3