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15 Cards in this Set
- Front
- Back
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Describe the Rabies virus:
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1. Lyssavirus of the rhabdoviridiae: ss RNA
2. bullet shape |
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What is the pathogenesis of rabies:
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1. inoculatin bite
2. it replicates in muscle cell 3. goes via AXOPLASM to CNS, spreads rapidly 4. centrifugal spread via nerves to most organs |
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What is the immune response to rabies?
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no detectable response until the encephalitis developes.
-neutralizing antibodies in 7 days and low interferon production (appears that the virus evades detection) |
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What are the clinical features of rabies?
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1. incubation: 7 days
2. prodromal phase: vague, itch at wound, cranky 3. furious (dog) or dumb/paralytic (bat) |
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What are the features of furious rabies?
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1. hydrophobia
2. aerophobia 3. intermittant periods of general arousal and lucid intervals (they are aware) 4. rapid progres to coma and flassic paralysis 5. survival about 7 days |
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what are the features of paralytic rabies?
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-paraesthesiae and flaccid ascending paralysis
-can last 2-3 weeks |
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How is Rabies diagnosed?
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1. IF (from neck or corneal impression)
2. virus detection and PCR: saliva, throat swabs, tracheal aspiration 3. antibody testing 4. post-mortem: NEGRI BODIES are typical |
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What is treatment for rabies infection?
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1. relieve suffering
2. manage complications (cardiac, pneumothorax, cerebral edema, convulsions, fluid/electrolyte disorder, hyperpyrexia, stress ulceration) 3. admit, sedate, analgesia |
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How is rabies prevent?
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1. vaccinate animals
2. keep pets and people away from wild/stray animals/animals in developing countries/strange acting animals |
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What are the rabies vaccines?
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I. Nerve tissue based (can cause encephalitis)
1. HDVC: human diploid cell vaccine ($$$$$) 2. PVRV: purifeid vero cell vaccine 3. PCEC: purified chick embryo vaccine II. cell culture vaccine (safer |
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What is the rabies prophylaxis?
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use cell culture vaccine on days 0,7,21,28
*malaria prophylaxis can interfer |
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What is the first aide for rabies:
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1. scrub wound with soap, water and iodine a lot, remove foreign material
2.Debride wound, don't suture or occlude wound 3. treat for tetanus and bacterial infections 4. rabies vaccine ± serum |
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treatment for minor rabies exposure (lick, pet, scratches, minor bites on covered arms, trunk, legs)
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vaccinate and treat until animal is healthy for 10 days, is brain negative, or give serum and vaccine for 7 days
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treatment for major rabies exposure: (licks of mucosa, multiple bites on face, head, fingers or neck)
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serum and vaccine until animal is proven clean
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What is the post-exposure vaccination regimens?
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1. IM: 1 ml on 0,3,7,14,28 or 2-1-1 regime
2. intradermal regimen: 2-site regimen or 8 site method (0.1ml on 8 sites, 4 sites in a week and 1 site in 3 weeks) |
