By ULY CLINIC

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Rabies

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Introduction

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Rabies is an acute viral infection of the central nervous system that affects all mammals and is transmitted to man by animal bites via infected secretions, usually saliva.  (For more information on Rabies, please refer to the section on infectious diseases) 

 

Diagnostic criteria

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• Early clinical features: apprehensiveness, restlessness, fever, malaise and headache  

• Late features: excessive motor activity and agitation, confusion, hallucinations, excessive salivation, convulsions and hydrophobia 

 

NOTE: Treat the person immediately after the animal bite, before onset of symptoms    

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Pharmacological Treatment

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Local wound therapy:-wash wound thoroughly with running water and soap for 10 minutes, and repeat process with: A: 10% Povidone iodine; to prevent secondary bacterial infection. 

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Active immunization:

 

Human Diploid Cell Vaccine (HDCV) – either ID or IM 

•  Anti-rabies Vaccines (2- 3 IU/dose)  IM: 1ml on days 0, 3, 7, 14, 28 (5 doses) ID: 0.2ml by dividing 0.1 ml on left shoulder and 0.1ml on right shoulder, on days 0, 3,7 and 28 (4 doses).

 

Intradermal (ID) is mostly advised. In addition, patients should receive rabies immune globulin with the 1st dose (day 0)

 

Passive Immunization 

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• Anti-rabies human immunoglobulin 20 IU/kg half the dose given   parenterally and the other half injected into and around the wound 

 

AND

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• Tetanus toxoid vaccine, please refer to the section on Tetanus 

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Updated on, 29.10.2020

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References

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1. STG