Rabies

Question 1

Anti-Rabies act

Answer 1

RA 9482 (2007)
Mandated the creation of a National Rabies Prevention and Control Program (NRPCP)

Question 2

Most effective measure to control canine rabies

Answer 2

Mass dog vaccination

Question 3

Rabies awareness month

Answer 3

March

Question 4

4R’s in animal rabies risk assessment

Answer 4

Recognizing
Recording
Reporting
Referral

Question 5

Category II: no human rabies vaccine shall be provided, provided that ALL of the ff conditions are satisfied:

Answer 5

Dog/cat is healthy and available for observation for 14 days

Dog/cat was vaccinated against rabies for the past 2 years

Question 6

Dosing of HRIG

Answer 6

20 IU/kg

Prep: 2mL per vial, 150IU/mL

Question 7

Dosing of ERIG

Answer 7

40 IU/kg

Prep: 5mL/vial, 200IU/mL

Question 8

Remarks on ERIG

Answer 8

As ERIG products are highly purified, skin testing is no longer recommended

Question 9

Mgt of anaphylaxis

Answer 9

Give 0.1% epinephrine (1:1,000 of 1mg/mL) 📌underneath the skin or into the muscle
Adults: 0.5mL
Children: 0.01mL/kg, max of 0.5mL
Repeat epi dose every 10-20mins for 3 doses
Give steroids after epinephrine

Question 10

Remarks on local wound treatmetn

Answer 10

1. Wash with soap and water preferably for 10 mins
2. Suturing of wounds shall be AVOIDED at all times since it may inoculate virus deeper into the wounds
3. If suturing is unavoidable, its shall be delayed for at least 2 HOURS after RIG administration to allow diffusion of the antibody through the tissues
4. Any oitment, cream, or wound dressing shall NOT be applied to the bite site for it will favor the growth of bacteria and will occlude drainage of the wound
5. Animal bites are considered tetanus prone wounds

Question 11

Tetanus vaccination IN ANIMAL BITES

Answer 11

UNKNOWN OR <3DOSES
Give both Td and TIG/ATS
*TDaP may be substituted for Td if the person has not received TDaP and is 10 years or older
*DPT may be given for patients <7/o
*TT may be given if Td is not available
3 OR MORE DOSES
Nothing to give, UNLESS last Td dose was >5 years,then give Td

Question 12

Most common organism isolated from dog and cat bites

Answer 12

Pasteurella multocida

Question 13

When to give antimicrobials in animal bites

Answer 13

All frankly infected wounds
All category III CAT bites
All other category III bites that are either deep, penetrating, multiple, or extensive or located on the hand/face/genital area