Rabies

Question 1

What causes rabies?

Answer 1

Rabies virus- lyssavirus

Question 2

How is rabies spread?

Answer 2

Saliva (from dogs/bats) comes into contact with mucous membranes
Virus travels up axons to CNS

Question 3

What is the incubation of rabies and what factors affect it?

Answer 3

4days to years

Shorter if child, proximal wound or multiple wounds

Question 4

What are the symptoms if rabies?

Answer 4

Itching/paraestesia at bite site
Furious rabies: fever, hydrophobia, autonomic++, aerophobia, salivation n
Dumb rabies: ascending paralysis

Question 5

How can you diagnose rabies?

Answer 5

History and clinically 
Nape of neck skin biopsy for PCR or imunofluorescence
Saliva PCR
Isolate virus
RDTs on animals

Question 6

What is the vaccine regime for rabies?

Answer 6

Tissue culture vaccine
3 doses IM or ID
Animals and humans
PO animal vaccine

Question 7

What is the PEP regiment or rabies?

Answer 7

Woundcare:wash with iodine 15mins, tetanus booster and ?Abx

If fully immunised: 2 vaccine doses
Not fully immunised: 4 doses and Ig if red risk
Immunocompromise: 5 doses and Ig

Palliative if clinical signs

Question 8

When a you stop rabies treatment?

Answer 8

If animal that bit has been observed and remains healthy after 10days or had a negative rabies brain biopsy

Question 9

How do you prevent rabies?

Answer 9

One health approach
Vaccinate dogs
Education around bite prevention
Vaccinate people
Surveillance and reporting

Question 10

What is the goal of the United Against Rabies Forum and what do they do?

Answer 10

Zero human deaths from dog mediated rabies by 2030

• Inclusion of rabies biologics in essential medicines list
• Scale up rabies PEP
• Validates countries free of the above
• Updates and disseminated guidance
• Disease surveillance