Rabies Flashcards
How long is incubation period?
(typically 20 to 90 days)
Rabies Postexposure Prophylaxis Schedule for Not previously immunized
WOUND CLEANSING: Cleanse all wounds with soap and water; irrigate wounds with 9:1 diluted solution of povidone-iodine (if available).
HRIG: Administer 20 IU/kg actual body weight. If anatomically feasible, infiltrate the full dose around the wound(s) and give any remaining volume IM at an anatomic site distant from vaccine administration; do not give HRIG in the same syringe as vaccine. HRIG may partially suppress active production of rabies virus antibody, so do not give more than the recommended dose.
VACCINE: HDCV or PCECV 1.0 mL (deltoid area†), one dose
on days 0,‡ 3, 7, and 14.
HDCV = human diploid cell vaccine; HRIG = human rabies immunoglobulin; PCECV = purified chick embryo cell culture vaccine.
Rabies Postexposure Prophylaxis Schedule for previously immunized
Cleanse all wounds with soap and water; irrigate wounds with 9:1 povidone-iodine solution.
HRIG should not be administered.
HDCV or PCECV 1.0 mL (deltoid area†), one dose on days 0‡ and 3.
True or false
immunocompromised persons, should receive a five- dose series of vaccine over a 28-day period
True
True or false
rabies vaccine should never be administered in the gluteal area; only the deltoid or anterolateral thigh (for younger children) is acceptable
 True
True or false
The active antibody response requires approximately 7 to 10 days to develop, and detectable rabies virus–neutralizing anti- bodies generally persist for several years
 True
When is HRIG administered?
HRIG is administered only once, at the beginning of antirabies prophylaxis, to provide immediate antibodies until the patient responds to rabies vaccine by producing antibodies.
HRIG was not given when vaccination was begun, it can be given through the seventh day after administration of the vaccine.
Beyond the seventh day after vaccination is begun, HRIG is not indicated, because an antibody response is presumed to have occurred.
True or false
On HRIG:
Centers for Disease Control and Prevention recommends that as much as possible of the full dose be infiltrated around the wound.
 True
True or false
HRIG should never be administered in the same syringe or into the same anatomic site as the vaccine, as the antibody and vaccine will neutralize each other.
 True
True or false
Any remaining HRIG that cannot be administered into the local wound area should be injected intramuscularly at a site distant from vaccine administration.
 True
True or false
Category I: touching or feeding animals, licks on intact skin (i.e., no exposure)
For category I exposures, no prophylaxis is required.
True
True or false
Category II: nibbling of uncovered skin, minor scratches or abrasions without bleeding
For category II, immediate vaccination is recommended.
 True
True or false
Category III: single or multiple transdermal bites or scratches, contamination of mucous membrane with saliva from licks, licks on broken skin, exposure to bats
For category III, immediate vaccination and administration of rabies immunoglobulin are recommended.
True
True or false
The severely immunocompromised are those who have congenital immunodeficiency, human immunodeficiency virus infection, leukemia or lymphoma, aplastic anemia, or generalized malignancy, or who are being treated with alkylating agents, antimetabolites, radiation, or large amounts of corticosteroids.
 True
True or false
pregnancy is not considered a contraindication to rabies postexposure prophylaxis or HRIG.
True
