Prevention and control of rabies


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Prevention and control of rabies

  1. 1. By: MOHIT KADYAN Roll no: 26
  2. 2.     Rabies is 100% fatal disease, till date only 4 victims had survived following intensive life support and nursing care It is preventable only with modern vaccines and immunoglobulins Rabies is preventable through wound care and correct rabies prophylaxis Incorrect/ wrong treatment physician can lead to death of animal bite victims and he may be sued under Consumer Protection Act.
  3. 3.   Rabies vaccine is defined as fluid or dried preparation of rabies “fixed” virus grown in neural tissues of rabbits,sheep,goats,rats or in embryonated duck eggs or in cell cultures inactivated by a suitable method
  4. 4. Neural vaccines Non neural vaccines
  5. 5.    (a). Semple vaccine: 5% suspension of sheep brain infected with fixed virus, inactivated with phenol at 37⁰c leaving no residual virus. (b). BPL vaccine: semple vaccine inactivated with beta propiolactone, more antigenic. (c). Infant brain vaccine: prepared from suckling mouse brain, inactivated by UV radiation, BPL or phenol. Chance of neurological complication is 1 in 1600
  6. 6. Egg vaccines Tissue culture vaccines Subunit vaccines
  7. 7.   1. Duck egg vaccine: fixed virus grown in duck eggs and inactivated with BPL 2. Live attenuated chick embryo vaccine: LEP- 40-50 eggs HEP- 180 eggs for cats and cattle
  8. 8.   1. Human diploid cell culture vaccine: purified concentrated preparation of “PITMAN-MOORE” strain grown on diploid cells highly antigenic , costly 2. Purified chick embryo vaccine: (PCEV) contains “ FLURY LEP” strain inactivated by BPL. ---WHO recommended most effective
  9. 9.  Recombinant vaccines containing cloned surface glycoprotein.
  10. 10.  • • Post-exposure prophylaxis local wound care vaccine administration Pre-exposure prophylaxis Post-expore treatment of persons who have been vaccinated previously
  11. 11.   Indicated when person has been bitten , scratched , or licked by an animal Aims at neutralizing the inoculated virus before it enters the nervous system
  12. 12. Local treatment of wound 1.Cleaning:    Immediate flushing and washing wounds or scratches with soap and water for atleast 15 minutes under tap water In case of puncture wounds, catheters should be used to irrigate wounds. It minimises the risk and this procedure is standard worldwide. 2.Chemical treatment: after cleaning, virucidal agents alcohol(400-700ml/l) or 0.01% aqueous solution of iodine or povidone iodine
  13. 13.  Quaternary ammonium compounds like savlon, cetavlon are no longer recommended.  3 Suturing: bite wounds should not be immediately sutured to prevent trauma which may spread virus to deeper tissues. If necessary after 24-48 hrs later with minimum stitches  4 Anti-rabies serum: local application of anti-rabies serum or its infiltration around the wound is highly effective. Dosage is 20 IU/kg wt.  5 Antibiotics and anti-tetanus measure: application of antibiotics and anti-tetanus procedures when indicated should follow local treatment
  14. 14.  Observing animal: the only way to estimate the risk after bite is to observe animal for atleast 10 days after bite. If symptoms of rabies are seen the animal is killed humanely and head sent under refrigeration to laboratory for rabies examination  If animal remains alive and healthy after 10 days of bite, there is no indication of anti-rabies treatment
  15. 15.  Cell culture and purified duck embryo vaccine with a potency of at least 2.5 IU should be applied . A. Intramuscular schedule B. Intradermal schedule
  16. 16.    Vaccine used: HDCS vaccine(tissue culture vaccine) Site: deltoid Dose: 1 ml Day 0 3 7 14 28 Rabies Ig Standard WHO vaccination regimen
  17. 17.  Dose: one IM dose (1.0 or0.5 ml) into deltoid Day 0 Day 7 Day 21 Rabies Ig On day 0 two doses are given one in right arm and other in left arm On day 7 and 21 one dose IM in deltoid.
  18. 18. 2 site intradermal regimen 8 site intradermal regimen
  19. 19.     Vaccine used: HDCV, PCECV and PVRV Site: ID on anterior abdominal wall Dose : 0.2 ml of HDCV and PCEC and 0.1 ml of PVRV REGIMEN: 2 doses simultaneously on two sites on days 0,3,7. no dose on day 14 and one dose each on day 28 and 90. Day0 Day3 Rabies Ig Day7 Day28 Day 90
  20. 20.    Vaccine: HDCV and PECE Dose: 0.1 ml Schedule: 8 doses on different sites, deltoid, lateral thigh, suprascapular region and lower quadrant of abdomen on day 0, no dose on day 4, then 4 doses simultaneous at four sites on deltoid , thighs , no dose on day 14 and single dose on day 28 and 90. 8 Day 0 4 Day7 Rabies Ig Day 28 Day90
  21. 21. Indications:       Lab. staff handling virus and infected animals Veterinarians Animal handlers and catchers Wildlife officers and naturalists Taxidermist and quarantine officers Vaccine used: tissue culture vaccine
  22. 22.  3 injections in doses of 1 ml IM or 0.1 ml intradermally in deltoid region or anterolateral area of thigh in children. Day 0 Day 7 Rabies Ig Day 28 1year(booster) Every3 yrs(booster)
  23. 23.   Boosters: if serum samples after one month of third dose shows titre less than 0.5 IU/ml , booster doses are a given in dose of 1ml IM or ID till antibody becomes demonstrable. Futher booster doses should be given at interval of 3 yrs as long as person remains exposed
  24. 24.  If antibody titre is unknown , or if wound is severe, three 1ml doses of HDC vaccine are given Day0  Day3 Day7 If antibody titre is known and is more than 0.5IU/ml and bite is not severe only 2 doses are needed Day0 Day 3
  25. 25.  Registration and licensing of all domestic dogs.  Immediate destruction of dogs and cats bitten by rabid animals  Restraint of dogs in public place  Immunization of dogs  Health education about prevention of rabies abies
  26. 26.     Animal India Trust runs an anti-rabies vaccination programme along with animal birth control programme. Dogs captured for sterilisation are vaccinated against rabies at the same time. This helps by reducing the no. of infective dogs and thus less dogs transfer disease to humans. Reduces medical expenses and reduction in risk of human health