Basic sensitization program for community health workers and first aiders on rabies prevention and dog bites.

1. MANAGEMENT OF ANIMAL
BITE VICTIMS AND RABIES RISK
EXPOSURE SENSITIZATION
CAMPAIGN
WAR AGAINST RABIES
FOUNDATION
Dr. Jerome U. Okpanachi
(DVM, MSc. Vet. Epid.)

2. EPIDEMIOLOGY
• RABIES aka Ciwon Haukan Kare, Ginnaji,
Digbolugi, Ara nkita, Nkita Nayera, Iwa ihundu,
Idat Ebusa, Abia Imu.
• Rabies virus (RABV) causes a fatal encephalitis
in all warm blooded animals.
• IP= 1-3 months. (10 days – 8 months).
• Mortality Rate/Prevention is 100%.
• Urban Reservoir is the domestic dog (and cat).
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3. EPIDEMIOLOGY
• In Nigeria RABV is primarily transmitted by the bite of
an infected dog, less frequently by cats.
• Signs in dogs: change in behaviour, loss of appetite,
inability to drink.
• Restlessness, aggressiveness, aimless wandering,
attacking other animals and man (Furious Rabies).
• Photophobia, Paralysis, Ataxia, death (Dumb Rabies).
• Diagnosis: CS, Lab, Pathology.
• Quarantine: 10 days of suspected animals.
• PEP: Scarce, Expensive, Adverse Rxn.
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4. CATEGORIZATION OF DOG BITES
• CATEGORY I: Intact skin plus contact with
saliva.
• CATEGORY II: Minor scratches plus contact
with saliva.
• CATEGORY III: One or more bites, scratches or
licks on broken skin.
• This Categorization help in deciding whether
to give ARV or RAS.
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5. MANAGEMENT OF THE BITE WOUND
• Clean wound with soap, detergent and water.
• Then with alcohol (70% ethanol).
• Then apply tincture of iodine.
• or 1% quaternary ammonium compound.
• Flush exposed mucous membranes with water.
• Suturing bite wound is contraindicated.
• Instill Rabies Immunoglobulin around the wound
site deeply.
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6. MANAGEMENT OF THE VICTIM
• Use RAS for passive immunity/immediate
action.
• Administer 1 dose of HRIG and 4 doses of ARV
over a 14 day period.
• Infiltrate HRIG around the bite and deep IM at
a distant site.
• Human diploid cell ARV given on Day 1, 3, 7,
14, 30 or 90 or Day 1, 3, 7, 14, 28 and 60.
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7. FIRST AID FOR DOG BITES
• NB*: Dog bites may be serious not only because
of wound infection but Rabies.
• *The dog should not be killed, but chained and
kept under observation for 10 days.
• *If it is healthy after 10 days, it is not rabid.
• *If it dies during these 10 days, the head should
be removed and sent to the ABU Veterinary
Teaching Hospital Zaria, WAR Foundation, NVRI or
any other Veterinary Clinic.
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8. FIRST AID FOR DOG BITES
• *To prevent Rabies, or other infection and
obtain medical/veterinary aid are the aims.
• Great care should be taken to swab the saliva
away from the wound and not into it.
• Wash the wound thoroughly with a strong
solution of soapy water.
• Cover with a dry sterile dressing.
• Splint the limb and obtain medical aid/send
patient to hospital.
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9. CONCLUSION
• Rabies is 100% preventable.
• Rabies is a zoonotic infection.
• Rabies is primarily transmitted by the bite of a rabid
animal usually a dog in Nigeria.
• Dogs and Cats should be vaccinated against rabies,
have pet green books and receive annual booster
shots.
• Dogs should be collared, leashed and should not be
allowed to stray .
• Children and the elderly are the Population at Risk.
• Thanks for Listening.
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