More Related Content
Rabies
- 1. Presented By, Shubham KumarJha IInd Yr. B.Sc.(N) Manjushree College Of Nursing Bangalore
- 2. Rabies isa viral disease that causes acute inflammation of the brain in humans and other warm-blooded animals.Rabies is transmitted to humans from other animals. Rabies can be transmitted when an infected animal scratches or bites another animal or human.
- 3. Rabies, alsoknown as hydrophobia is an acute, highly fatal viral disease of the central nervous system, caused by Lyssavirus type 1. It is primarily a zoonotic disease of warm-blooded animals
- 4. Rabies isan enzootic and epizootic disease of worldwide importance Some countries have achieved "rabies free" status by vigorous campaigns of elimination, while in others the disease has never been introduced. Geographic boundaries seem to play an important role here. Water appears to be the most effective natural barrier to rabies. Water appears to be the most effective natural barrier to rabies. Australia, China (Taiwan}, Cyprus, Iceland, Ireland, Japan, Malta, New Zealand, the U.K. and the islands of Western Pacific are all free of the disease.
- 5. Rabies occursin more than 150 countries and territories. Vast majority of the estimated 55,000 deaths caused by rabies each year occur in rural areas of Africa and Asia. In India, Union Territory of Lakshadweep and Andman and Nicobar islands are free of the disease. In India alone, 20,000 deaths (that is, about 2 per lac population at risk) are estimated to occur annually.
- 6. Agent (Lyssavirus type1 of Rhabdovirus family) Host •Warm blooded animals •Dog handlers •Hunters •Veterinarians •Laboratory Staff Environment • Rabid dogs • Cats • Vampire Bats • Jackal • Hyena • Fox, etc.
- 7. 4.1.1) Agent:- Thecausative agent is Lyssavirus Type I of Rabdoviridiae-serotype I. Serotype II, III & IV are rabies related but antigenically different. The virus is excreted through saliva of affected animals. 4.1.2) Source of infection:- Saliva of Rabid animals is source of infection. Virus recovered or excreted from naturally occurring cases is called street virus.
- 8. 4.1.3) ReservoirOf Infection:- Rabies exist in three distinct forms:- a) Urban Rabies b) Wild-life Rabies c) Bat Rabies
- 9. Urban Rabies:- Transferof Rabies from wild life to domestic dogs in creation of urban cycle of Rabies. Wild-Life Rabies:- Wild-Life Rabies or Sylvatic form of Rabies presents and intractable problem. It is perpetuated by Jackal, Fox, Hyena & other wild animals, which are the main reservoir of infection. Bat Rabies:- The vampire bats are main host and vector of rabies. They feed exclusively on blood of Human & Animals. Rabies caused by Vampire bats is thought to kill thousand of cattle. Humans are affected while sleeping outdoor.
- 10. Warm bloodedanimals Dog Handlers Hunters Veterinarians Laboratory Staff working on Rabies virus
- 11. Rabid dogs Cats Vampire bat Jackal Fox Hyena • They are main Reservoir & Transmitter of rabies.
- 12. Rabies isusually transmitted through a bite from an infected anima Transmission can also occur when infectious material - usually saliva -comes into direct contact with human mucosa or fresh skin wounds. Human-to-human transmission by bite is theoretically possible but has never been confirmed. Rarely, rabies may be contracted by inhalation of virus-containing aerosol or via transplantation of an infected organ.
- 13. . The incubationperiod in man is highly variable, commonly 1-3 months following exposure but may vary from 7 days to many years. The incubation period depends on the site of the bite, severity of the bite, number of wounds, amount of virus injected, species of the biting animal, protection provided by the clothing and treatment undertaken,etc. incubation period tends to be shorter in severe exposures and bites on face, head, neck and upper extremities and bites by wild animals.
- 14. Fever Headache Nausea Vomiting Agitation Anxiety Confusion Hyperactivity Difficulty swallowing
- 15. As the infectionprogresses Insomnia Restlessness Excessive swallowing Hydrophobia Photophobia Severe muscular spasm Paralysis of lower legs Anxiety Irritability Difficulty swallowing
- 16. Rabies inman is called hydrophobia. The disease begins with prodromal symptoms such as headache, malaise, sore throat and slight fever lasting for 3-4 days. The prodromal stage is followed by widespread excitation and stimulation of all parts of nervous system usually involving, in order, the sensory system, the motor system. The patient is intolerant to noise, bright light or a cold draught of air (sensory).
- 17. Examination mayshow increased reflexes and muscle spasms (motor) along with dilatation of the pupils and increased perspiration, salivation and lachrimation. The symptoms are progressively aggravated and all attempts at swallowing liquid become unsuccessful. At later stage the mere sight or sound of water may provoke spasm of the muscles of deglutition. This characteristic symptom of hydrophobia (fear of water) is pathognomonic of rabies and is absent in animals. The duration of illness is 2 to 3 days, but may be prolonged to 5-6 days in exceptional cases. The patient may die abruptly during one of the convulsions or may pass on to the stage of paralysis and coma.
- 18. 1. History Collection 2.Physical Examination 3. Immunofluroscence Test 4. Skin Biopsy 5. Virus Isolation 6. ELISA
- 19. There is nospecific treatment for rabies. Case management includes the following procedure : The patient should be isolated in a quiet room protected as far as possible from external stimuli such as bright light, noise or cold draughts which may precipitate spasms or convulsions. Relieve anxiety and pain by liberal use of sedatives. Morphia in doses of 30-45 mg may be given repeatedly. If spastic muscular contractions are present use drugs with curare-like action.
- 20. Ensure hydrationand diuresis Intensive therapy in the form of respiratory and cardiac support may be given. NOTE:- Patients with rabies are potentially infectious because the virus may be present in the saliva, vomits, tears, urine or other body fluids. Nursing personnel attending rabid patients should be warned against possible risk of contamination and should wear face masks, gloves, goggles and aprons to protect themselves.
- 21. This may beconsidered under 3 heads : 1. Post-exposure prophylaxis 2. Pre-exposure prophylaxis 3. Post-exposure treatment of persons who have been vaccinated previously.
- 22. POST-EXPOSURE PROPHYLAXIS Generalconsiderations : The vast majority of persons requ1rmg anti- rabies treatment are those who were bitten by a suspected rabid animal. The aim of post-exposure prophylaxis is to neutralize the inoculated virus before it can enter the nervous system. Every instance of human exposure should be treated as a medical emergency.
- 23. Local Treatmentof Wound : 1. Cleansing 2. Chemical treatment 3. Suturing 4. Antibiotics & Anti-tetanus methods
- 24. Immunization – Pre-exposureprophylaxis consists of three 1.0 mL doses Rabies vaccine {Cell culture Vaccine/Human dioloid cell vaccine/Embryonated egg cell vaccine}administered using a sterile needle and syringe, one injection per day on Days 0, 7, and 21 or 28. SITE :- Deltoid/Thigh ROUTE :- IM/ID
- 25. Pre Exposure Prophylaxis PrEP may be performed with any of the modern cell- derived vaccines and is recommended for anyone at increased risk of exposure to rabies virus. PrEP schedule requires intramuscular doses of lml or 0.5 ml, depending on the vaccine type, or intradermal administration of 0.1 ml volume per site (one site each day) given on days 0, 7 and 21 or 28.
- 26. Post-exposure Treatment ofPersons Who Have Been Vaccinated Previously For rabies-exposed patients who can document previous complete pre-exposure vaccination or complete post-exposure prophylaxis with a CCEEV, 1 dose delivered intramuscularly or a CVV delivered intradermally on days 0 and 3 is sufficient
- 27. . In developing countriesover 90% of human deaths from rabies are caused by dog bites and dog rabies control is the key that can lock the door against human rabies. . INCUBATION PERIOD The incubation period in dogs ranges from 3-8 weeks, but it may be as short as 10 days or as long as a year or more.
- 28. CLINICAL PICTURE Rabies indogs may manifest itself in two forms Furious rabies and Dumb rabies. Furious Rabies :- This is the typical "mad-dog syndrome", characterized by (i) a change in behaviour (ii) running amuck (iii) change in voice (iv) excessive salIvation (v) Paralytic stage
- 29. Dumb rabies:- In this type, the excitative or irritative stage is lacking. The disease is predominantly paralytic. The dog withdraws itself from being seen or disturbed. It lapses in to a stage of sleepiness and dies in about 3 days.
- 30. 1. FLUORESCENT ANTIBODYTEST 2. MICROSCOPIC EXAMINATION 3. MOUSE INOCULATION TEST 4. CORNEAL TEST
- 31. Prophylactic vaccination ofdogs against rabies is one of the most important weapons in rabies control. All dogs should receive primary immunization at the age of 3-4 months and booster doses should be given at regular intervals, according to the type of vaccine used. 1. BPL inactivated nervous tissue vaccine (Single dose) : This is based on 20% suspension of infected sheep brain. The dose is 5 ml for dogs and 3 ml for cats. Revaccination is advised after 6 months, and subsequently every year.
- 32. 2. Modified livevirus vaccine : This is based on 33% chick embryo suspension infected with modified virus. The dose is 3 ml by single injection, and boosters every 3 years.
- 33. Since dogis the major source of infection, the most logical and cost-effective approach is elimination of stray and ownerless dogs. Registration and licensing of all domestic dogs. Restraint of dogs in public places. Quarantine for about 6 months of imported dogs. Health education of people regarding the care of dogs and prevention of rabies. Prevent bats from entering living spaces or other structures near your home.
- 34. Avoid contactwith wild animals. Oral vaccines :- An attempted live rabies vaccine harmless but immunizing to foxes, is a great advancement in the rabies prophylaxis of wild life.