Rabies is a viral disease causing acute encephalitis in warm-blooded animals, primarily transmitted to humans through bites or scratches from infected animals, mostly dogs. Symptoms include bizarre behavior, hydrophobia, and paralysis, with a high fatality rate once they develop, necessitating immediate treatment including wound care and vaccinations. Prevention involves pre-exposure and post-exposure prophylaxis, with attention to timely management and infection control in cases of confirmed rabies.

1. ANJALI TRIATHI
BSC (H) MICROBIOLOGY
DEPARTMENT OF INDUSTRIAL MICROBIOLOGY
16BSMBH012

2. CONTENT
 Definition
 Introduction
 Sign and Symptoms
 Prognosis
 Treatment
 Prevention

3. Definition
 Rabies is a viral disease that causes
acute encephalitis
(inflammation of the brain) in warm
blooded animals.
 Rabies is a zoonotic disease (a
disease that is transmitted to
humans from animals) that is caused
by a virus

5. INTRODUCTION
 The disease infects domestic and wild animals,and is
spread to people through close contact with infected
saliva via bites or scratches.
 Dogs are the source of 99% of human rabies deaths
 Once symptoms of the disease of the disease develop,
rabies is nearly always fatal

6. SOURCE OF INFECTION
 The source of infection to manis the saliva of rabid
animals.
 In dogs and cats ,the virus may be present in the saliva
for 3-4 days before the clinical onset and during the
course of illness till death.

8. INCUBATION PERIOD
 It is highly variable in man,commonly3-8 weeks
following exposure.
 The closure the bite to the brain,the shorter the
incubation.
 Rabies virus travels one centimeters per day

9. DOG BITE

10. PATHOGENSIS
 Live virus Epidermis , Mucus membrane
Peripheral nerve
centripetally
CNS ( grey matter )
centrifugally
Other tissues (salivary glands)

12. SIGN & SYMPTOMS
 Bizarre behavior
 Agitation
 Seizures
 Difficulty in drinking
 Patients will be able to eat solids
 Afraid of water – Hydrophobia
 Even sight or sound of water disturb the
patient
 But suffer with intense thrist
 Spasms of pharynx produces choking
 Death in 1-6 days
 Respiratory arrest/death/some may survive.

13. Continued..
 Headache, fever, sorethroat
 Nervousness, confusion
 Pain and tingling at the site of bite
 Hallucinations
 Paralysis

14. PREVENTATION
 PRE EXPOUSURE PROPHYLAXIS
 POST EXPOUSRE PROPHYLAXIS

15. PRE EXPOSURE VACCINATION

16. PRE EXPOSURE PROPHYLAXIS
 Provided to subjects at the risk before occupational or
vocational exposure to rabies.
 Subject include diagnosticians laboratory and vaccine
workers, vatenarians, cavers.
 Simplifies post exposure management.
 Only vaccine used.

17. POST EXPOSURE PROPHYLAXIS
 Provided to subjects after rabies exposure.
 Consist of wound care, rabies immune globulin, and vaccine
 Cleansing.
 Chemical treatment.
 Suturing.
 Anti-rabies serum.
 Antibiotics and anti-tetanus measure.
 Observe the animal for 10 days.
 Wash lesions well with soap and water.
 Infiltrate rabies immune globulin (20 IU/kg) into and around
the margin of bites.
 Administer vaccine around 90 days.

18. RABIES IMMUNOGLOBULIN
 Two Human Rabies Immunoglobulin are available;
 Both supplied in vials at– 150 IU/ml

21. WOUND CLEANING & TREATMENT
Wash the area of an animal bite thoroughly

22.  Initial treatment for an animal bite should include
through cleansing however all animal bite should be
seen by Physician.

23.  Apply pressure if bite is actively bleeding.

24. TREATMENT
 POST EXPOSURE TREATMENT
A. LOCAL WOUND TREATMENT
Wash with soap/detergent and warter preferably for 10
minutes.
Apply alcohol, povidone iodine/ any antiseptic.
Anti-tetanus
Avoid suturing wounds.
Do not apply oinment, creams/ wound dressing

25. ANTIMICROBIAL
Amoxicillin
Cloxacillin
Cefuroxime
For those instances where there is no obvious signs of
infection (Amoxicillin as prophylaxis)

26. VACCINE ADMINISTRATION
1. Intra muscular schedule
6 dosage schedule
Reduced multisite intra mascular
regime (2-1-1)
2. Intradermal schedule
2 site intradermal schedule(2-2-2-
0-1-1)
8 site intraderal schedule (8-0-4-
0-1-1)

27. Vaccination
INTRADERMAL SCHEDULE
Day of Immunization PVRV/PCECV Site
DAY 0 0.1 ml L & R deltoids/
anterolateral thighs of
infants
DAY 3 0.1 ml L & R deltoids/
anterolateral thighs of
infants
DAY 7 0.1 ml L & R deltoids/
anterolateral thighs of
infants
DAY 28/30 0.1 ml L & R deltoids/
anterolateral thighs of
infants

28. MANAGEMENT OF RABIES PATIENT
 Once symptoms start, treatment should centre on comfort
care, using sedation and avoidance of intubation and life
support measures once diagnosis is certain.
 MEDICATIONS
Diazepam
Midazolam
Haloperidol + Dipenhydramine

29. 2. SUPPORTIVE CARE
Confirmed rabies should receive adequate sedation and
comfort care in an appropriate medical facility
once rabies diagnosis has been confirnmed invasive
procedure must be avoided
Provide suitable emotional and physical support
Discussion and provide important information to relative
concerning tranmission of disease and indication for PET of
contacts.
Honest, gentle communication should be provided to
relatives of patients.

30. 3. INFECTION CONTROL
Patient should be admitted in a quiet, draft-free
isolation room.
HLCR workers and relatives in contact with patients
should wear proper personal protective equipment.
4. DISPOSAL OF DEAD BODY

31. THANK YOU