rabies presentation

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Page 1: Rabies presentation
Page 2: Rabies presentation

* Rabies is a zoonotic disease (a disease that is transmitted from animals to humans) that is caused by a virus.

* Nearly half of those bitten by suspect rabid animals are children under 15 years of age.

* Rabies is spread to people through close contact with infected saliva via bites or scratches.

* Most of the deaths occur in the absence of post-exposure prophylaxis

Page 3: Rabies presentation
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Element of paralysis is dominating, animal is quiet ,timid and shy

Page 9: Rabies presentation

*Rabies is caused by RNA virus of genus Lyssavirus*Family-Rhabdoviridae*Bullet shape *Neurotropic virus*New species discovered in bats

Page 10: Rabies presentation

Virus is transmitted through saliva of infected animal*Bites*scratch*Licks on injured skin*Licks on mucous membranes*Aerosols (bats in caves)Uncommon routes *Transplants of infected organs*Bite of a rabid human being

Page 11: Rabies presentation

Incubation period Varies from few days to years

Average 30-90 days

Depends upon site, degree and virus load, number of wounds

Provides opportunity to start treatment

Page 12: Rabies presentation

Sr. No District/Area No. of Rabies

Patients

Treatment Time between bite and rabies

1. Lahore 01 Not received One month 2. Lahore 01 Not received 20 days

3. Lahore 01 Not received one and a half month

4. Lahore 01 Not received 3 months 5. Shakargarh (Narowal) 01 Not received one and a half month6. Chakwal 01 Not received one and a half month

7. Rahim Yar Khan 01 Not received 3 months 8. Khushab 01 Not received one and a half month

9. Shraqpur Sharif 01 Not received 2 months 10. Okara 01 Not received 5 months 11. Muridke 01 Partly received One month12. Daska 01 Not received 2 and half month

13 Sialkot 01 Not received 3 months 14. Qadirabad 01 Not received One year15. Sargodha 01 Not received 3 months 16. DG gkan 01 Not received 2.5 years

Page 13: Rabies presentation

S.No District Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec1 Attock 213 163 207 159 172 170 136 226 182 173 122 1432 Bahawalnagar 202 249 302 277 223 231 351 368 314 180 155 1483 Bahawalpur 202 253 367 258 253 288 392 401 279 290 219 2134 Bhakkar 220 212 259 235 296 198 162 196 88 194 178 2225 Chakwal 153 217 229 204 212 226 248 251 191 163 158 1506 Chiniot 113 96 106 106 96 106 107 76 64 86 112 1037 D.G.Khan 790 100 185 56 312 252 402 60 307 31 158 1428 Faisalabad 367 469 698 707 719 519 610 573 559 527 405 4489 Gujranwala 230 189 491 429 424 766 274 360 305 204 144 69410 Gujrat 350 199 219 247 249 1034 666 172 652 831 883 27811 Hafizabad 132 371 299 292 281 302 433 328 223 252 193 22012 Jhang 247 214 258 173 149 202 240 202 192 191 162 17913 Jhelum 145 205 245 179 96 202 163 156 198 171 121 18414 Kasur 452 449 484 608 729 503 584 579 350 511 536 53915 Khanewal 163 227 230 234 263 340 199 259 194 250 200 17316 Khushab 128 95 90 95 102 141 141 111 140 129 80 12417 Lahore 215 188 343 448 671 695 366 403 214 583 61 21618 Layyah 161 149 198 214 235 177 242 99 193 108 2 1519 Lodhran 309 206 256 650 228 208 268 506 340 263 186 23220 M.B.din 62 58 61 51 41 60 87 86 75 104 62 7421 Mianwali 379 689 362 424 273 345 526 456 487 146 233 15122 Multan 205 221 210 265 283 250 273 233 178 191 169 15223 Muzaffargarh 228 200 482 647 527 557 515 184 376 382 460 26924 Nankana Sahib 68 67 88 108 93 112 104 128 99 86 76 14025 Narowal 85 104 138 100 92 69 82 89 86 78 66 7326 Okara 148 178 157 190 169 218 172 174 187 103 160 14927 Pakpattan 166 143 273 222 182 198 200 211 270 186 134 14428 R.Y.Khan 394 425 564 452 552 441 463 584 345 313 259 22629 Rajanpur 135 157 179 192 215 219 248 202 220 148 129 14030 Rawalpindi 158 155 180 119 223 211 190 228 196 194 144 13831 Sahiwal 238 146 233 157 208 302 116 253 235 201 140 14632 Sargodha 131 122 123 98 81 108 136 152 138 113 114 20033 Sheikhupura 249 317 314 335 329 221 258 223 221 213 187 20034 Sialkot 216 248 273 239 283 273 238 286 208 133 200 18635 T.T.Singh 107 91 325 226 227 220 294 232 152 179 112 21736 Vehari 294 273 395 356 252 272 319 280 320 260 243 257

Page 14: Rabies presentation

S.No District Jan-11 Feb-11 Mar-11 Apr-111 Attock 141 191 272 1992 Bahawalnagar 179 207 212 2203 Bahawalpur 211 262 497 7494 Bhakkar 61 121 133 1015 Chakwal 185 223 235 2616 Chiniot 109 137 149 927 D.G.Khan 188 212 227 1638 Faisalabad 552 673 621 3109 Gujranwala 503 355 376 13510 Gujrat 327 121 160 106111 Hafizabad 148 120 166 13212 Jhang 133 186 185 17713 Jhelum 203 114 210 19614 Kasur 599 504 500 39215 Khanewal 251 213 193 23716 Khushab 134 114 104 15617 Lahore 555 514 714 42318 Layyah 150 100 108 6019 Lodhran 250 278 258 29920 M.B.din 58 69 88 8421 Mianwali 216 205 201 13222 Multan 139 145 200 23223 Muzaffargarh 369 320 208 23024 Nankana Sahib 70 86 143 8025 Narowal 76 87 61 5026 Okara 158 177 166 18927 Pakpattan 185 120 223 19128 R.Y.Khan 351 284 361 30029 Rajanpur 205 179 185 14630 Rawalpindi 145 183 233 19731 Sahiwal 195 187 219 20532 Sargodha 205 218 116 19833 Sheikhupura 228 174 190 27134 Sialkot 245 218 217 33135 T.T.Singh 128 195 116 18036 Vehari 216 301 288 304

TOTAL 8068 7793 8535 8683

Page 15: Rabies presentation

Prodromal Phase (2-10 days) Fever, flu like symptoms, headache, anorexia, lethargy, itching or abnormal sensation at the site of wound

Acute Neurological Phase (2-7 days) Anxiety, confusion, aggression or lack of aggression, hyper salivation, muscular spasm, difficulty in swallowing leading to hydrophobia, photophobia, aerophobia

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Coma and Death Symptoms progress towards paralysis and coma in both furious and dumb rabies

Death usually occurs from respiratory paralysis within days after onset of symptoms

Page 18: Rabies presentation

*Wounds should be washed/flushed and disinfected immediately. Vaccine and immunoglobulin therapy (when required for the latter) instituted as soon as possible,* If rabies immunoglobulin is not available on first visit its

use can be delayed by a maximum of 7 days from date of first vaccine injection,*Initiation of PEP should not await the results of laboratory

diagnosis or be delayed by dog observation when rabies is suspected,*Pregnancy and infancy are never contraindications to PEP,*Persons who present for evaluation and rabies post-

exposure prophylaxis even months after having been bitten should be dealt with in the same manner as if the contact occurred recently.

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*Category I : touching, feeding of animals or licks on intact

skin no exposure therefore no prophylaxis if history reliable

*Category II:- minor scratches or abrasions without bleeding

or and nibbling of uncovered skin use vaccine alone

*Category III: single or multiple transdermal bites or

scratches, licks on broken skin, contamination of mucous membrane with saliva (i.e. licks) and suspect contacts with bats:

use immunoglobulin plus vaccine

Page 20: Rabies presentation

* Should be immediate* Is essential even if the person presents long after exposureConsists of:*Immediate washing and flushing for 15 minutes with soap and water, or water alone,*disinfection with ethanol (700ml/l) or iodine (tincture or aqueous solution).

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* The 5 dose intramuscular regime: one dose of the vaccine should be administered on days 0, 3, 7, 14 and 28 in deltoid region or, in small children, into the antero-lateral area of the thigh muscle;

* The 2-1-1 regimen may also be used. Two doses are given on day 0 in the deltoid muscle, right and left arm. In addition one dose in the deltoid muscle on day 7 and one on day 21.

* Vaccines should not be injected into the gluteal region;

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*This vaccine is of sufficient potency to allow its safe use in one of the WHO recommended intradermal post-exposure regimens

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*Immediate Case Notification.

*Availability of Anti-Rabies Vaccine. *Special Dog killing campaigns launched by the districts.

* Behavioural Change Campaigns.

*World Rabies Day- 28th September.

Page 24: Rabies presentation