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Rabies/ Hydrophobia/ Lyssa:
is a specific, viral infection communicated to man by the saliva of an infected animal.
- -a bullet-shaped filterable virus with a strong affinity in the CNS.
- -the organism is sensitive to SUNLIGHT, UV LIGHT, ETHER, FORMALIN, MERCURY and NITRIC ACID.
- -resistant to: phenol, merthiolate, and common antibacterial agents.
- DOGS: one week to seven-and-a-months
- HUMANS: 10 days to 15 years
- *Incubation period depending on the ff factors: (D-E-R-R-S)
- 1. distance of bite to the brain
- 2. extensiveness of the bite
- 3. richness of nerve supply in the area of the bite
- 4. resistance of the host
- 5. species of animal
three to five days before the onset of sx until the entire course of illness.
INFECTED ANIMAL: carries the rabies virus in its saliva and transmits it to humans by biting.
virus is also spread when the saliva is in contact in the person's mucus membranes (mouth and eyelids or broken skin).
Clinical manifestations: 3 PHASES
- 1. PRODROMAL/ INVASION PHASE:-(+) fever, anorexia, malaise, sore throat, copious salivation, lacrimation, perspiration, irritability, hyperexcitability, apprehensiveness, restlessness, drowsiness (sometimes), mental depression, melancholia (deep sadness), and marked insomnia.
- -(+) PAIN at the site of bite and pain and aches at diff parts of the body; headache and nausea.
- -sensitive to light, sound and temperature.
- -anesthesia, numbness and tingling, burning and cold sensation may be felt along the peripheral nerves involved and the site of the bite.
- 2. EXCITEMENT/ NEUROLOGICAL PHASE:
- -(+)marked excitation and apprehension.
- -terror may occur.
- -(+) delirium assoc with nuchal rigidity, involuntary twitching or generalized convulsions.
- -(+) maniacal behavior; eyes are fixed and glossy; cold and clammy skin.
- -(+) severe and painful spasms at the mouth, pharynx and larynx when there is an attempt to swallow water or food or even at the mere sight of them.
- -(+) aerophobia
- -profuse drooling
- -tonic clonic contraction of the muscles.
- -death-> episode of spasms or from cardiac/resp failure.
- -if survived this phase: pt deteriorates rapidly and enters the terminal phase.
- 3. TERMINAL/ PARALYTIC PHASE:-quiet and unconscious.
- -loss of bowel and bladder control.
- -(-)spasm and (+)paralysis
- -tachy and labored resp
- -death: resp paralysis, circulatory collapse or heart failure.
- ★ VIRUS ISOLATION frm the pt's saliva or throat.
- ★ FLUORESCENT RABIES ANTIBODY (FRA): most definitive!!!★ (+) NEGRI BODIES on the dog's brain.
- -wash the bite and scratches with soap and running water for at least three minutes.
- -check pt's immunization status.
- -give TT if needed.
- -give anti rabies vaccine: BOTH ACTIVE AND PASSIVE (depending on the site and size of bite and the health condition of the biting animal).
- -provide comfort and px injury.
- -darken room and provide quiet environment.
- -pt is NOT bathed; there should be NO running water near the pt's room or anywhere that the pt can still hear.
- -IV fluid-wrapped; securely anchor the needle to the vein to avoid dislodging.
- -concurrent and terminal disinfection should be carried out.
PREVENTION AND CONTROL:
GOAL: interruption of the mode of transmission.
a. vaccination of ALL DOGS.
- b. 10-14 days confinement of any dog that has bitten a person.
- c. public education: avoidance and reporting of all animals that appears sick