Signs of Rabies in Human: Symptoms, Causes, Treatment, and Prevention-
Signs of Rabies in human beings show you are a heartwarming video seen in my life. Symptoms of disease in human video show you develop of Rabies of bite (in Day): 43 Days. Signs of Rabies in humans after a dog bite the first symptoms can appear from a few days to more than a year after the bite occurs. In this case of a patient suffering from a fever, headache, muscle aches, loss of appetite, nausea, and fatigue.
History of this Rabies Patient:
Date: 11th February 2016
Age (In Years): 62 Years
Nature of injury: Bite
Type of Bite: With Bleeding
Site of Bite: Head
Number of Bites: Multiple
The severity of Bite: Sever
History of Vaccination: Absent
Anti-Serum: Not Used
History of the bite by Stray Animal
Name of Animal: Dog
Development of Rabies of bit (in Day): 43 Days
The fate of animal: Killed by public
Symptoms: Hydrophobia, Aerophobia
In the advanced stage of the infection, as it spreads to other parts of the nervous system, these symptoms may develop, problems moving facial muscles, abnormal movements of the diaphragm and muscles that control breathing, difficulty swallowing and increased production of saliva, causing the “foaming at the mouth” usually associated with rabies infection. As well as Hydrophobia, Aerophobia.
Prevention of Human Rabies:
In this post, you will talk about animal sting management and pre and post-exposure vaccination schedules. Let us first look at the history of Rabies. The name of his picture is Mr. Louis Pasteur.
Rabies Virus: Mode of Transmission
Animal to Man:
- Bites of rabid animals.
- Scratches by rabid animals—rabies Virus Types.
- Licks on abraded skin or mucous membranes.
- In caves harboring rabies-infected bats.
- In laboratories handling rabies-infected neural tissue.
- She was drinking un-boiled raw milk of rabies-infected cow or goat.
- Eating the meat of rabid animals can theoretically lead to Rabies.
Man to Man:
- A corneal transplant from an infected person.
- Solid-organ transplant (liver, kidney) from an infected person.
- Bite from a rabid human; theoretical risk but no confirmed cases reported as yet.
Animal Exposure Management:
- Wound management
- Post Exposure Prophylaxis (PEP)
- Rabies Immune Globulin (RIG)
- Tetanus prophylaxis
WHO Wound Category:
Type of Contact: Touching or feeding of animals Licks on intact skin
Type of Contact: Nibbling of uncovered skin Minor scratches or abrasions without bleeding
Type of Contact: Single or multiple transdermal bites or scratches licks on broken skin and
Contamination of mucous membrane with saliva (i e. licks)
Recommended post-exposure prophylaxis: ↓
- Wound management
- Rabies immunoglobulin
- Antirabies vaccine
People with weak Immune Systems:
Especially people with any of these conditions:
- People infected with HIV,
- Substance abuse
- Diabetes mellitus
- Cancer of the head or neck
- Leukemia or Hodgkin’s disease
- Severe kidney disease
- Low body weight, Malnutrition
- Specific medical treatments (such as corticosteroid
- Treatment or organ transplants)
- Specialized therapy for rheumatoid arthritis or Crohn’s disease
PEP – Local wound treatment:
- Physically removing virus particles
- Further inactivation of the remaining virions by chemical disruption
- Delay as much as possible the suturing of the wound.
- Avoid direct touching of wounds with bare hands.
- Gentle, thorough washing with soap or detergent and flushing the wound with running water for 10-15 minutes, for five times.
- If soap and detergent are not immediately available, wash with running water for at least 10 minutes.
- Later anti-septic will be used.
STRUCTURE OF RABIES VIRUS:
- Single-Stranded RNA Virus
- Bullet Shaped.
- Size 75 nm x 180 nm.
- Enveloped Virus – Lipoprotein
- Numerous spikes present on the envelope made up of glycoprotein.
- Glycoprotein necessary for viral attachment & induces protective antibodies.
- Nucleoprotein is also essential and known to offer protection.
Wound Management: Surgical Care
- Suturing of the wound should be avoided as far as possible. If surgically unavoidable, minimum loose sutures should be applied after adequate local treatment along with proper infiltration of rabies immunoglobulins (RIG).
- Cauterisation of the wound is no longer recommended as it leaves a horrible scar and does not confer any additional advantage over washing the wound with water and soap.
Prevention of human Rabies: The 5 essential things-
PEP-Post Exposure Prophylaxis for non-immunized subjects:
WHO approved ID regimens for Post-Exposure Prophylaxis:
Intradermal route and rabies vaccine potency requirements:
The antigenic potency of all the WHO-approved vaccines has proven similar and is well above the minimum value of 2.5 IU/ampoule.
WHO minimum potency requirement for human rabies vaccines for intradermal use should not be increased beyond 2.5 IU (per single intramuscular dose) by national authorities unless the need for a change is substantiated by clinical or field studies.
PEP vaccination schedule for pre-immunized subjects:
- Those who have previously undergone complete pre-exposure VaccinationVaccination or post-exposure prophylaxis with cell-derived rabies vaccines.
- Those who have been vaccinated against Rabies and demonstrated neutralizing antibody titers of at least 0.5 I0/mL.
Source: WHO Expert consultation on Rates Frg report Technical Report Series 931, 2006.1-121
PEP vaccination schedule for pre-immunized subjects:
- Vaccination was not documented or incomplete.
- The person was vaccinated with vaccines of unproven potency.
- The person was vaccinated with a nerve tissue rabies vaccine, and the neutralizing antibody titers were less than 0.5 IU/mL.
- It is an immunocompromised person.
Source: WHO Expert Consultation on Rabies, First report, Technica Repen Seres 93 D00s 1121 38. Sanofi Pasteur Company Core Data Sheet Rabies (VERO) Vaccine, February 2007 Data on file
TCV Schedules (ID):
- For pre-exposure prophylaxis, 1st booster injection one year later, and subsequent booster injections recommended. Regular serology testing of neutralizing antibodies to assess seroconversion of subjects at increase risk of exposure to rabies virus, with a frequency, adapted to that risk.
Source: WHO Expert Consultation on Rabies, First report Technical Report Senes 931, 2005,1-121.38. Sanofi Pasteur Company Core Data Sheet Rabies (VERO). Vaccine, February 2007. Data on file
RIG: Type and Dose-
Equine rabies immunoglobulins (ERIG):
40 IU per kg body weight up to a maximum of 3000 IU.
Human rabies immunoglobulins (HRIG):
20 IU per kg body weight up to a maximum of 1500 IU.
RIG (Rabies Immune Globulin): Mode of Action
- According to WHO- RIG is a must in severe Rabies.
Category III Definition:
Exposure: WHO Category III
- To provide early protection for patients
- Schematic diagram explaining antibodies kinetic after antirabies VaccinationVaccination.
Deaths have been reports due to “Management errors.”
These are usually the result of:
- Delay in treatment
- Lack o RIG administration
- Failure to inject RIG into all the bite wounds.
Positive test reaction:
- Induration >10mm with or without constitutional symptoms.
- If the skin test is positive – HRIG is preferred (affordability, availability)
- If ERIG has to be administered, then pre-treat with Adrenaline / Epinephrine and with Antihistamine before administering the full dose.
01. To protect:
- Persons with unrecognized exposure or those for whom post-exposure therapy might be delayed
02. To simplify:
- Eventual post-exposure treatment by decreasing the number of doses of vaccine required.
- The need for rabies immune globulin (RIG)
- Diagnostic, research and production, laboratory staff
- Nurses, medical staff, animal handlers, and veterinarians
Pre-Exposure Vaccination Schedule:
- IM injections in the deltoid muscle
- Or in the anterolateral part of the thigh, if necessary (children)
- Or 0,1mL ID for WHO recognized rabies vaccines
Source: WHO Expert Consultation on Rabies, First report Technical Report Senes 931, 2005,1-121
Tetanus Toxoid, IM
- Injection tetanus toxoid should be given to the un-immunized individual.
- TIG (Tetanus Immune-Globulin), IM
- To prevent infection or sepsis in the wound, a suitable course of an antibiotic may be recommended.
Analyzing Post-Exposure Prophylaxis Failure:
- Absence of wound care (including first aid treatment)
- No use of RIG along with the vaccine
- Wound not infiltrated with RIG (Immediate suturing of the wound)
- Inadequate infiltration of RIG around and into wounds
- Delay in starting the treatment
- Immunocompromised patients
- Non-compliance with the Schedule
Source: Wilde H. Choomkaslent P. Hemachudha T. Supich C. Chutivongse V. Failure of post-exposure treatment in Thailand. Vaccine. 108
- Administration of Rabies post-exposure prophylaxis is a medical urgency,
Therefore, decisions must not be delayed.