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Rabies. Why is this so important?. Dogs, 99%. Sylvatic :. “Animal carer dies from rabies 'after being scratched by dog in Africa two years ago” “Rabies victim 'failed to tell doctors about about dog bite or her trip to India”
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Dogs, 99% Sylvatic:
“Animal carer dies from rabies 'after being scratched by dog in Africa two years ago” • “Rabies victim 'failed to tell doctors about about dog bite or her trip to India” • “When Milly nipped me, I thought nothing of it... then she died and I heard she had rabies” • “Bat bite rabies victim dies”
Pathogenesis Virus-laden saliva. Retrograde axonal transport towards brain. Incubation:4 days-years. Clinical: 1-10 days. Fatal if it reaches CNS. Encephalopathy.
Symptoms. Hallucinations Flacid paralysis http://www.youtube.com/watch?v=-moG6JDmJdc
Before you travel: “Pre-exposure rabies vaccination is strongly recommended for all travellers to rabies-endemic regions.” WHO guidelines Chick embryo or Human diploid 0,7 and 21 days Booster at 3-5yrs
Exposed? Lipoprotein envelope
Post exposure prophylaxis. Rabies immunoglobulin. Human or equine. Vaccine.
Scenarios. • You wake up in your tent in Scotland to find that the tent was not zipped up properly. There is a bat in the tent, you do not find any cuts or bites on you. You have been vaccinated with a full vaccination course.
Scenario 2 • You are on elective in India. A patient presents with a deep scratch from a monkey. He is unsure as to whether he has been vaccinated.
Scenario 3 • You are on an expedition in China when a stray dog bites you. You have been vaccinated, but do not have any booster shots with you. You will have to curtail the expedition to get to a hospital.