Infectious Disease
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| What does a rabid animal look like? | -3 phases: prodromal, furious, paralytic
-anxiety,docile
-excitability, barking,biting, pica, pharyngeal/laryngeal spasm, muscle tremor, seizure, coma, death
- change in voice, "choking", dropped jaw
- respiratory muscle paralysis, coma/death in 2-4
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| How is rabies transmitted? | -nearly always by biting
-rarley by aerosol in caves
-ingestion of infected tissue
-mucosal contact with saliva
-transplants
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| What should you do if rabies is on your list of differentials? | -Animals with suspected rabies should be handled with extreme caution and euthanized as soon as possible. Treatment should not be attempted.
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| How is rabies infection confirmed? | **direct FA for virus (brain)
-RT-PCR/culture of saliva
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| What do you tell a client who calls worried about rabies because his dog was bitten by a squirrel? | Rodent species are rarely infected with rabies. Check vaccine status.
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| What do you tell a client who calls worried about rabies because his dog was bitten by a racoon? | Depends on vaccine status. Unvaccinated: euthanize or quarantine for 6mo then vaccinate 1mo before release. Vaccinated: revaccinate then confine for 45d
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| If you are bitten by a rabid animal, will you definitely contract disease? |
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| How long after exposure to rabies will it take before you develop clinical signs? | humans - 3wks to >1yr
Dogs and cats - 1 to 2mo
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| Is there any way of preventing disease after exposure to rabies? | -inj of human rabies Ig + vax x5 over 1mo
-if vaccinated, no HR-IG, and only 2 vax doses
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| When should you vaccinate for rabies? | -4mo
-1yr later
-q 1-3yrs depending on vax and local regulations
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| How good are the vaccines for rabies? Are there any adverse effects? | good; vaccination is the single best measure for prevention
adverse effects include postvaccinal rabies (MLV), vaccine rxn, vaccine-induced sarcoma
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| If one of your patients bites someone, what are the rules for rabies prevention and why? | healthy vaccinated: confine/observe 10d
unvaccinated: euthanize and test, or Q. 10d in hospital
stray: euthanize and test
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| what's the most important reservoir of rabies in the US? | -the skunk
-tons of virus in the saliva
-can be chronically infected
-can adapt to human environments
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| Pathogenesis of rabies virus infection | -bite wound
-virus multiplies in myocytes (wks to months)
-virus travels up peripheral nerves to CNS and multiplies
-encephalitis
-virus moves out through peripheral/cranial nerves
-saliva infective for days before clinical signs
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Created by:
modonnell