3. CONTENTS
1. Definition 9.Treatment
2. History 10. Prevention
3. Distribution 11. Recomendation
4. Epidemiology
5. Life cycle
6. Symptomology
7. Diagnosis
8. Prognosis
4. RABIES!? SAY WUH!?
is a viral disease that causes
acute encephalitis (inflammation
of the brain) in warm-blooded
animals
Rabies is a zoonotic disease (a
disease that is transmitted to
humans from animals) that is
caused by a virus
5.
6. Etymology
The term is derived from
the Latin rabies, "madness". Thi
s, in turn, may be related to the
Sanskrit rabhas, "to do
violence“
The Greeks derived the word
"lyssa", from "lud" or "violent";
this root is used in the name of
the genus of rabies lyssavirus
7. The rabies virus is type
species of Lyssavirus
genus, in the family
Rhabdoviridae, order
Mononegavirales
10. The disease infects domestic
and wild animals, and is spread
to people through close contact
with infected saliva via bites or
scratches.
Dogs are the source of 99% of
human rabies deaths
Once symptoms of the disease
develop, rabies is nearly always
fatal.
11.
12. Where did this all begin?
Rabies may be the
oldest infectious disease
known to man.
2300 BC
Dog owners in the Babylonian
city of Eshnunna are fined heavily
for deaths caused by their dogs
biting people.
14. The first written record of rabies
is in the Mesopotamian Codex of
Eshnunna (ca. 1930 BC), which
dictates that the owner of a dog
showing symptoms of rabies
should take preventive measure
against bites
15. Inancient medical times, the
attachment of the tongue (the
frenum linguae, a mucous
membrane) was cut and
removed from where they
thought the rabies came from.
This changed once they found
the actual cause of rabies.
16. Rabies was considered a scourge for
its prevalence in the 19th century
In France and Belgium, where Saint
Hubert was venerated, the "St
Hubert's Key" was heated and
applied to cauterize the wound; by an
application of magical thinking, dogs
were branded with the key in hopes of
protecting them from rabies
17. At Cahors France a 16-Year Old Boy
Grabs and Controls a Rabid Dog
Which is Terrifying Passers-By
19. All human cases of rabies
were fatal until a vaccine was
developed in 1885 by Louis
Pasteur and Emile Roux.
Their original vaccine was
harvested from infected
rabbits, from which the virus
in the nerve tissue was
weakened by allowing it to dry
for five to ten days
23. Distribution
occurs in more than 150 countries and
territories
Worldwide, more than 55 000 people die
of rabies every year.
Every year, more than 15 million people
worldwide receive a post-exposure
preventive regimen to avert the disease –
this is estimated to prevent 327 000
rabies deaths annually.
24. Rabies is present on all
continents with the exception
of Antartica, but more than
95% of human deaths occur
in Asia and Africa
25.
26.
27. Rabies in the Philippines
High numbers of rabies cases are
from Western Visayas, Central
Luzon, Bicol, Central
Visayas, Ilocos and Cagayan
Valley regions
200- 300 deaths per year (281 in
2007)
28. Majority of rabies victim are
children under 15 years of age
More males (55.7%) than
females (44.3%)
Dogs remain the principal cause
of animal bites and rabies cases
in 2006- and 2007 90%, Cats
(7%)
29. CHDs with Most Number of
Human Rabies
Rank 2007 2006
(281 cases) (219 cases)
1 CHD5(41) CHD2(27)
2 CHD3(40) CHD3(23)
3 CHD4A(38) CHD5(22)
4 CHD2(23) CHD6&12(20)
5 CHD7(22) CHD7&8(19)
30. Provinces with Most Number
of Human Rabies
RANK 2007 (269 cases) 2006 (219 cases)
1 Camarines Sur(21) Cagayan(13)
2 Cagayan (16) Isabela(12)
3 Nueva Ecija(12) Iloilo(10)
4 Bulacan, Bohol(10) Nueva Ecija, Bohol
5 Laguna(9) Tarlac (8)
Albay(7)
31. Epidemiology
Rabies is widely distributed across
the globe, with only a few countries
(mainly islands and peninsulas)
being free of the disease.
Jackals, bat-eared foxes and
mongoose are involved in rabies
transmission in Africa, particularly
in the south-eastern part of the
continent.
35. By contrast, canine rabies
predominates in most of the
developing countries of central
and south America, Africa and
Asia, where the greater burden
of human rabies falls. More than
90% of cases of human rabies
are transmitted by dogs; most
deaths occur in Asia and Africa.
39. Epidemiology in the
Philippines
Although rabies is not among the
leading causes of disease and death
in the country it has become a public
health problem of significance for two
reasons
most acutely fatal infections which
causes the death of between 200-500
Filipinos annually
40. 4thWorldwide
53.7 percent of animal bites
patients are children
Based on the report from
NCDPC (2004)
This is due to early provision of
post exposure vaccination to dog
bite victims. Dogs remain the
principal animal source of rabies
41. Life Cycle
Rabies viruses move from the site of
entry, such as through a wound, and
are transported along nerve fibres
towards the spinal cord and ultimately
the brain, where the virus undergoes
replication.
Abnormal behaviour results from the
effects of viral infection in nerve
tissues.
42. From the brain, rabies virus is
further spread to other organs
via the nervous system.
The salivary glands, located in
the tissues of the mouth and
cheeks, receive high
concentrations of virus, making
saliva an effective medium
for virus transfer when the
infected animal bites another
animal.
43.
44. Symptomology
The incubation period for rabies
is typically 1–3 months, but may
vary from <1 week to >1 year.
The initial symptoms of rabies
are fever and often pain or an
unusual or unexplained tingling,
pricking or burning sensation
(paraesthesia) at the wound site.
45. As the virus spreads through the
central nervous
system, progressive, fatal
inflammation of the brain and spinal
cord develops.
Two forms of the disease can follow.
People with furious rabies exhibit
signs of hyperactivity, excited
behaviour, hydrophobia and
sometimes aerophobia. After a few
days, death occurs by cardio-
46.
47.
48.
49. Paralytic rabies accounts for about 30%
of the total number of human cases. This
form of rabies runs a less dramatic and
usually longer course than the furious
form.
The muscles gradually become
paralyzed, starting at the site of the bite or
scratch.
A coma slowly develops, and eventually
death occurs. The paralytic form of rabies is
often misdiagnosed, contributing to the
underreporting of the disease.
50.
51.
52. Diagnosis
Several tests are necessary to
diagnose rabies ante-mortem
(before death) in humans; no single
test is sufficient
Tests are performed on samples of
saliva, serum, spinal fluid, and skin
biopsies of hair follicles at the nape
of the neck.
53. Saliva can be tested by virus
isolation or reverse transcription
followed by polymerase chain
reaction (RT-PCR)
Serum and spinal fluid are tested
for antibodies to rabies virus
Skin biopsy specimens are
examined for rabies antigen in the
cutaneous nerves at the base of
hair follicles.
54. Postmortem, the standard
diagnostic technique is to
detect rabies virus antigen in
brain tissue by fluorescent
antibody test.
55.
56. Prognosis
Treatment after exposure (receiving
the vaccines), known as post-
exposure prophylaxis (PEP), is highly
successful in preventing the disease
if administered promptly, in general
within ten days of infection.
Begun with little or no delay, PEP is
100% effective against rabies
57. Inunvaccinated humans, rabies is
usually fatal
after neurological symptoms have
developed, but prompt post-
exposure vaccination may
prevent the virus from
progressing.
58.
59. Treatment
Effective treatment soon (within a few
days, but as soon as possible) after
exposure to rabies can prevent the
onset of symptoms and death.
Post-exposure prevention consists of
local treatment of the
wound, administration of rabies
immunoglobulin (if indicated), and
immediate vaccination.
60. post-exposure
prophylaxis
consists of 1 dose of rabies
immunoglobulin (20IU/kg)
and 5 doses of rabies
vaccine over 28 days (days
0, 3, 7, 14 and 28)
61.
62.
63.
64.
65. Table: Recommended post-exposure prophylaxis for rabies
infection
Category of exposure to
Post-exposure measures
suspect rabid animal
Category I – touching or feeding
animals, licks on intact skin (i.e. None
no exposure)
Category II – nibbling of
Immediate vaccination and local
uncovered skin, minor scratches
treatment of the wound
or abrasions without bleeding
Category III – single or multiple
transdermal bites or scratches, Immediate vaccination and
licks on broken skin; administration of rabies
contamination of mucous immunoglobulin; local treatment
membrane with saliva from licks, of the wound
exposures to bats.
66. PREVENTION
Eliminating rabies in dogs
Rabies is a vaccine-preventable
disease. The most cost-effective
strategy for preventing rabies in
people is by eliminating rabies in
dogs through vaccination.
67. Vaccination of animals (mostly
dogs) has reduced the number of
human (and animal) rabies cases
in several countries, particularly
in Latin America.
However, recent increases in
human rabies deaths in parts of
Africa, Asia and Latin America
suggest that rabies is re-
emerging as a serious public
health issues
68. Preventive immunization in
people
Pre-exposure immunization in people
is recommended for travellers to high-
risk areas in rabies-affected
countries, and for people in certain
high-risk occupations such as
laboratory workers dealing with live
rabies virus and other lyssaviruses,
and veterinarians and animal
handlers in rabies-affected areas
69. World Rabies day
September 28
raise awareness about the
impact of human and
animal rabies, how easy it
is to prevent it, and how to
eliminate the main global
sources
70. Sincethe inaugural campaign in
2007, World Rabies Day events
have been held in 135 countries;
educating 150 million people
and vaccinating 4.6 million
dogs.
71.
72.
73.
74. In the Philippines
National Rabies Prevention and
Control Program
Goal: To eliminate human rabies in
the Philippines and Declare a
Rabies – free Philippines by year
2020
75.
76.
77.
78. Recommendations
Do a program in order to inform
the people where rabies are
endemic
Inform them on the disease and
how to avoid it
○ Includes vaccination of
animals
79. Make it mandatory to have people
vaccinate their pets and also dog &
cats who are stray
If they do not vaccinate, a fee will
be imposed
Post posters showing the signs
and symptoms of a rabid animal
and person
Once animal is rabid, euthanize it