Clinical features: Rabies is an acute viral disease of the central nervous system that affects all mammals and is transmitted to man by infected secretions, usually saliva. Early or prodromal clinical features of the disease include, apprehensiveness, restlessness, fever, malaise and headache. The late features of the disease are excessive motor activity and agitation, confusion, hallucinations, excessive salivation, convulsions and hydrophobia. Death is considered the invariable outcome.
Treatment guidelines
• Local wound therapy
Wash wound thoroughly with water and soap and repeat process with 1% cetrimide solution or apply tincture of iodine.
• Passive immunization
Anti rabies human immunoglobulin give by careful instillation in the depth and around the wound (dose 20 IU/kg body weight half the dose given parenterally and the other half injected into and around the wound)
• Active immunization
Human Diploid Cell Vaccine (HDCV) give 1 mL I.M. as soon as possible after exposure. 'Subsequent doses of HDCV are given on days 3, 7, 14, 21, 28 and 90
• Tetanus toxoid vaccine give 0.5 ml I.M. on days. 1, after 1 month and 6-12 months
• Adults |
Procaine penicillin 1.2 MU I.M. daily for 5 days.
If patient is sensitive to penicillin, give Erythromycin 500 mg 8 hourly for 5 days. |
• Children |
Procaine Penicillin 0.4 - 0.8 MU I.M. every 24 hours
If patient is sensitive to Penicillin, give
Erythromycin 10 mg/kg body weight every 6 hours both for five days. |
