Podcast #134: Rabies

d765c2c8-e3ba-4889-81f3-06894ad2286dRun Time: 4 minutes

Author: Susan Brion M.D.

Educational Pearls:

  • Rabies causes 61,000 deaths per year worldwide, mostly in Africa and Asia, and associated with dog bites. In the US there are 2 fatal rabies cases per year, all associated with bats.
  • Dogs in the US: the only concern is if you are bitten along the US/Mexico border, there are actually more documented cases of rabies in cats in the US than in dogs.
  • All 49 continental states have documented rabies cases with bats. Even if a patient woke up in a room with a bat, the patient is a child, has developmental delay, or is intoxicated they should be treated prophylactically.
  • There are no documented case of rabies in small rodents, no documented transmission of rabies from infected patients to providers.
  • Theoretically rabies can be transmitted from human to human, but it is not well documented.
  • BOTH immunoglobulin AND vaccine are given for prophylaxis. Wound cleaning reduces chance of transmission by 90%. Dosing is 20 int units /kg.
  • It is recommended to give as much of the immunoglobulin as feasible at the site of the wound, the rest is given IM. If there is no obvious wound the immunoglobulin is given IM.
  • Prophylaxis is given on days 1, 3, 7, 14.

Link to Podcast: http://medicalminute.madewithopinion.com/rabies/ 

References: http://www.cdc.gov/rabies/medical_care/

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