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RABIES(Hydrophobia)

RABIES (Hydrophobia)

DESCRIPTION

Rabies is a serious virus infection of the central nervous system, transmitted by the bite of an infected animal. Body parts involved include the central nervous system--including the brain, the coverings of the brain (meninges), and the spinal cord -- and peripheral nerves as well as body parts bitten by the rabid animal. Appropriate health care includes: physician's monitoring of general condition and medications; surgery to clean and repair the bite wound (sometimes); hospitalization, if symptoms develop.

SIGNS & SYMPTOMS

  • Symptoms may appear 3 to 7 weeks after the bite. Early symptoms are: restlessness and irritability; fatigue; slight fever; cough; sore throat; increased saliva and tears.
  • 2 to 10 days later: violent spasms of throat muscles that make swallowing impossible; hyperactivity and violent behavior; confusion; high fever; irregular heartbeat; irregular breathing.

    CAUSES

  • A virus in the saliva of infected animals passes to humans through broken skin or a mucous membrane. The virus travels slowly from the bite area to the brain.
  • Animals that are commonly infected include dogs (especially wild dogs), bats, skunks, foxes, coyotes, and raccoons. Other animals can also be infected, so consult your local health department after any animal bite.

    RISK FACTORS

  • Multiple bites or bites on the child's face, head, neck, or upper body.
  • Outdoor activities that expose your child to wild animals, especially cave exploration and hunting (in which animals are handled).

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Vaccinate your dog or cat against rabies, report stray animals in the neighborhood and teach your child to avoid them, and anyone whose work involves animals should have a rabies immunization.
  • Keep your child's tetanus immunizations up-to-date. See Appendix 1 for an immunization schedule.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of the animal's behavior. Try to determine if the animal was provoked. Unprovoked attacking animals are more likely to be infected.
  • Medical history and physical exam by a doctor.
  • Laboratory blood tests, and fluid and electrolyte measurements.
  • Pathological exam of the animal's tissue.

    POSSIBLE COMPLICATIONS

    Dehydration and shock; coma; paralysis; death.

    PROBABLE OUTCOME
    Rabies can be prevented with early treatment for your child following an animal bite. Once symptoms begin, survival is unlikely. The mortality rate is 80%.

    TREATMENT

    HOME CARE

  • Wash the bite area for 10 minutes with soap and water to remove all saliva.
  • Cover the child's wound with a clean bandage.
  • Call your doctor or local emergency room for advice.
  • Call your local animal-control center to catch the animal, if possible.
  • If the animal is killed, remove the head and refrigerate or freeze it until it can be examined by pathologists.
  • Don't panic. The incubation period allows time for diagnosis and treatment of your child.

    MEDICATION
    Painful injections in the abdomen are no longer necessary. Your doctor may prescribe one of the following:

  • Injections of rabies-immune globulin.
  • Injections of human-diploid-cell-strain vaccine, if the animal is proven rabid.
  • Tetanus booster.

    ACTIVITY
    No restrictions unless symptoms begin. If they do, bed rest in a hospital is necessary for your child.

    DIET & FLUIDS
    No special diet during outpatient treatment before symptoms begin. Intravenous fluids and nutrients are necessary during the child's hospitalization.

    OK TO GO TO SCHOOL?

    Not until signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

    Your child is bitten by an animal.

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