Today is our topic of discussion Categories of contact and recommended post-exposure prophylaxis
Categories of contact and recommended post-exposure prophylaxis
Indications for anti-rabies treatment:
1. All bites by wild animals
2. If the animal shows signs of rabies or dies within 10 days of observation
3. If the biting animal cannot be traced or identified
4. Unprovoked bites
The people most at risk:
1. People most at risk live in rural areas where human vaccines and immunoglobulin are not
available or accessible.
2. Poor people are also at a higher risk, as the average cost of rabies post-exposure prophylaxis after contact
with a suspected rabid animal is high.
3. Although all age groups are susceptible, rabies is most common in children under 15.
4. Anyone in continual, frequent or increased danger of exposure to rabies virus – either by nature of their residence or occupation – is also at risk.
Prevention & control measures for rabies:
1. Eliminating rabies in dogs through vaccination of pet dogs
2. Making dogs virus-free: The program recently undertaken by CDC, DGHS.
3. Controlling dog propagation: Dhaka City Corporation and ‘Ovoaronno’ (NGO) taken initiatives for controlling dog population by castration named ‘ABC’ (Animal Birth Control)
4. Killing of rabid dogs.
5. Making puble awareness about its control and prevention by observing ‘world rabies day’.
responsible for high prevalence of rabies:
1. Endemic canine rabies
2. High dog population density
3. Large number of unvaccinated stray, community and ownerless dogs
4. Lack of knowledge about animal bite management (nomino) xetine esnatu
5. Non-availability of tissue culture vaccine (at government level) & RIG
6. No effort for animal rabies control
Past existing anti-rabies activities:
1. Post-exposure management by locally produced nerve tissue vaccine (NTV)
2. Very limited use of tissue culture vaccine (TCV) at private sector
3. Non-scientific infrequent killing of stray dogs by City Corporation and Pourashava
4. Very limited use of pet dog vaccination at private sectors
Monitoring of IDRV when SACMO/MO as supervisor:
1. Temperature in the refrigerator, range of +2 to +8°C.
2. Adequate vaccines in the stock.
3. Does the health worker follow patient for 30 minutes (observation) following vaccination?
4. Knowledge & skill of health workers/ service providers.
5. Does the health worker check for the following during immunization:
a. Expiry date?
b. Frozen vaccines?
c. First expiry first out?
6. Is the vaccine reconstituted correctly?
7. Reconstituted vaccine used in how many hours?
Fig: Picture of Tika Card used in government hospitals for IDRV
Target of GoB:
Prevention and control of rabies by the year 2020.
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