Rabies_PSM_Presentation with PEP. pptx

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1. Rabies: A Public Health Perspective Epidemiology, Pathogenesis, Clinical Features, Investigations, Treatment, and Control Strategies Prepared by: [Your Name] Date: [Presentation Date]

2. Epidemiology of Rabies in India • India accounts for approximately 35% of global human rabies deaths (~5,700 annually). • Children under 15 years are highly vulnerable (30–60% of cases). • Transmission primarily through rabid dog bites (97% cases). • In 2024, over 3.7 million dog bite cases and 54 suspected deaths.

3. Pathogenesis of Rabies • Entry via broken skin or mucous membranes. • Travels through peripheral nerves to the CNS. • Affects the brainstem, causing encephalitis and paralysis. • Incubation period: 1–3 months, shorter if near the head/neck.

4. Clinical Features • Prodromal phase: fever, malaise, headache, pain at bite site. • Neurological phase: hydrophobia, aerophobia, agitation, confusion, seizures, paralysis. • Coma and death due to respiratory failure.

5. Investigations (Brief) • DFA test: gold standard, detects viral antigens. • RT-PCR: detects viral RNA. • Serology: antibody detection, not for acute diagnosis. • Skin biopsy: Negri bodies in nerve tissue.

6. Treatment of Rabies Post-Exposure Prophylaxis (PEP): • Immediate wound care: wash thoroughly. • Rabies Immunoglobulin (RIG): Category III exposures, infiltrated around wound and IM. • Anti-Rabies Vaccine (ARV): Day 0,3,7,14,28 intramuscular. Pre-Exposure Prophylaxis (PrEP): • For high-risk groups like veterinarians. • Schedule: Day 0,7,21/28, booster every 2–3 years.

7. The Golden 15 Minutes • Critical period after exposure to start wound care and PEP. • Timely intervention greatly reduces rabies risk.

8. Rabies Immunoglobulin (RIG) • Types: - Equine RIG: widely available, higher allergy risk. - Human RIG (HRIG): lower adverse reactions. • Administer as soon as possible, infiltrated locally. • No contraindications.

9. One Health Approach • Integrates human, animal, and environmental health. • Mass dog vaccination campaigns. • Surveillance, reporting, and awareness programs. • National Action Plan aims for zero rabies deaths by 2030.

10. Recent Guidelines in India • Improved ARV and RIG availability. • Updated operational protocols by the Ministry of Health. • State initiatives: - Lucknow: microchipping stray dogs. - Delhi: guidelines for street dog management.

11. References • WHO, National Centre for Disease Control (NCDC), Ministry of Health and Family Welfare. • Links to official guidelines and reports.