Episode 56 – Management of Suspected Rabies Exposure in the Emergency Department
EMplify – April 2021
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Management of Suspected Rabies Exposure in the Emergency Department – An Interview with Dr. Bess Storch
- Fatality rate of over 99%
- Half of cases occur in children
- 95% of cases are in resource limited countries, 35% in India
- 99% caused by infected dogs (worldwide)
- In the US, cases are predominantly bat variant
Why this topic?
- “In a recent survey of licensed physicians, less than half could identify rabies transmission routes, the correct PEP schedule, and the correct anatomic administration sites.”
- What causes it? The RNA virus Lyssavirus
- How is it transmitted?
- How does it reach the brain?
- What does it look like clinically?
- 5 stages- incubation, prodrome, acute neurologic phase, coma death
- Why doesn’t everyone just get vaccinated?
- What patient medical history is important ? Steroids, chloroquine
- What animals are high risk?
- What about pets and quarantine?
- What about rodents ?
- Is there any role for labs or imaging ?
- What is the treatment regimen for those who are unvaccinated? And vaccinated?
- What about people who are immunosuppressed?
- Recently traveled?
Last Updated on April 29, 2022