Rampengan, Novie Homenta
(2017)
Rabies post exposure prevention.
Bali Medical Journal, 6 (2).
pp. 449-455.
ISSN 2089-1180
Abstract
Rabies virus is found in large quantities in the saliva of infected animals,
and transmission occurs almost exclusively through inoculation of the
infected saliva through a bite or scratch from a rabid mammal. Initial
aggressive management with adequate supportive therapy may help
in the survival of the patient. Rabies is generally fatal, and neither
rabies immunoglobulin (RIG) nor rabies vaccine provides benefit
once symptoms have appeared. The three-pronged approaches to
prevent death caused by rabies in humans are stray animal control,
post-exposure prophylaxis, and prior vaccination of people with a
higher risk of exposure. Modern rabies vaccines have been proven
to be safe, well- tolerated, and highly effective in preventing rabies,
even if administered after exposure to bites. PEP consists of wound
cleaning, rabies vaccination, and passive immunization with rabies
immune globulin (RIG), of which the most important treatment is
rabies vaccination. Several regimens of rabies vaccination approved
by WHO have shown to be immunogenic. Smaller doses and more
advanced processing techniques have a relatively higher safety for the
patients, especially for the young children. No significant differences in
safety and immunogenicity between PVRV and PCECV both in Zagreb
and Essen regimens. WHO recommends completing PEP against rabies
with the same cell culture or embryonated egg rabies vaccine and with
the same route of administration and any deviation from this shall be
an exception. PEP was safe and effective despite cha
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