Rabies

Case Definition/Classification:

Suspect Case
A person presenting with an acute neurological syndrome (encephalitis) dominated by forms of hyperactivity (furious rabies) or paralytic syndrome (dumb rabies) that progresses towards coma and death, usually by respiratory failure, within 7-10 days after the first symptom if no intensive care is instituted or as diagnosed by attending physician.

Probable Case
Suspect case plus history of contact with suspected or laboratory-confirmed rabid animal.

Confirmed Case
A suspected case that is laboratory confirmed.

Laboratory Confirmation:

Detection of rabies viral antigens by direct fluorescent antibody test (FAT) or by ELISA
in clinical specimens, preferably brain tissue (collected post mortem).
Detection by FAT on skin biopsy (ante mortem).
FAT positive after inoculation of brain tissue, saliva or CSF in cell culture, or after intracerebral inoculation in mice or in suckling mice.
Detectable rabies-neutralizing antibody titer in the serum or the CSF of an unvaccinated person.
Detection of viral nucleic acids by PCR on tissue collected post mortem or intra vitam in a clinical specimen (brain tissue or skin, cornea, urine or saliva).
lsolation of rabies virus from clinical specimens and confirmation of rabies viral antigens by direct fluorescent antibody testing.

Current Address: (Specify House/Lot #, Street/ Purok/ Subdivision, Barangay, Municipality/City, Province, Region	Sex: Male Female	Date of Birth:	Age: Days Months Years
Permanent Address: (Specify House/Lot #, Street/ Purok/ Subdivision, Barangay, Municipality/City, Province, Region
District: HCPN:

Date of Report:	Name of Reporter:	Contact Nos.:
Date of Investigation:	Name of Investigators:	Contact Nos.:
II. EXPOSURE HISTORY
Type of exposure: Bite scratch Affected site: saliva consumed meat unknown others, specify Date of Exposure: Place of exposure: Category of Exposure Feeding/touching an animal Licking of intact skin (with reliable history and thorough physical examination) Exposure to patient with signs and symptoms of rabies by sharing of eating or drinking utensils Casual contact (talking to, visiting and feeding suspected rabies cases) and routine delivery of health care to patient with signs and symptoms of rabies. Nibbling of uncovered skin with or without bruishing/hematoma Minor scratches/abrasions without bleeding Minor scratches/abrasions which are included to bleed All Category II exposures on the head and neck area are considered Category III and should be managed as such Transdermal bites (puncture words, lacerations, avulsions) or scratches/abbrassions with spontaneous bleeding Licks on broken skin or mucous membrane Exposure to a rabies patient through bites, contamination of mucous membranes (eyes, oral/nasal mucosa, genital/anal mucous membranes) or Open skin lesions with body fluids through splattering and mouth-to-mouth resuscitation Unprotected handling of infected carcass or ingestion of raw infected meat All Category II exposures on head and neck area Type of animal: dog cat bat others, specify: Lab diagnosis done?: Yes No Unknown If Yes, result: Animal status: Domestic Stray Wild Others, specify:
III. VACINATION HISTORY
Animal vaccination history: Vaccinated Unvaccinated Unknown Patient History: Wound cleaned?: Yes No Unknown Patient given RIG?: Yes No Unknown (RIG is Rabies Immunoglobutin) Patient given rabies vaccine?: Yes No Unknown Date vaccine started: Brand Name of Vaccine: Route of Administration IM Intradermal Post exposure completed Yes No
IV. CLASSIFICATION AND OUTCOME:
FINAL CLASSFICATION
Suspect Case Probable Case Confirmed Case	Alive Died Date Died:
Case Definition/Classification: Suspect Case A person presenting with an acute neurological syndrome (encephalitis) dominated by forms of hyperactivity (furious rabies) or paralytic syndrome (dumb rabies) that progresses towards coma and death, usually by respiratory failure, within 7-10 days after the first symptom if no intensive care is instituted or as diagnosed by attending physician. Probable Case Suspect case plus history of contact with suspected or laboratory-confirmed rabid animal. Confirmed Case A suspected case that is laboratory confirmed. Laboratory Confirmation: Detection of rabies viral antigens by direct fluorescent antibody test (FAT) or by ELISA in clinical specimens, preferably brain tissue (collected post mortem). Detection by FAT on skin biopsy (ante mortem). FAT positive after inoculation of brain tissue, saliva or CSF in cell culture, or after intracerebral inoculation in mice or in suckling mice. Detectable rabies-neutralizing antibody titer in the serum or the CSF of an unvaccinated person. Detection of viral nucleic acids by PCR on tissue collected post mortem or intra vitam in a clinical specimen (brain tissue or skin, cornea, urine or saliva). lsolation of rabies virus from clinical specimens and confirmation of rabies viral antigens by direct fluorescent antibody testing.

Case Investigation Form

Rabies (ICD 10 Code: A82)

Category of Exposure

Case Definition/Classification:

Laboratory Confirmation:

I. PATIENT INFORMATION
Patient Number:	Patient's Last Name First Name: Middle Name: