2025 – PAGE 315 – INFECTIOUS DISEASES
(DOUBLE TAKE) RABIES VIRUS
Rabies is caused by a VIRAL infection in which the virus is transmitted through bites, scratches, and contact with mucous membranes of infected animals, such as BATS, dogs, cats, foxes, RACCOONS (most common in the U.S.), skunks, and WOODCHUCKS. If the history suggests a possible exposure to a wild/aggressive animal, treat with standard wound care PLUS Human Rabies Immunoglobulin (HRIG) PLUS the four vaccine doses. If the animal is a pet, observation of the patient and animal is allowed without giving HRIG or vaccine.
PEARL: Rabbits, rats, and squirrels (rodents) are NOT associated with rabies.
PEARL: For the boards, if the word “BAT” is mentioned (alive, escaped, whatever!), treat as an exposure!
MEASLES (AKA RUBEOLA)
“COUGH, CONJUNCTIVITIS, and CORYZA” are the classic symptoms of measles (AKA rubeola). Coryza refers to rhinorrhea. Also look in the mouth for KOPLIK SPOTS and on the skin for a rash. The three C’s come first, then the Koplik spots, and the LAST symptom to appear is the RASH. The rash starts at the head (around the hairline) and progresses down. The rash resolves after about 5 days. The major cause of death is PNEUMONIA. Measles is an airborne infection and is so contagious that patients require negative pressure isolation. Patients are contagious from FOUR days prior to the onset of the rash until FOUR days after the rash appears.