Ch. 22 - Microbial Diseases of the Nervous System

Tortora - Microbiology: An Introduction 14th Edition

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Tortora 14th Edition

Ch. 22 - Microbial Diseases of the Nervous System

Problem 8a

Chapter 22, Problem 8a

Outline the procedures for treating rabies after exposure. Outline the procedures for preventing rabies prior to exposure. What is the reason for the differences in the procedures?

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Step 1: Understand the post-exposure prophylaxis (PEP) procedures for rabies treatment. This involves immediate and thorough washing of the wound with soap and water to reduce viral load, followed by administration of rabies immunoglobulin (RIG) to provide passive immunity, and a series of rabies vaccinations to stimulate active immunity.

Step 2: Outline the pre-exposure prophylaxis (PrEP) procedures for rabies prevention. This typically includes a series of rabies vaccinations given before any exposure occurs, especially for individuals at high risk (e.g., veterinarians, animal handlers, travelers to endemic areas). No immunoglobulin is given in this case.

Step 3: Highlight the timing and purpose differences: Post-exposure treatment is urgent and combines passive and active immunization to immediately neutralize the virus and develop long-term immunity, whereas pre-exposure vaccination primes the immune system in advance to respond quickly if exposed.

Step 4: Explain why immunoglobulin is used only after exposure: Because it provides immediate antibodies to neutralize the virus before the body can mount its own immune response, which is critical after a potential infection has occurred.

Step 5: Summarize that the differences in procedures are due to the need for immediate protection after exposure versus preventive immune priming before exposure, reflecting the urgency and nature of rabies infection progression.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Post-Exposure Prophylaxis (PEP) for Rabies

PEP involves immediate wound cleaning, administration of rabies immunoglobulin to provide passive immunity, and a series of rabies vaccinations to stimulate active immunity. This treatment is critical after exposure because rabies virus incubation can be variable, and early intervention prevents virus progression to the nervous system.

Pre-Exposure Prophylaxis (PrEP) for Rabies

PrEP consists of a series of rabies vaccinations given before any exposure, primarily to individuals at high risk. It primes the immune system to respond quickly upon exposure, reducing the need for immunoglobulin and simplifying post-exposure treatment if exposure occurs.

Differences in Procedures Due to Immune Response Timing

The difference in procedures arises because post-exposure treatment must provide immediate passive immunity and stimulate active immunity quickly to prevent disease onset, while pre-exposure vaccination prepares the immune system in advance. This timing difference dictates the use of immunoglobulin only after exposure.

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Provide evidence that Creutzfeldt-Jakob disease is caused by a transmissible agent.

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Textbook Question

Match the following choices to the statements in questions 7 and 8:

a. antirabies antibodies

b. HDC

Used for passive immunization.

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Textbook Question

Match the following choices to the statements in questions 7 and 8:

a. antirabies antibodies

b. HDCV

Produces longest lasting protection.

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Textbook Question

On the following figure, identify the portal of entry of H. influenzae, C. tetani, botulinum toxin, M. leprae, poliovirus, Lyssavirus, arboviruses, and Acanthamoeba.

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Textbook Question

Use the following choices to answer the question given below:

a. Cryptococcus

b. Haemophilus

c. Listeria

d. Naegleria

e. Neisseria

Microscopic examination of cerebrospinal fluid from a person who washes windows on a building in a large city reveals ovoid cells.

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