Lenges is a 12-year-old boy who presents with a bite wound at Laikipia county referral hospital (Kenya) after being bitten by a suspected rabid dog 2 weeks ago (Obonyo et al, 2016). He has never had a vaccination against rabies before the bite. Additionally, he did not receive any vaccine after the bite as required. His elder bother says that according to the Samburu people culture, he is not supposed to be given any form of injection (Obonyo et al, 2016). The bite site is swollen with localized pain. Lenges is sent to the laboratory where the virus was isolated from a skin biopsy from the area around the wound. Another method that can be used to diagnose rabies is the isolation of the virus from the saliva or detection of antibodies which are only produced after the development of the disease.
Treatment
Lenges is supposed to start a course of prophylactic therapy immediately to prevent the disease from developing because once signs of the disease develop, the disease has high mortality rate (Bitek et al., 20190). Treatment involves giving the patient a series of shots of rabies immune globulins to prevent the virus from thriving and reaching other body parts such as the brain.
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Nursing intervention/teaching plan
Health education should be introduced to the community where Lenges comes from about the importance of the prophylactic treatment, pre-exposure vaccination, and vaccination of their pets such as dogs and cats (Bitek et al., 20190). The patient (Lenges) must be introduced to patient education and be convinced to accept the post-exposure injections (Bitek et al., 20190). The injection should be delivered close to the bite wound. The first injection should be followed by at least two more injections of rabies immune globulin for the next two to four weeks (Bitek et al., 20190). This is important because the pre-formed antibodies neutralize the virus hence protecting the patient from the disease which is fatal should it be left to develop.
References
Obonyo, M., Akoko, J. M., Orinde, A. B., Osoro, E., Boru, W. G., Njeru, I., & Fèvre, E. M. (2016). Suspected rabies in humans and animals, Laikipia County, Kenya. Emerging infectious diseases, 22(3), 551.
Bitek, A. O., Osoro, E., Munyua, P. M., Nanyingi, M., Muthiani, Y., Kiambi, S., ... & Hampson, K. (2019). A hundred years of rabies in Kenya and the strategy for eliminating dog-mediated rabies by 2030.
