Annexure

Annex 1: Post-exposure prophylaxis requires vaccines and rabies immunoglobulin.

Source: WHO Rabies and One Health Course 2021.

Annex 2: Flow chart for management of rabies patient.

Annex 3: Schematic presentation for field investigation of rabies patient and reporting.

CS: Civil Surgeon, DRRT: District Rapid Response Team, DLS: Department of Livestock Services, DLO: District Livestock officer, UHFPO: Upazila Health and Family Planning Officer, ULO: Upazila Livestock Officer, URRT: Upazila Rapid Response Team

Annex 4: Schematic Diagram of Rabies Prevention and Post Exposure Prophylaxis (PEP)

Post Exposure Prophylaxis (PEP)
by Cell Culture Vaccine (CCV)

Annex 5: Recommended guidelines for physical facilities and staff requirements for an anti-rabies clinic (an ideal situation)

I. Accommodation

1. Clinic room 20’ X 15’ (minimum) and waiting hall
2. Toilet with tap water for washing the wound

II. Staff (as per work load)

1. Medical Officer- 2-3 (Medical Graduate)
2. Staff Nurse- 2-3
3. Attendants - 2

III. Furniture

1. Office Table – Big – 1 (MO) and Small – 1 (Staff Nurse)
2. Armchairs – 4
3. Revolving stools – 3
4. Table for examining the patient -1
5. Footstep stand – 1
6. Almirah - 1

IV. Equipments and Instruments

1. Refrigerator (with voltage stabilizer and thermometer) – 1
2. Weighing machine – 1
3. Vaccine carrier and ice packs (with wells) – 1
4. BP apparatus – 1
5. Oxygen cylinder with mask – 1
6. IV line stand – 1
7. Telephone – 1
8. Health education material – Display / Distribution (as adequate)
9. Fixographs (Big) – 2 with letters

V. Drugs (Injectables and Applicants)

1. Anti-rabies vaccines
2. Anti-rabies serum (Equine and Human)
3. Adrenaline
4. Pheniramine Maleate
5. Oral anti-histamines
6. Steroid
7. Ranitidine
8. Surgical spirit
9. Povidone Iodine
10. Normal Saline
11. Glucose Saline
12. Tetanus Toxoid
13. Antibiotics, Antipyretics, Analgesics and Anti-Inflammatory drugs

VI. Other Supplies and Consumables

1. Cotton
2. Adhesive plaster
3. Dressing material
4. Surgical gloves
5. Insulin syringes with 26G needles
6. 2 mL and 5mL syringes with 24 G needles
7. Artery forceps
8. Toothed forceps
9. Swab holder
10. Kidney tray
11. Dressing bin
12. Foot-operated waste bin
13. Mattress and linen
14. Used Vaccine & RIG box

VII. Stationary and Others

1. Outpatient register
2. Temperature monitoring chart
3. Standard Clinical Record forms
4. Prescription pads
5. Self-addressed postcards (reply paid) for patient responses
6. Notice board
7. Computers, Multimedia, Printer, Scanner and other Accessories

VIII. Wound wash Place/area

1. Specific place
2. Tap-Water / Facilities for the use of water
3. Soap/ Detergent
4. Antiseptic
5. Disposable Gloves