SLIDE 1

Ang Rabies ay isang napakadelikadong uri ng impeksyon/ dahil kadalasan

ay nauuwi sa kamatayan.// Bagamat nakamamatay,/ ang rabies virus
infection po/ ay isang highly preventable disease.//

SLIDE 2

For the learning outline/ of my discussion for rabies/, we will define/ what
rabies infection is/, we will also talk about its causative agent,/ its
incubation period /and mode of transmission.// We will also tackle/ the
types of contact /and categories of exposure /and the ways on how we can
prevent/ and treat the infection.// So /let us start/ with its definition.//

SLIDE 3

Ang rabies infection/ according to my slide/ is a zoonotic disease// na dulot

ng rabies virus.// Karaniwan itong nakukuha/ sa kagat ng mga hayop na
apektado ng nasabing virus/ particularly mga mammals//. Maaari itong
magmula/ sa mga wild animals / katulad ng mga bats // or pwede din sa
ating mga alagang hayop / gaya ng dogs, cats and monkeys/ and even
some livestock animals/ gaya ng mga cattles and horses.//

SLIDE 4

As you see/, the causative agent of rabies is rhabdovirus/, an RNA virus.// It

is borne/ or nakukuha ito/ by being infected/ by a bite of an infected
animal.//

The incubation period/ theoretically / is 20-90 days // but in reality / dito sa

pilipinas/, mejo mas mabilis//. The prognosis depends on the viral load /(or
kung gaano kadami ang virus / na ininoculate sa nakagat) // and the
immune system of the bitten individual.//

In the Philippines, /usually/ it will take 7-10 days /depending again kung
saan po nakagat.//
SLIDE 5

Hindi natin masasabi basta basta/ that an animal has rabies by just looking
at it//—the only way to know for sure/ is to perform laboratory testing. //

However/, once na ang animal ay nainfect ng virus/at nakarating na ito sa

kanilang brain/, usually /they will start showing symptoms of rabies//. They
may act strangely. // It is either in the furious/ o ung sinasabing aggressive
type//. Wherein / the animal may become hypersensitive to touch/ and will
try to bite you.// Maaari din na magkaroon sila ng seizure / or / they may
drool more than normal// so makikita ninyo, parang nagfofoam yung
laway sa bibig nila//

Yung ibang animals naman po/ may act timid/ or shy/, nawawalan sila ng
apetite/ and they may appear weak//. So that will fall naman po/ to the
dumb type/ or the paralytic type of symptoms/ ng rabid animal.//

Rarely/ may mga rabid dog/ na hindi nagpakita ng anumang sintomas.//

Maaaring kasing nasa window period pa po sila/ then eventually
magkakaroon na din sila ng sintomas once the virus gets into their brain.//

For the MODE OF TRANSMISSION to human/ dalawa po ito// it is either

through Direct Contact/ or through Inhalation//

Nangyayari ang direct contact /kapag po ang laway na infected animal /ay
nagkaroon ng contact sa broken skin /or sa ating mga mucous
membranes/ gaya ng eyes, nose and mouth.//

Not necessary mayroon bite exposure/ kasi may tinatawag din po tayong
non-bite exposure/ katulad ng scratches,/ abrasions /or kung may open
wound na kayo/ tapos naexpose sa laway ng rabid animal/, pasok po iyan
sa direct contact transmission.//

Another mode is through inhalation of aerosolized rabies virus// kapag ka

nasa enclosed space kayo, at may infected human doon, maaaring maipasa
ang virus. kaya mahalaga ang pagsusuot ng personal protective equipment
gaya ng mask.//
Dumako naman po tayo sa types of contact/ and categories of exposure//.
Based on my slide,/ we have 3 categories.//

1. You will fall on category 1/, Kapag nilick ka ng aso na may rabies/
pero intact pa ang skin mo.// As long as wala kang nick sa skin,/
category 1 po iyan//
2. Next/ If mayroon kang scratch/ or bite/ kahit hndi ito nagbleed/, tpos
nalick ito ng asong may rabies,/ that will fall on category 2//.
The person needs to be vaccinated.// So what you do/ is to observe
the dog/ for 10 to 14 days//. do not hurt them//. Kasi mamamask
yung observation nio sa aso//, pag nasaktan ang aso/ baka magbago
yung health ng dog/, mahihirapan ka na madistinguish if the dog is
rabid or not.// If okay ang aso ng 10 to 14 days/ more or less / hindi
iyon rabies//. But If and when that dog dies// Most probably/ the
animal is infected.// the brain of the dog is to be examined//. Kasi sa
brain ng rabid animal nagrereside ang virus.//
3. kapag mayroon kang avulsion/ or malalalim ang mga kagat/, or ang
site of the bite/ is from neck and up/ tpos stray dog ang nakakagat/,
meaning gala, hindi mo sigurado kung may bakuna ang aso na iyon,/
that would be under category 3//.
You need to vigorously clean the site with soap and water at pumunta
agad sa pinaka malapit na animal bite center para makarecieve ka ng
necessary vaccination//.

Mayroon po tayong tinatawag na stages or levels of Rabies.

1. Incubation Period – it’s the time of inoculation (bite)/ and appearance

of symptoms.// This may vary based on/: location of the bite,/ sa
dami ng viral load / and existing immunity of the individual//
For all you know/ ang rabies virus po/ can run 2mm per day.// The
farther the site of the bite/ the longer the time the virus will get in
the brain//. The higher the chance of survival//
2. Then virus will go up/ to nearby nerves/ to multiply//. Dito
magsisimula ng pumasok/ sa prodomal stage.// Sa period na ito/
 lumalabas ang non-specific symptoms of rabies.// Usually similar to
the flu/ kung saan ang tao po ay nakararanas ng weakness /or
discomfort,/ fever or headache//.
3. Once the virus reaches the brain/, it will progress po to neurologic
stage// where the infection becomes fatal in almost all cases.//
Again, it’s the furious type or the dumb type.// Pag furious type
(read).. sa type na ito talagang wet, ung naglalaway or may
salivation// , nakakaexperience din sila ng laryngeal spasm//, so
maoobserve natin/ na kapag inoffer mo ng water/, talagang nasasakal
sila / nahihirapan silang huminga//. Naninigas sila// Parang
somewhat like a tetanus infection.// Or it could also be paralytic type
or nakakaexperience sila ng paralysis//.
4. Then unfortunately/, the final stage is coma / which leads to death.//
Almost 100% ang mortality rate/ ng full blown rabies.//

The reason kung bakit po natin kinakategorize/ kasi yung treatment po is

based on the categories.//

1. For the category 1,/ wala naman po tayong gagawin pa doon.// So

handwahing lng po,/ clean the site/ with ample amount of soap and
water//. Then observe the dog/ kung okay po ang dog for 14 days,/
vaccinate the dog with anti-rabies.//
2. Sa category 2 naman/, wound cleaning/ and then you have to go/ to
the nearest animal bite center/ to receive active vaccination.// No
need to receive passive vaccination or yung immunoglobulin na
tinatawag/ pag po category 2. Later ididifferentiate natin yang dalawa
na yan for better understanding//
3. Sa category 3/, kailangan na po yung dalawang klaseng anti-rabies//.
It is also recommended/ na magbigay ng antitetanus vaccine /
depending on the severity of the wound. // So pwedeng mabigyan ng
ATS or tetanus toxoid accordingly.//
Let us now talk about the vaccine for rabies.

We have two types of vaccine actually//.

Number 1/ is the pre-exposure vaccine//. Ibinibigay po ito before a bite as

a prevention//. People high risk of exposure to rabies/ katulad ng mga
animal lovers or pet owners/, mga veterinarian/ kailangan nilang
protectahan ang kanilang mga sarili/ by getting this type of vaccine.//

Usually/ Ibinibigay ito/ in a scheduled 3 shots/ day 0, 7 and 21./ and The
guaranteed effect of this is 3 years.//

Second type of vaccine/ is the post exposure vaccine// which is given after
a bite/ or exposure.// under this/ we have two sub types// this are the
active/ and the passive vaccination//.

Pag active vaccination/ it is given in 5 series shots//. Ung unang tatlong

bakuna/ is the treatment dose/ and the last 2 doses are the boosters.// Let
us say nakagat ka ng aso,/ you have to receive itong 3 series shots/ and
then you observe the dog for 14 days//. If the dog survives after 2 weeks/
the 4th and 5th dose of this active vaccination/ is optional na po.// Pero in
cases/ like stray animal yung nakakagat/, the 4 th and 5th dose are
necessary.//

Another sub type/ under post exposure/is passive vaccine// This one
naman/ is injected as a single shot/ para maprevent yung development ng
rabies//. Ito yung tinatawag na immunoglobulin shot// and its dosage is
computed by weight//. This type of vaccine is a bit pricey/ kasi fast acting
po xa.//

May mga misconceptions tayong commonly naeencounter/ patungkol sa

rabies infection//. Kadalasan natin ito maassess/ during history taking,/
kapag tinanong natin sila king ano yung ginawa nila nung kinagat sila//
May ugali kasi tayong mga Pilipino/ na kapag nakagat or nakalmot ng
hayop,/ agad agad pipigain or ppaaduguin ang sugat.// Those were some
alternative ways of dealing with the bite na maling nagagawa ng ilan sa
atin//

Listed on the slide/ are the top 3 misconceptions/ that are commonly
encountered//

Una ditto/ is sucking the blood of bite site.// Paano kung may butas ka sa
ngipin edi mas napalala pa yung exposure mo. Kasi neck up is considered
as category 3 kung talagang may rabies yun. So that is a no, no.

Another is severing/ or commonly known as tandok.// This is highly

unhygienic/ kasi ung ginagamit na bato/ or sungay ng animal/ ay hindi
naman guaranteed na malinis.// Accordingly/ sisipsipin daw noon yung
rabies,/ but that has no scientific basis//. One thing lang that is for sure/
mas Malaki yung chance/ na maiinfect po yung bite site. //

Yung iba naman po is/ nilalagyan nila ng bawang yung sugat//. That can
cause burning of the skin/ and can lead to further discomfort/ at mas
lalong prone to infection ang sugat.//.

I think this is the last part of my slide for rabies infection./ As a take away
note for everyone/, sa lahat po ng nakakagat ng animals/, ay huwag ninyo
po itong ipagsawalang bahala//. The first thing that you should do/ is to
clean the wound/ with generous amount of soap and water/ at pumunta
po kayo sa nearest animal bite center or ER.// Oras po/ na makaranas po
kayo/ ng manifestation of rabies / like difficulty of breathing, hydrophobia
or aerophobia,/ you must seek medical advice at once.//

Gaya po ng nabanggit ko kanina,/ For pet owners, pre exposure vaccination

is encouraged//. Pets is also advised/ to be vaccinated against rabies.// This
is our best way /to help lessen the rabies infection rate in the country. //
dahil Part of being a responsible pet owners/ is to take care of the health
of our pets/, kasi kung hindi sila magkakarabies,// hindi ka din
magkakarabies.// that concludes may discussion for rabies/ sana po ay may
naintindihan kayo// we will start our lecture on leptospirosis after 2 Minutes
break. You can have water or bladder break po muna. Thank you.

Okay back to our discussion. Our next topic po is Leptospirosis.

Isa sa mga sakit na binabantayan ng department of health sa panahong ito

na rainy season ay ang leptospirosis na nakukuha mula sa ihi ng hayop.
Kalimitang humahalo sa tubig baha ang ihi ng hayop na nagtataglay ng
leptospira bacteria. Masasabi na karaniwan o common ang naturang sakit
dahil ayon sa record ng World Health Organization, 7-10 million na tao ang
nagkakaroon ng leptospira infection taon taon. Sa pilipinas, ang
pinakamataas na kaso ay naitatala sa National Capital Region, sunod sa
regions 6, 3, 11 at 2. Common na naiinfect ng bacteria ang mga taong edad
2-83 years old. habang 7.33% ng reported cases ang nauuwi sa kamatayan.
Ang leptospirosis ay nagagamot kung maagapan kaya importante ang
health education tungkol sa sakit na ito.

Gaya ng nasabi ko kanina ito ay dulot ng isang bacteria na Leptospira

Interrogans. Ang mikrobyong ito ay hugis spiral na may hook sa dulo. At ito
ay nagboborrow sa loob ng katawan ng tao.

Ang sakit na ito ay hindi nakahahawa. Common carrier ng bacteriang ito ay

mga daga pero may mga ibang uri ng mga hayop na maaari ring maging
vector ng leptospirosis katulad ng mga cattles, pigs at dogs.

ito ay nakukuha kapag ang bacteria na nasa ihi o dumi ng apektadong

hayop ay humalo sa tubig baha o lupa at ito ay pumasok sa mga sugat,
galos, o nanunuyong balat ng tao. Maaari ring magkaroon ng sakit na ito
kapag ang mikrobyo nito ay pumasok sa bibig, ilong, at ari.

Once na mapumasok na ang bacteriang ito sa ating dugo at mapupunta na

ito sa iba’t ibang parte ng ating katawan.
Ang incubation period ng sakit na ito is 5-14 days. during the prodromal
phase kalimitang manifestation ang flu like symptoms like high fever,
muscle pain and headache. The distinguishing feature from flu is Calf-
muscle pain and reddish eyes pero walang eye discharges.

There are patients na habang lumalala ang leptospirosis, maaapektuhan

ang mga kidney, utak, atay, mata atbpng organ ng katawan. Maaaring
magkaroon ng pagkonti ng ihi to the point of anuria (no urine at all) kaya
maaari mong sabihin sa pasyente na obserbahan moa ng pag-ihi mo kung
kumokonti o dumadalang ang output mo or ung frequency ng pagihi mo.
Signs iyon na naapektuhan na ang kidney. Mayroon ding sa liver, kung saan
nagkakaroon ng paninilaw ang balat at mata similar with that of hepatitis.