0 2590 3176-9 0 2965 9484

email : zoo_cdc@yahoo.com
website : http://thaigcd.ddc.moph.go.th
Facebook : Zoonosis Thailand

ISBN
978-616-11-1057-4


1 2555 3,000

1

I.
1.
1.1
1.2
1.3
2.
2.1
2.2
2.3
2.4
3. (post-exposure immunization)
3.1
3.2
3.3
4. (RIG)
4.1
4.2 RIG ERIG
4.3
4.4 RIG
5. (pre-exposure immunization)



II.
1.
2.
3.

3
5
6-8
9-60
10-26
10-13
10
11
12
14
14
14
14
14
14-19
14
16
19
20-22
20
21
22
22
23-26
24
25
26
27-33
27
30
30

34-38
III.
34

34

35

36

36

39-40

41-60

41
1
42
2 (.36)
44
3
45

46
4
48
5
52
6
54
7
57
8
(Necropsy)
58
9 ()
59
()
2

RIG

61-83
62
70
72
76
83

1

2
3 Direct Fluorescent Rabies
Antibody test (DFA)
4
5 ()
6 (Rabies Immunoglobulin : RIG)

7
8

10
11
13
14
19
20
29
31
84

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11

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60

61


1. 2 6
6
( 1 10 20 )
6 20
2 0 3 RIG

2. 1 2
(D0)
(D3)

1
2

3. 5 3

(D0)
(D3)
(D7)

IM-ID-ID-ID 2 D30

4. ID 2 IM
ID IM
5.


1.

2.

62

 6.
6 1 6
2
7.

8.

6 1 6 2
9.

10. 3 10
4 5

11.
10
a.
b. 2
1
c.

63

 12. RIG




.. 2545
13.

14.
( 1)

15.
3
RIG
16. 17

17.


18. Verorab
PCEC

64

 19. 6

20. 0, 3 7
4 5
10

21. 3
()

22 28 30
3

23.

48
24.

25. 10 9

65

 26. 3 3 5 ()

- 6 1 6
2 0 3

-
27. pre-exposure post-exposure 3
1 1
1 ( 3)
6
1 6 2 0 3
28. 3



( 7 1 )
( 2 1)

RIG

29.
2
- Pre-exposure prophylaxis ()
- Post-exposure prophylaxis
(treatment)
30. 2
*
* (Abrasion)

15

66

 31. 14
2536
32.
2525
33. D30
- D30


-
1
34. 10

10
35. 3 5

- 3
- 5
1
36.

37. 2-4
. .. 2535
2-4

11
1-3

67

 38. HIV

HIV
39. PCEC 8 RIG
PCEC 8
7
RIG 8

40. 2

41. 2
1

42. (ID) (IM)

HIV

43.
Tetanus-diphtheria toxoid (Td) Tetanus toxoid (TT)

44. Tetanus toxoid (TT)

68

 45. RIG

46.

47. Verorab

48. HIV Verorab RIG

RIG
49. Tetanus toxoid

Tetanus toxoid

50.

2 1


51.

69

 52. ()

14
53.

54. 0 10

55. ID 2-2-2-0-2 0, 3, 7 30 0, 3
3 14
( 10 )

56. 3

3

57.

- WHO



-

70

 58. 0, 3, 7 2
3
- WHO
3 7
14
3

- 2-3

59. 0,3,7


24-48
3
60. 3 2
1 D4
2 D5
3 D6
3
1 2 3 D7 3 3
D8 D9

61. 7 14 double dose

schedule
62. PCEC 2 1

3

71

 63. ID 2-2-2-0-2 0, 3, 7, 30 4
(D30)
10

64. 4

-

-

65. D0 D21

D28
66. ( ID IM)

RIG
67. 16 HRIG 320 IU
HRIG 300 IU
1
68. 20 HRIG 770 IU
HRIG 300 IU 75% ERIG
ERIG HRIG
ERIG
RIG
69. RIG
(ERIG 40 IU/kg HRIG 20 IU/kg)

72

 70. RIG

1. 3

2. RIG 48

RIG 7 RIG


71. ERIG HRIG

7 48

72. 3
RIG

RIG
-
RIG

- RIG


73. HRIG ERIG
HRIG ERIG

1.
2.
3.

HRIG
(Human Rabies Immunoglobulin)

ERIG
(Equine Rabies Immunoglobulin)

1:100,000
4. (IU/kg) 20
40
5.

6.
2 ml (300 IU) 5 ml (750 IU) 5 ml (1000 IU)

73

 74. RIG

1.

2. RIG OPD
card

3.
75. ERIG HRIG Maximum dose
ERIG 40 IU/kg HRIG 20 IU/kg

76. RIG

77. HRIG HRIG

78. RIG
RIG
HRIG HRIG
79. RIG
RIG
RIG

80. RIG
RIG
81. RIG

74

RIG rabies
virus

RIG

 82. ERIG ERIG 1:100 NSS 0.02 ml

ERIG NSS

83. ERIG HRIG

HRIG HRIG
ERIG
skin test
84. RIG
RIG RIG

85. HRIG ERIG skin test

HRIG skin test
HRIG
86.
RIG



RIG
87. ERIG HRIG
2-8 8
88. ERIG HRIG
(HRIG )

75

 89. RIG

()
RIG

90.

91.

92.

93.

94. rabies


- 2-8 7 1 (
2554 8 )

- 3-8 2 6
95. (Incubation Period)
1-6
96.

76

 97.

98.

99.


100.

101.

102.
10
103.
Ampicillin
104.

15
105.

77

106.

. .. 2535
2-4
200
107.
.. 2535
433

108.

10

109.

110.









111.

78

112.

113.

114.



()

115.
2
1

116.
(2-8 C)

117.

118.

79

119.

120.

2-6
121.

122.

123.


124.

125.

126.

80

127. ()


SARS, Nipah, Ebola
128.
- Tetanus toxiod
toxiod



-

129. (
)

- 6

1 0.1 ml

- 6 2 0 3

1 0.1 ml


10

81

82


Ugolini G. Rabies virus as a transneuronal tracer of neuronal connections. Adv Virus Res.
2011; 79: 165-202.
Klingen Y, Conzelmann KK, Finke S. Double-labeled rabies virus: live tracking of enveloped
virus transport. J Virol. 2008; 82(1): 237-45.
Mitrabhakdi E, Shuangshoti S, Wannakrairot P, Lewis RA, Susuki K, Laothamatas J, et al.
Difference in neuropathogenetic mechanisms in human furious and paralytic rabies.
J Neurol Sci. 2005; 238(1-2): 3-10.
Hemachudha T, Wacharapluesadee S, Mitrabhakdi E, Wilde H, Morimoto K, Lewis RA.
Pathophysiology of human paralytic rabies. J Neurovirol. 2005; 11(1): 93-100.
Laothamatas J, Wacharapluesadee S, Lumlertdacha B, Ampawong S, Tepsumethanon V,
Shuangshoti S, et al. Furious and paralytic rabies of canine origin: neuroimaging with
virological and cytokine studies. J Neurovirol. 2008; 14(2): 119-29.
Lafon M. Evasive strategies in rabies virus infection. Adv Virus Res. 2011; 79: 33-53.
Shantavasinkul P, Tantawichien T, Wacharapluesadee S, Jeamanukoolkit A, Udomchaisakul
P, Chattranuklchai P, et al. Failure of rabies postexposure prophylaxis in patients
presenting with unusual manifestations. Clin Infect Dis. 2010; 50(1): 77-9.
Burton EC, Burns DK, Opatowsky MJ, El-Feky WH, Fischbach B, Melton L, et al. Rabies
encephalomyelitis: clinical, neuroradiological, and pathological findings in 4 transplant
recipients. Arch Neurol. 2005; 62(6): 873-82.
Maier T, Schwarting A, Mauer D, Ross RS, Martens A, Kliem V, et al. Management and outcomes after multiple corneal and solid organ transplantations from a donor infected
with rabies virus. Clin Infect Dis. 2010; 50(8): 1112-9.
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(2546) .. 2535
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83

1. .
2.
3.

1.
2.
3.
4.

5.

1.
2.
3.
4.
5.
6.

1.
2.
3.
4.

84

..