Self-Assessment Questions (SAQs) for Study Session 38

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the following questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 38.1 (tests Learning Outcomes 38.1, 38.2 and 38.3)

Mr. Kebede is bitten on the face by a dog which has shown abnormal behaviour in the last three days. The skin is clearly broken and the wound is bleeding a little bit.

  • a.What category of exposure is this event?
  • b.If Mr. Kebede comes quickly to your Health Post, which of the following actions should you do for him? In each case, explain why the action is correct or incorrect.

A  Give him an antibiotic and send him home

B  Suture his wound

C  Thoroughly clean his wound with soap and water and send him to the nearby health centre for post-exposure prophylaxis

D  Admit him to the Health Post and give him intravenous fluids.

Answer

Mr Kebede has had a Category III exposure – he is bleeding after being bitten by a dog that showed abnormal behaviour.

The correct and incorrect actions are listed below:

A is incorrect. Rabies is caused by a virus. Antibiotics kill bacteria – they have no activity against viruses.

B is incorrect. Suturing the wound seals the viruses inside the body and makes it more difficult to flush it with soap and water, detergent, alcohol or iodine.

C is the correct answer. Thoroughly clean the wound and send Mr Kebede to the nearest health facility for post-exposure prophylaxis.

D is incorrect. Mr Kebede’s wound is only bleeding a little bit. He does not need IV fluids! Admitting him to the Health Post delays referring him for urgent vaccination and rabies immunoglobulin treatment. The delay threatens his life!

SAQ 38.2 (tests Learning Outcomes 38.1, 38.2, 38.3 and 38.4)

Kemal is a three-year-old boy who has had close contact with his pet dog. In the last two days, the dog has showed abnormal behaviour and now it has run away. You examine Kemal carefully all over his body. You find that he has not been bitten and he does not have any scratches or breaks in his skin.

  • a.What is Kemal’s category of exposure?
  • b.What do you advise Kemal’s family?

Answer

  • a.Kemal has had close contact with a dog that has shown some abnormal behaviour, but there are no signs of any bites or scratches on his body and there are no breaks in his skin. Therefore, he is in Category I – no exposure.
  • b.Kemal’s family should be advised to search for the dog and approach it with great care. It should be destroyed if its behaviour is abnormal; otherwise it should be kept contained for ten days to see if it develops any signs of rabies and killed if it does. They should ensure that Kemal has no further contact with this (or any other) dog, because children are at high risk of being bitten.

SAQ 38.3 (testing Learning Outcomes 38.1, 38.2, 38.3 and 38.4)

Which of the following statements is false? In each case, explain what is incorrect.

A  Most people who show symptoms of rabies will be cured if they are referred for medical treatment.

B  Taeniasis causes discomfort in people who have a tapeworm in their intestines, but the disease is almost never fatal.

C  Eating well-cooked beef may not protect people from taeniasis.

D  Abdominal pain and the appearance of flat white worms in faeces are signs of taeniasis.

E  Open defaecation in grazing lands is a risk factor for taeniasis.

Answer

A is false. It is almost inevitable that a person will die if they develop symptoms of rabies, no matter what medical treatment they receive.

B is true. Taeniasis causes discomfort in people who have a tapeworm in their intestines, but the disease is almost never fatal.

C is false. Thorough cooking kills the tapeworm larvae embedded in the meat and prevents their transmission to humans who eat the meat.

D is true. The common symptoms of taeniasis are abdominal pain and the appearance of flat white worms in the stools.

E is true. Open defaecation in grazing lands is a risk factor for taeniasis, because the eggs deposited in human faeces are eaten by cows; the lifecycle of the tapeworm is completed when the larvae become cysticerci in the cows’ muscles and people eat infected raw or undercooked beef.

Summary of Study Session 38