Maggie De Block, Minister of Social Affairs and Public Health: “The aim is to ensure that patients receive the best possible care. Rabies is a rare disease requiring advanced care by specialised teams. It was therefore important to centralise experts’ skills and knowledge in a reference centre.”
Rabies is a rare disease in Europe, but it is 100% lethal. It can be cured if you react quickly and efficiently in the hours following exposure to animals with rabies. The Belgian federal public health authorities have developed a new procedure for healthcare professionals in order to be able to respond to suspected cases of rabies. This procedure is available on the ITM website at the following address (in French).
The basic treatment has not changed: if a doctor suspects that a patient has been exposed to and possibly infected with rabies, he/she must first wash the wound with soap and water. The wound should then be treated with a solution of povidone-iodine. Finally, the patient should be classified in the appropriate risk category: this will determine the need for PEP for rabies, with or without immunoglobulins.
What is different in the new procedure?
The ITM is now the only hospital that can carry out post-exposure prophylaxis (PEP) with immunoglobulins, in collaboration with Antwerp University Hospital (UZA), which stores the immunoglobulins. PEP without immunoglobulins can still be handled by travel clinics or by the treating physician.
If you have questions concerning treatment and follow-up, ITM has also become the centre of expertise for rabies in Belgium. A doctor who suspects the possibility of rabies in a patient can therefore contact ITM experts in order to get their opinion. Doctors from ITM and UZA provide infectious disease care outside office hours or on weekends. Every general practitioner has received a circular in his/her e-health box containing useful contacts.
“Belgian tourists are often exposed to rabies in endemic countries and rapid action is needed. Centralising expertise in a single centre helps to streamline processes and keep a good level of competence for this very rare and life-threatening disease,” said Dr. Patrick Soentjens, head physician of ITM’s policlinic.
Rabies is a notifiable disease. If the patient develops suggestive symptoms or if the place of contamination is Belgium, the attending physician must inform the medical inspector in charge of infectious disease surveillance immediately in order to take the appropriate prevention measures and, in particular, contact the Federal Agency for the Safety of the Food Chain (FASFC) and the national animal rabies laboratory to carry out a risk analysis of the animal.
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