What is the first step in the management of a patient immediately following a suspected rabies exposure?

A Administration of rabies vaccine

B Wound cleansing with soap and water

C Injection of rabies immunoglobulin

D Tetanus toxoid vaccination

Solution

Correct Answer: Option B

- The first and most critical step following suspected rabies exposure is immediate and thorough wound cleansing with soap and water.
- This mechanical action significantly reduces viral load by washing away saliva, virus particles, and other contaminants, thereby lowering the risk of viral entry into peripheral nerves.
- Early and meticulous wound care is proven to be the most effective single measure to prevent rabies.
- Subsequent administration of rabies vaccine and immunoglobulin are important but should follow prompt wound cleansing to maximize efficacy.
- Immediate wound hygiene is a simple, accessible intervention that can significantly impact morbidity and mortality.

Reference: Davidson’s Principles and Practice of Medicine, 23rd Edition, Chapter: Infectious Diseases, Page 528.

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