Necropsy team
Necropsy Lead. Every time a necropsy for rabies sampling is performed, it should be clear who is the Necropsy Lead. The Necropsy Lead, typically the veterinarian, holds the responsibility for the safety of those present, ensuring correct protocol is followed, and handling any adverse situations, such as a possible exposure to an infectious substance. The project leadership must clearly define who is permitted/qualified to act as the Necropsy Lead and rabies sampling must never be performed without a Necropsy Lead present.
Minimum staff. There should always be at least two people present when sampling for rabies diagnosis , with one person remaining uncontaminated at all times. This is to ensure that whilst one or more people conduct the necropsy, there is at least one non-contaminated person available to assist in with everything outside of the contaminated area. This may include handling non-contaminated items, taking notes, labelling sample pots and responding to any situation that may occur during the necropsy procedure.
PrEP requirement - All those present must have completed pre-exposure prophylaxis and be trained in what rabies is, how it is transmitted and what to do in the event of possible exposure to the rabies virus. Anyone not adequately trained or who cannot prove that they are protected with pre-exposure vaccination should be asked to leave the room.
Preparation
Before beginning, the lead should ensure that the correct personal protective equipment (PPE) is worn by those present. If any item of PPE is not available or is incorrectly correctly fitting, the procedure should be postponed until suitable equipment is available to complete it safely.
Equipment needed for conducting the necropsy should be checked and sample pots labelled before the area is contaminated.
Equipment needed:
- Personal Protective Equipment (PPE) including googles, face mask, apron or overalls that cover forearms and clothes, gloves
- Plastic sheeting
- Scalpel blade
- Sampling equipment (spatula)
- Disposal bag x 2
- Disinfectant
- Sterile universal sample container pot (10ml)
- Outer sample container
Necropsy method
There are three general approaches to sampling brainstem for rabies diagnostic testing:
- Ventral approach to the foramen magnum
- Dorsal approach to the foramen magnum
- Craniotomy
Dorsal approach to foramen magnum
The dorsal approach enables the brainstem to be sampled with minimal dissection and exposure of central nervous system and other body fluids. It is therefore the method of choice in most settings. The following video provides a summary of the necropsy procedure for the dorsal approach to the foramen magnum: