Rabies


RABIES

Description:

Highly fatal infectious disease that may affect all species of warm-blooded animals, including humans; transmitted by the bite of infected animals including dogs, cats, skunks, wolves, foxes, raccoons, and bats, and caused by a neurotropic species of Lyssavirus, a member of the family Rhabdoviridae, in the central nervous system and the salivary glands. The symptoms are characteristic of a profound disturbance of the nervous system, e.g., excitement, aggressiveness, and madness, followed by paralysis and death. Characteristic cytoplasmic inclusion bodies (Negri bodies) found in many of the neurons are an aid to rapid laboratory diagnosis.

Alternative Name: Hydrophobia.

Terminology Related with rabies include: Dumb rabies, furious rabies, and paralytic rabies.

Rabies is regarded as one of the most important zoonotic diseases in the world (a disease which primarily affects animals, but can cause disease in humans.

Humans get rabies when they are bitten by infected animals. Wild animals - especially bats - are the most common source of human rabies infection in the United States. Skunks, raccoons, dogs, cats, coyotes, foxes, and other mammals can, also transmit the disease.

The rabies virus is present on all continents except Antarctica. Some countries have implemented vigilant control measures and succeeded in eradicating the disease to meet the OIE requirements for rabies free status. However, in some countries, the disease remains endemic with rabies present mainly in wild animal hosts. Although the infection of domestic livestock could have economic consequences in some countries, it is the occurrence of rabies in domestic dogs posing a threat to humans that is of major concern in several developing and in-transition countries

Although rabies among humans is rare in the United States, every year an estimated 18,000 people receive the rabies vaccine for pre-exposure prophylaxis, and an additional 40,000 receive the rabies vaccine for post-exposure prophylaxis.

Untreated, rabies can lead to coma and death.

Symptoms:

At ?rst there might not be any symptoms. But weeks,or even months after a bite, rabies can cause pain,fatigue, headaches, fever, and irritability. These arefollowed by seizures, hallucinations, and paralysis.Human rabies is almost always fatal.

General symptoms may include:

    Anxiety, stress, and tension.

  • Drooling.

  • Convulsions.

  • Excitability.

  • Exaggerated sensation at the bite site.

  • Loss of feeling in an area of the body.

  • Loss of muscle function.

  • Low-grade fever.

  • Muscle spasms.

  • Numbness and tingling.

  • Restlessness.

  • Swallowing difficulty.

Causes and Risk factors:

Rabies is an infection caused by the rabies virus. This virus attacks the brain, causing severe inflammation (encephalitis) and death.

A person or animal can become infected with the rabies virus in one of a few ways, including bites, non-bite exposure, and human-to-human transmission.

Bites from a rabid animal (an animal with rabies) are the most common way in which rabies transmission occurs. Non-bite exposure and human-to-human exposure are both rare.

Rabies is transmitted through the saliva of aninfected animal. Infection occurs primarily via bitewounds, or infected saliva entering an open cut wound or mucous membrane, such as those inthe mouth, nasal cavity or eyes. Infection throughinhalation of the virus has been documented, for example, in the environment of a densely populated bat cave. The virus will generally remain at the entry site for a period of time before traveling along the nerves to the brain. In the brain, the virus multiplies quickly, resulting in clinical signs. The virus then

People at high risk of exposure to rabies, such asveterinarians, animal handlers, rabies laboratoryworkers, spelunkers, and rabies biologics productionworkers should be offered rabies vaccine.

Diagnosis:

Any encounter with a domestic or wild animal where a bite is received must be investigated.

The risk of rabies transmission must be evaluated based on thenature of the encounter, species of animal involved, prevalence of rabies in the area, and evaluation of the vaccination and clinical status ofthe animal and its availability for diagnostic testing.

Direct fluorescence antibody testing of a biopsy specimen of skin from the nape of the neck is the diagnostic test of choice. Diagnosis can also be made by PCR of CSF, saliva, or tissue. Specimens tested for rabies antibodies include serum and CSF. CT, MRI, and EEG are normal or show nonspecific changes.

Treatment:

There is no known effective treatment for people with symptoms of a rabies infection.

Anyone who has been bitten by an animal, or whootherwise may have been exposed to rabies, shouldclean the wound and see a doctor immediately. Thedoctor will determine if they need to be vaccinated.

If there is any risk of rabies, you will be given a series of a preventive vaccine. This is generally given in five doses over 28 days.

Most patients also receive a treatment called human rabies immunoglobulin (HRIG). This is given the day the bite occured.

Talk with a doctor before getting rabies vaccine if you:

    Ever had a serious (life-threatening) allergic reaction to a previous dose of rabies vaccine, or to any component of the vaccine.

  • Have a weakened immune system.

  • If you are moderately or severely ill, you should probably wait until you recover before getting a routine (non-exposure) dose of rabies vaccine.

Medicine and medications:

Human rabies immune globulin.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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