The Full Wiki

Rabies: Wikis

  
  
  
  
  
  

Did you know ...


More interesting facts on Rabies

Include this on your site/blog:

Encyclopedia

From Wikipedia, the free encyclopedia

Rabies
Classification and external resources

Dog with rabies virus
ICD-10 A82.
DiseasesDB 11148
eMedicine med/1374 eerg/493 ped/1974
MeSH D011818
Rabies (pronounced /ˈreɪbiːz/. .From Latin: rabies) is a viral disease that causes acute encephalitis (inflammation of the brain) in warm-blooded animals.^ Rabies is a viral disease that affects the CNS. The genus Lyssavirus contains more than 80 viruses.

^ Ten viruses are in the rabies serogroup, most of which only rarely cause human disease.

[1] It is zoonotic (i.e., transmitted by animals), most commonly by a bite from an infected animal but occasionally by other forms of contact. .Rabies is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms.^ Debbie JG, Trimarchi CV. Prophylaxis for suspected exposure to bat rabies.

^ If rabies treatment is not initiated before the onset of symptoms, death is imminent.

^ Shill M, Baynes RD, Miller SD. Fatal rabies encephalitis despite appropriate post-exposure prophylaxis.

.The rabies virus travels to the brain by following the peripheral nerves.^ The rabies virus travels along these axons at a rate of 12-24 mm/d to enter the spinal ganglion.

^ Incubation period The rabies virus transfers from peripheral areas to the CNS. The infected individual remain asymptomatic.

.The incubation period of the disease is usually a few months in humans, depending on the distance the virus must travel to reach the central nervous system.^ Rabies is a highly neurotropic virus that evades immune surveillance by its sequestration in the nervous system.

^ Incubation period: The virus transfers from peripheral areas to the CNS. Physical findings are not present.

^ Incubation period The rabies virus transfers from peripheral areas to the CNS. The infected individual remain asymptomatic.

[2] Once the rabies virus reaches the central nervous system and symptoms begin to show, the infection is effectively untreatable and usually fatal within days.
.Early-stage symptoms of rabies are malaise, headache and fever, progressing to acute pain, violent movements, uncontrolled excitement, depression, and hydrophobia.^ Symptoms may include malaise, anorexia, headaches , fever, chills, pharyngitis , nausea, emesis, diarrhea, anxiety, agitation, insomnia , and depression .

[1] .Finally, the patient may experience periods of mania and lethargy, eventually leading to coma.^ Patients may not recall exposure because of the prolonged incubation period.

.The primary cause of death is usually respiratory insufficiency.^ The primary cause of death is usually respiratory insufficiency.

^ It eventually causes death, which usually occurs from cardiac or respiratory arrest.

^ In both "furious" and "dumb" rabies, death usually occurs within seven days due to breathing failure caused by paralysis of the respiratory system.
  • Rabies - Travel Health - Public Health Agency of Canada 8 January 2010 1:21 UTC www.phac-aspc.gc.ca [Source type: News]

[2] .Worldwide, the vast majority of human rabies cases (approximately 97%) come from dog bites.^ Viral studies of human cases reported from US border states implicate an urban canine rabies strain and a link to coyote rabies in southern Texas.

^ Bat rabies virus variants were implicated in the rabies cases in Texas and Indiana, whereas exposure to a dog in the Philippines was responsible for the case in California.

^ The survival of a teenaged girl from Wisconsin received substantial attention in October 2004 as the first case of human survival of rabies in the absence of preceding vaccination or postexposure prophylaxis.

[3] .In the United States, however, animal control and vaccination programs have effectively eliminated domestic dogs as reservoirs of rabies.^ The prevalence of rabies varies by location depending on animal-control effectiveness and immunization programs.

^ Less than 5% of cases in developed nations occur in domesticated dogs; however, unvaccinated dogs serve as the main reservoir worldwide.

^ Foxes Dogs and cats along the Mexican border: Because of limited resources and minimal public health infrastructure in the bordering communities, efforts to maintain animal control through dog-vaccination programs are hindered.

[4] In several countries, including the United Kingdom, Australia and Japan, the virus has been eradicated entirely.[citation needed]
The economic impact is also substantial, as rabies is a significant cause of death of livestock in some countries.

Contents

Signs and symptoms

Patient with rabies, 1959
The period between infection and the first flu-like symptoms is normally two to twelve weeks, but can be as long as two years. .Soon after, the symptoms expand to slight or partial paralysis, cerebral dysfunction, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, terror, hallucinations, progressing to delirium.^ Patients develop agitation, hyperactivity, restlessness, thrashing, biting, confusion, or hallucinations.

^ Symptoms may include malaise, anorexia, headaches , fever, chills, pharyngitis , nausea, emesis, diarrhea, anxiety, agitation, insomnia , and depression .

[2][5] The production of large quantities of saliva and tears coupled with an inability to speak or swallow are typical during the later stages of the disease; this can result in hydrophobia, in which the patient has difficulty swallowing because the throat and jaw become slowly paralyzed, shows panic when presented with liquids to drink, and cannot quench his or her thirst.
.Death almost invariably results two to ten days after the first symptoms; the few humans who are known to have survived the disease were all left with severe brain damage, with one recorded exception purportedly resulting from implementation of the Milwaukee protocol.^ The largest number of human deaths annually was recorded during the first half of the 20th century, with an average of 50 documented cases per year.

^ Most US cases result in death within 14 days because of complications, despite intensive supportive care.

^ The survival of a teenaged girl from Wisconsin received substantial attention in October 2004 as the first case of human survival of rabies in the absence of preceding vaccination or postexposure prophylaxis.

[6]

Virology

TEM micrograph with numerous rabies virions (small, dark grey, rodlike particles) and Negri bodies (the larger pathognomonic cellular inclusions of rabies infection).
The rabies virus is the type species of the Lyssavirus genus, which encompasses other similar viruses. .Lyssaviruses have helical symmetry, with a length of about 180 nm and a cross-sectional diameter of about 75 nm.^ INTRODUCTION Rabies is an infectious disease of animals caused by a bullet-shaped, enveloped RNA virus, 180 x 75 nm.
  • RABIES 8 January 2010 1:21 UTC www.uct.ac.za [Source type: FILTERED WITH BAYES]

^ The nucleocapsid is uncoiled filamentous, or cylindrical (coiled, is cross-banded with a length of uncoiled about 700 nm and a width of uncoiled 20 nm, or 30-70 nm.
  • ICTVdB Virus Description - 01.062.0.02.001. Rabies virus 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Each virus is bullet-shaped and approximately 180 nm long and 75 nm wide.

[1] .These viruses are enveloped and have a single stranded RNA genome with negative-sense.^ The rabies virus is a bullet-shaped virion with a single-stranded RNA nucleocapsid core and lipoprotein envelope.

The genetic information is packaged as a ribonucleoprotein complex in which RNA is tightly bound by the viral nucleoprotein. The RNA genome of the virus encodes five genes whose order is highly conserved: nucleoprotein (N), phospholipid (L), matrix protein (M), glycoprotein (G) and the viral RNA polymerase (L).[7]
.From the point of entry, the virus is neurotropic, traveling quickly along the neural pathways into the central nervous system (CNS), and then further into other organs.^ Rabies is a highly neurotropic virus that evades immune surveillance by its sequestration in the nervous system.

^ From here, the rabies virus spreads quickly, at a rate of 200-400 mm/d, into the CNS, and spread is marked by rapidly progressive encephalitis .

^ The rabies virus travels along these axons at a rate of 12-24 mm/d to enter the spinal ganglion.

[2] .The salivary glands receive high concentrations of the virus thus allowing further transmission.^ In the last stages of the disease, the virus moves from the brain into the salivary glands and saliva.

^ RABIES IN BATS: Bats, unlike other animals, can have rabies virus in their salivary glands and be capable of transmitting rabies for several weeks and even moths before showing clinical signs of rabies.
  • Rabies: What To Do 8 January 2010 1:21 UTC mdc.mo.gov [Source type: FILTERED WITH BAYES]

^ However, aerosol transmission has occurred under very specialized conditions in which the air contains a high concentration of suspended particles or droplets carrying viral particles.
  • Rabies: Introduction - The Merck Veterinary Manual 8 January 2010 1:21 UTC www.merckvetmanual.com [Source type: FILTERED WITH BAYES]
  • Rabies Watch provided by Air Animal Pet Moving Services 8 January 2010 1:21 UTC www.airanimal.com [Source type: FILTERED WITH BAYES]

Diagnosis

The reference method for diagnosing rabies is by performing PCR or viral culture on brain samples taken after death. .The diagnosis can also be reliably made from skin samples taken before death.^ Tests are performed on samples of serum, saliva, spinal fluid, and skin biopsies taken from the nape of the neck.
  • Rabies 8 January 2010 1:21 UTC www.healthsystem.virginia.edu [Source type: FILTERED WITH BAYES]
  • Rabies - New York Presbyterian Hospital 8 January 2010 1:21 UTC nyp.org [Source type: FILTERED WITH BAYES]
  • Bridgeport Hospital, CT - Health & Wellness 8 January 2010 1:21 UTC www.bridgeporthospital.org [Source type: FILTERED WITH BAYES]
  • Rabies | Health Library | Weill Cornell Physicians | Advancing Science. Enhancing Life. 8 January 2010 1:21 UTC www.weillcornell.org [Source type: FILTERED WITH BAYES]
  • Rabies - Morgan Stanley Children's Hospital of NewYork Presbyterian 8 January 2010 1:21 UTC childrensnyp.org [Source type: FILTERED WITH BAYES]
  • Rabies 8 January 2010 1:21 UTC www.healthsystem.virginia.edu [Source type: FILTERED WITH BAYES]
  • Rabies | CHOP | The Children's Hospital of Philadelphia 8 January 2010 1:21 UTC www.chop.edu [Source type: FILTERED WITH BAYES]
  • Rabies - Morgan Stanley Children's Hospital of NewYork Presbyterian 8 January 2010 1:21 UTC childrensnyp.org [Source type: FILTERED WITH BAYES]

^ However, if samples are taken before treatment, the rabies' antibody is utilized for diagnosis.
  • Rabies & The Rhabdovirus 8 January 2010 1:21 UTC webspace.ship.edu [Source type: Academic]

^ A sample of skin is taken (usually from the neck) and examined under a microscope (skin biopsy) to determine whether the virus is present.
  • Rabies: Infections of the Brain and Spinal Cord: Merck Manual Home Edition 8 January 2010 1:21 UTC www.merck.com [Source type: FILTERED WITH BAYES]

[8] .It is also possible to make the diagnosis from saliva, urine and cerebrospinal fluid samples, but this is not as sensitive.^ Wacharapluesadee S, Hemachudha T. Urine samples for rabies RNA detection in the diagnosis of rabies in humans.

Inclusion bodies called Negri bodies are 100% diagnostic for rabies infection, but are found in only about 80% of cases.[1] .If possible, the animal from which the bite was received should also be examined for rabies.^ Organ donation: Clinical screening of potential organ donors should include a history of animal bites, presence of clinical features of rabies, and a travel history (within a period of months) to areas where rabies is endemic.

[9]
.The differential diagnosis in a case of suspected human rabies may initially include any cause of encephalitis, particularly infection with viruses such as herpesviruses, enteroviruses, and arboviruses (e.g., West Nile virus).^ Human infection due to recombinant vaccinia-rabies glycoprotein virus.

^ Viral studies of human cases reported from US border states implicate an urban canine rabies strain and a link to coyote rabies in southern Texas.

^ Bat rabies virus variants were implicated in the rabies cases in Texas and Indiana, whereas exposure to a dog in the Philippines was responsible for the case in California.

The most important viruses to rule out are herpes simplex virus type 1, varicella-zoster virus, and (less commonly) enteroviruses, including coxsackieviruses, echoviruses, polioviruses, and human enteroviruses 68 to 71.[10] In addition, consideration should be given to the local epidemiology of encephalitis caused by arboviruses belonging to several taxonomic groups, including eastern and western equine encephalitis viruses, St. Louis encephalitis virus, Powassan virus, the California encephalitis virus serogroup, and La Crosse virus.[citation needed]
.New causes of viral encephalitis are also possible, as was evidenced by the recent outbreak in Malaysia of some 300 cases of encephalitis (mortality rate, 40%) caused by Nipah virus, a newly recognized paramyxovirus.^ From here, the rabies virus spreads quickly, at a rate of 200-400 mm/d, into the CNS, and spread is marked by rapidly progressive encephalitis .

[11] .Similarly, well-known viruses may be introduced into new locations, as is illustrated by the recent outbreak of encephalitis due to West Nile virus in the eastern United States.^ West Nile virus .
  • Rabies PCR test 8 January 2010 1:21 UTC www.zoologix.com [Source type: Academic]

^ In recent years, raccoons in the eastern United States have been severely affected by the rabies virus.
  • Rabies Prevention in Livestock, VME-1-97 8 January 2010 1:21 UTC ohioline.osu.edu [Source type: FILTERED WITH BAYES]

^ What about West Nile virus?
  • Bats and Rabies 8 January 2010 1:21 UTC www.batcon.org [Source type: FILTERED WITH BAYES]

[12] .Epidemiologic factors (e.g., season, geographic location, and the patient’s age, travel history, and possible exposure to animal bites, rodents, and ticks) may help direct the diagnostic workup.^ Is it possible to survive a bite from a rabid animal?
  • Cat Rabies Article From AllergicPet.com 8 January 2010 1:21 UTC www.allergicpet.com [Source type: FILTERED WITH BAYES]

^ If possible, locate the animal that inflicted the wound.
  • Animal Bites and Rabies 8 January 2010 1:21 UTC www.umm.edu [Source type: FILTERED WITH BAYES]
  • Rabies - New York Presbyterian Hospital 8 January 2010 1:21 UTC nyp.org [Source type: FILTERED WITH BAYES]
  • Rabies - New York Presbyterian Hospital 8 January 2010 1:21 UTC nyp.org [Source type: FILTERED WITH BAYES]
  • Bridgeport Hospital, CT - Health & Wellness 8 January 2010 1:21 UTC www.bridgeporthospital.org [Source type: FILTERED WITH BAYES]
  • Rabies | Health Library | Weill Cornell Physicians | Advancing Science. Enhancing Life. 8 January 2010 1:21 UTC www.weillcornell.org [Source type: FILTERED WITH BAYES]
  • Rabies 8 January 2010 1:21 UTC www.healthsystem.virginia.edu [Source type: FILTERED WITH BAYES]

^ What should be done in case of an animal bite or other possible rabies exposure?
  • DoctorNDTV: Health Information on Rabies 8 January 2010 1:21 UTC doctor.ndtv.com [Source type: FILTERED WITH BAYES]

Cheaper rabies diagnosis will be possible for low-income settings: accurate rabies diagnosis can be done at a tenth of the cost of traditional testing using basic light microscopy techniques.[13]

Prevention

.All human cases of rabies were fatal until a vaccine was developed in 1885 by Louis Pasteur and Émile Roux.^ Occurrence after treatment with human diploid cell vaccine but not rabies immune globulin.

^ Since 1940, when canine rabies vaccination programs began, the average number of documented cases declined to 2 per year.

^ In 2006, 3 cases of human rabies were reported in California, Indiana, and Texas.

Their original vaccine was harvested from infected rabbits, from which the nerve tissue was weakened by allowing it to dry for five to ten days.[14] .Similar nerve tissue-derived vaccines are still used in some countries, as they are much cheaper than modern cell culture vaccines.^ Some vaccines used in other countries and some older vaccines are made from nerve tissue.
  • Rabies-Treatment Overview 8 January 2010 1:21 UTC www.webmd.com [Source type: General]

^ The Semple vaccine is still used in some developing countries.
  • Rhabdoviruses, Rabies Virus, Rabies Virus Infection 8 January 2010 1:21 UTC virology-online.com [Source type: FILTERED WITH BAYES]

^ Unfortunately, nerve tissue vaccines are still the most widely used prophylaxis for rabies.

[15] The human diploid cell rabies vaccine was started in 1967; however, a new and less expensive purified chicken embryo cell vaccine and purified vero cell rabies vaccine are now available.[9] .A recombinant vaccine called V-RG has been successfully used in Belgium, France, Germany and the United States to prevent outbreaks of rabies in wildlife.^ Human rabies prevention--United States, 1999.

^ Compendium of animal rabies prevention and control, 2004: National Association of State Public Health Veterinarians, Inc.

^ Unexplained rabies in three immigrants in the United States.

[16] .Currently pre-exposure immunization has been used in both human and non-human populations, whereas in many jurisdictions domesticated animals are required to be vaccinated.^ This is followed by active immunization, using human diploid cell vaccine.
  • Rabies, Making Sense of ... at azodium 8 January 2010 1:21 UTC www.azodium.com [Source type: FILTERED WITH BAYES]

^ Pre-exposure immunization consists of three doses of vaccine.
  • ISDH: Rabies Education Home 8 January 2010 1:21 UTC www.in.gov [Source type: FILTERED WITH BAYES]

^ As mentioned earlier, it is important that the vaccination requirements for domestic animals are adhered to.
  • Rabies Presentation Transcript : Florida Division of Environmental Health 8 January 2010 1:21 UTC www.doh.state.fl.us [Source type: FILTERED WITH BAYES]

[17]
.In the U.S., since the widespread vaccination of domestic dogs and cats and the development of effective human vaccines and immunoglobulin treatments, the number of recorded deaths from rabies has dropped from one hundred or more annually in the early twentieth century, to 1–2 per year, mostly caused by bat bites, which may go unnoticed by the victim and hence untreated.^ Vaccinate all cats, dogs and livestock.
  • Illinois Raptor Center Informational Brochures/Rabies 8 January 2010 1:21 UTC www.illinoisraptorcenter.org [Source type: FILTERED WITH BAYES]

^ Domestic cats and dogs should be immunized periodically against rabies.
  • DoctorNDTV: Health Information on Rabies 8 January 2010 1:21 UTC doctor.ndtv.com [Source type: FILTERED WITH BAYES]

^ Bat rabies accounts for approximately one human death per year in the United States.
  • Bats and Rabies 8 January 2010 1:21 UTC www.batcon.org [Source type: FILTERED WITH BAYES]

[4]
September 28 is "World Rabies Day", which promotes information on, and prevention and elimination of the disease.[18]

Management

Post-exposure prophylaxis

Treatment after exposure, known as post-exposure prophylaxis (PEP), is highly successful in preventing the disease if administered promptly, generally within ten days of infection.[1] .Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is very effective at reducing the number of viral particles.^ The wound is cleansed immediately and thoroughly with soap and water or benzalkonium chloride.
  • Rabies: Brain Infections: Merck Manual Professional 8 January 2010 1:21 UTC www.merck.com [Source type: Academic]

^ If you are bitten by an animal, it’s vital to wash the wound thoroughly with plenty of water and if possible a soap or wound cleanser.
  • BBC - Health - Conditions - Rabies 8 January 2010 1:21 UTC www.bbc.co.uk [Source type: News]

^ Immediately wash the wound with lots of soap and running water.
  • Rabies Safety Bulletin 8 January 2010 1:21 UTC cc.ysu.edu [Source type: FILTERED WITH BAYES]

“If available, a virucidal antiseptic such as povidone-iodine, iodine tincture, aqueous iodine solution or alcohol (ethanol) should be applied after washing...Exposed mucous membranes such as eyes, nose or mouth should be flushed well with water.”[19]
.In the United States, patients receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a fourteen day period.^ Human rabies prevention--United States, 1999.

^ Unexplained rabies in three immigrants in the United States.

^ Occurrence after treatment with human diploid cell vaccine but not rabies immune globulin.

.The immunoglobulin dose should not exceed 20 units per kilogram body weight.^ According the Centers for Disease Control and Prevention, exposed humans who have not previously been vaccinated against rabies should receive an initial IM injection of Human Rabies Immune Globulin (HRIG), twenty international units per kilogram body weight or nine international units per pound of body weight in total.
  • Bats and Rabies 8 January 2010 1:21 UTC www.batcon.org [Source type: FILTERED WITH BAYES]

^ Although the cost varies, a course of rabies immunoglobulin and five doses of vaccine given over a 4-week period typically exceeds $1,000.
  • The Ascension of Wildlife Rabies 8 January 2010 1:21 UTC www.fas.org [Source type: Academic]

^ Treatment consists of one dose of rabies immune globulin (dosage dependent on body weight) and five doses of rabies vaccine given on days 0, 3, 7, 14 and 28 after exposure.
  • Columbia County Department of Health 8 January 2010 1:21 UTC www.columbiacountyny.com [Source type: FILTERED WITH BAYES]

.HRIG is very expensive and constitutes the vast majority of the cost of post-exposure treatment, ranging as high as several thousand dollars.^ Post-exposure The treatment regimen after exposure depends on several factors.
  • Rabies in North America and Europe 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ What is the protocol for rabies post-exposure treatment?
  • Rabies Clinic 8 January 2010 1:21 UTC www.vldhealth.org [Source type: FILTERED WITH BAYES]

^ This is called rabies post-exposure treatment.
  • NJDHSS, Communicable Disease Service: Rabies 8 January 2010 1:21 UTC www.state.nj.us [Source type: FILTERED WITH BAYES]

.As much as possible of this dose should be infiltrated around the bites, with the remainder being given by deep intramuscular injection at a site distant from the vaccination site.^ The injection can be given into the skin (intradermal) at a tenth of the dose of the intramuscular injection.

^ As much of the RIG should be injected around or near the exposure site as anatomically possible.
  • Rabies 8 January 2010 1:21 UTC www.mnpoison.org [Source type: FILTERED WITH BAYES]

^ Up to half the dose should be infiltrated in and around the wound after cleansing and the rest by intramuscular injection.
  • Rabies in North America and Europe 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[20] .The first dose of rabies vaccine is given as soon as possible after exposure, with additional doses on days three, seven and fourteen after the first.^ I cannot get rabies vaccine on the day I am supposed to get my next dose?

^ Pre-exposure rabies vaccines are administered by a series of three injections: .

^ The vaccine is given in 3 IM or ID doses on days 0, 7 and 21 or 28.
  • Rabies 8 January 2010 1:21 UTC www.mnpoison.org [Source type: FILTERED WITH BAYES]

Patients who have previously received pre-exposure vaccination do not receive the immunoglobulin, only the post-exposure vaccinations on day 0 and 2.
.Modern cell-based vaccines are similar to flu shots in terms of pain and side effects.^ What are the side effects of the vaccine?
  • Rabies Questions and Answers Page 8 January 2010 1:21 UTC www.ndhealth.gov [Source type: FILTERED WITH BAYES]

^ What side effects have been reported with this vaccine?

^ Although rabies shots used to be painful and given in the abdomen, current rabies vaccines are no more painful than other shots and are given in the arm.

.The old nerve-tissue-based vaccinations require multiple painful injections into the abdomen with a large needle, are cheap, and are now used only in remote poor areas in India, but are being phased out and replaced by affordable WHO ID (intradermal) vaccination regimens.^ This vaccine is only approved for use in wildlife.
  • USDA - APHIS - Wildlife Damage Management 8 January 2010 1:21 UTC www.aphis.usda.gov [Source type: FILTERED WITH BAYES]

^ Only five injections are required.
  • DoctorNDTV: Health Information on Rabies 8 January 2010 1:21 UTC doctor.ndtv.com [Source type: FILTERED WITH BAYES]

^ Pre-exposure vaccination using the ID route is approved by the WHO [1].
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

[9]
.Intramuscular vaccination should be given into the deltoid, not gluteal area which has been associated with vaccination failure due to injection into fat rather than muscle.^ These shots should be given in the deltoid muscle of the arm.

^ The injection can be given into the skin (intradermal) at a tenth of the dose of the intramuscular injection.

^ The vaccine is given in the deltoid muscle as a series of 3-5 shots.

.In infants the lateral thigh is used as for routine childhood vaccinations.^ Post vaccination serology, to determine the level of rabies neutralizing antibody, may be useful in some circumstances, but should not be undertaken routinely for travellers.
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ Dogs and cats should get rabies vaccines by 4 months of age, followed by a booster shot 1 year later, and another one every 1 or 3 years, depending on the type of vaccine used.
  • Rabies: MedlinePlus Medical Encyclopedia 8 January 2010 1:21 UTC www.nlm.nih.gov [Source type: FILTERED WITH BAYES]
  • Rabies - Symptoms, Diagnosis, Treatment of Rabies - NY Times Health Information 8 January 2010 1:21 UTC health.nytimes.com [Source type: News]
  • Rabies | Infectious Diseases | Wake Forest University Baptist Medical Center 8 January 2010 1:21 UTC www2.wfubmc.edu [Source type: FILTERED WITH BAYES]

^ The rabies vaccine is not recommended for routine use in the general population.

.Finding a bat in the room of a sleeping infant is regarded as an indication for post-exposure prophylaxis.^ Post-exposure prophylaxis .
  • Rabies | Nursing Crib 8 January 2010 1:21 UTC nursingcrib.com [Source type: FILTERED WITH BAYES]

^ If a young child or a mentally incapacitated person is found alone with a bat in the same room and the possibility of a bite cannot be eliminated, post-exposure treatment should be considered unless prompt testing of the bat can rule out infection.
  • Bats and Rabies 8 January 2010 1:21 UTC www.batcon.org [Source type: FILTERED WITH BAYES]

^ However, because bat bites are small and may possibly go unnoticed, post-exposure prophylaxis may be wise after physical contact with bats unless bite or mucous membrane exposure can be reliably ruled out.
  • Rabies in Indonesia - Prevention and Treatment 8 January 2010 1:21 UTC www.expat.or.id [Source type: FILTERED WITH BAYES]

.The recommendation for the precautionary use of post-exposure prophylaxis in occult bat encounters where there is no recognized contact has been questioned in the medical literature based on a cost-benefit analysis.^ Post exposure prophylaxis .
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ The child denied any contact with the bat, and no post-exposure treatment was initiated.
  • The Ascension of Wildlife Rabies 8 January 2010 1:21 UTC www.fas.org [Source type: Academic]

^ There are no contraindications to post-exposure treatment.
  • Rabies, Making Sense of ... at azodium 8 January 2010 1:21 UTC www.azodium.com [Source type: FILTERED WITH BAYES]

[21] However, recent studies have further confirmed the wisdom of maintaining the current protocol of precautionary administering of PEP. in cases where a child or mentally compromised individual has been left alone with a bat, especially in sleep areas (where a bite/or exposure may occur while the victim is asleep and unaware or awake and unaware that a bite occurred). This is illustrated by the case of a nine-year old boy from Quebec who died an agonizing death (over a 14 day period) from rabies 4 weeks after being in the presence of a sick bat, even though there was no apparent report of a bite; as shown in the following conclusion made by the doctors involved in the case:
.Despite recent criticism (45), the dramatic circumstances surrounding our patient's history, as well as increasingly frequent reports of human rabies contracted in North America, support the current Canadian guidelines which state that RPEP [PEP] is appropriate in cases where a significant contact with a bat cannot be excluded (45).^ In 2006, 3 cases of human rabies were reported in California, Indiana, and Texas.

^ From 2001-2005, 15 cases of human rabies were reported in the United States.

^ Because children may not be able to recall contact with a bat, if a bat is found in a room where a child has been sleeping, the bat should be captured and submitted for examination to the county or state health authorities.

The notion that a bite or an overt break in the skin needs to be seen or felt for rabies to be transmitted by a bat is a myth in many cases.[22]
It is highly recommended that PEP be administered as soon as possible. Begun with little or no delay, PEP is 100% effective against rabies.[6] In the case in which there has been a significant delay in administering PEP, the treatment should be administered regardless of that delay, as it may still be effective.[20] .If there has been a delay between exposure and attempts at treatment, such that the possibility exists that the virus has already penetrated the nervous system, the possibility exists that amputation of the affected limb might thwart rabies, if the bite or exposure was on an arm or leg.^ Rabies is a highly neurotropic virus that evades immune surveillance by its sequestration in the nervous system.

^ Bat rabies virus variants were implicated in the rabies cases in Texas and Indiana, whereas exposure to a dog in the Philippines was responsible for the case in California.

^ The development of monoclonal human rabies virus-neutralizing antibodies as a substitute for pooled human immune globulin in the prophylactic treatment of rabies virus exposure.

.This treatment should be combined with an intensive PEP regimen.^ Healthcare providers should immediately report any PEP treatment on the appropriate form to their local health department.
  • Rabies Prevention 8 January 2010 1:21 UTC www.nwcphp.org [Source type: FILTERED WITH BAYES]

[citation needed]

Blood-brain barrier

.Some recent works have shown that during lethal rabies infection, the blood-brain barrier (BBB) does not allow anti-viral immune cells to enter the brain, the primary site of rabies virus replication.^ Figure 2 - Replication of rabies virus The cycle of rabies infection and replication CDC .

^ Rabies is an infection caused by a virus.
  • Rabies-Topic Overview 8 January 2010 1:21 UTC www.webmd.com [Source type: General]

^ To cause an infection, the rabies virus must enter the body and reach nerve cells.
  • OSH Answers: Rabies 8 January 2010 1:21 UTC www.ccohs.ca [Source type: FILTERED WITH BAYES]

[23] .This aspect contributes to the pathogenicity of the virus and artificially increasing BBB permeability promotes viral clearance.^ The rabies virus’ pathogenicity, or ability to produce disease, contributes to its reputation as one of the most feared zoonotic diseases.
  • Rabies Presentation Transcript : Florida Division of Environmental Health 8 January 2010 1:21 UTC www.doh.state.fl.us [Source type: FILTERED WITH BAYES]

[24] .Opening the BBB during rabies infection has been suggested as a possible novel approach to treat the disease, even though no attempts have yet been made to determine whether or not this treatment could be successful.^ Treatments and drugs There is no specific treatment for rabies infection.

^ There is no treatment for rabies after symptoms of the disease appear .
  • Rabies & Your Pet - Paw's Place Animal Rescue 8 January 2010 1:21 UTC www.pawsplace.org [Source type: FILTERED WITH BAYES]

^ No, it is not possible to get rabies from the vaccine.
  • Rabies Safety Bulletin 8 January 2010 1:21 UTC cc.ysu.edu [Source type: FILTERED WITH BAYES]

[citation needed]

Induced coma

.In 2005, American teenager Jeanna Giese survived an infection of rabies unvaccinated.^ The survival of a Wisconsin teenager who contracted rabies may point the way to a treatment for this horrifying disease see Rodney E. Willoughby, Jr. Scientific American, http://www.sciam.com , 2007 .
  • A Coffin for Rabies - Opinionator Blog - NYTimes.com 8 January 2010 1:21 UTC judson.blogs.nytimes.com [Source type: FILTERED WITH BAYES]

^ Yes, unvaccinated domestic animals can contract rabies from wild animals and transmit the infection to humans.
  • NJDHSS, Communicable Disease Service: Rabies 8 January 2010 1:21 UTC www.state.nj.us [Source type: FILTERED WITH BAYES]
  • Rabies Clinic 8 January 2010 1:21 UTC www.vldhealth.org [Source type: FILTERED WITH BAYES]

^ RABIES SURVIVOR: Jeanna Giese plays with her dog Maggie in her yard last summer in Fond du Lac, Wisc.
  • Medical Mystery: Only One Person Has Survived Rabies without Vaccine--But How?: Scientific American 8 January 2010 1:21 UTC www.scientificamerican.com [Source type: News]

She was placed into an induced coma upon onset of symptoms and given ketamine, midazolam, ribavirin, and amantadine. .Her doctors administered treatment based on the hypothesis that detrimental effects of rabies were caused by temporary dysfunctions in the brain and could be avoided by inducing a temporary partial halt in brain function that would protect the brain from damage while giving the immune system time to defeat the virus.^ Rabies is caused by a virus of the Rhabdovirus family.
  • Rabies in Horses: Should Horses be Vaccinated in Colorado? 8 January 2010 1:21 UTC www.ext.colostate.edu [Source type: FILTERED WITH BAYES]

^ An injection of anti rabies globulin is also administered at the time of the first treatment.
  • Questions About Rabies - Sonoma County Animal Shelter 8 January 2010 1:21 UTC www.sonoma-county.org [Source type: FILTERED WITH BAYES]
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: FILTERED WITH BAYES]

^ Rabies is caused by a virus.

.After thirty-one days of isolation and seventy-six days of hospitalization, Giese was released from the hospital.^ After six days under, and many more in the hospital, Jeanna Giese emerged with only slight brain damage, and now lives a normal life.
  • rabies – Neatorama 8 January 2010 1:21 UTC www.neatorama.com [Source type: General]

^ If the owner is unwilling to have this done, the animal should be placed in strict isolation for six months with no human or animal contact, and vaccinated one month before being released.
  • Rabies Prevention 8 January 2010 1:21 UTC www.nwcphp.org [Source type: FILTERED WITH BAYES]

[25] She survived with almost no permanent sequelae and as of 2009 was starting her third year of university studies.[26]
Giese's treatment regimen became known as the "Milwaukee protocol", which has since undergone revision (the second version omits the use of ribavirin). There were 2 survivors out of 25 patients treated under the first protocol. A further 10 patients have been treated under the revised protocol and there have been a further 2 survivors.[27] The anesthetic drug ketamine has shown the potential for rabies virus inhibition in rats,[28] and is used as part of the Milwaukee protocol.
On April 10, 2008 in Cali, Colombia, an eleven year-old boy was reported to survive rabies and the induced coma without noticeable brain damage.[29]

Prognosis

In unvaccinated humans, rabies is almost always fatal after neurological symptoms have developed, but prompt post-exposure vaccination may prevent the virus from progressing. .Rabies kills around 55,000 people a year, mostly in Asia and Africa.^ Rabies causes an estimated 55,000 deaths worldwide each year.
  • Rabies: Infections of the Brain and Spinal Cord: Merck Manual Home Edition 8 January 2010 1:21 UTC www.merck.com [Source type: FILTERED WITH BAYES]

^ Around the world, an estimated 55,000 people die of rabies each year, mostly in rural areas of Africa and Asia.

^ Rabies kills around 55,000 people a year, mostly in Asia and Africa.

[30] There are only six known cases of a person surviving symptomatic rabies, and only one known case of survival in which the patient received no rabies-specific treatment either before or after illness onset.[31][32][33]
The most current survival data using the Milwaukee protocol is available from the rabies registry.[34]

Epidemiology

Transmission

Any warm-blooded animal (including humans) may become infected with the rabies virus and develop symptoms (though birds have only been known to be experimentally infected[35]). Indeed the virus has even been adapted to grow in cells of poikilothermic vertebrates[36][37]though natural transmission has only been documented among mammals.[citation needed] .Most animals can be infected by the virus and can transmit the disease to humans.^ The virus can be transmitted when people are bitten by an infected animal, usually a wild animal.
  • Rabies: Infections of the Brain and Spinal Cord: Merck Manual Home Edition 8 January 2010 1:21 UTC www.merck.com [Source type: FILTERED WITH BAYES]

^ The rabies virus causes the disease by infecting nerves in animals and people.
  • OSH Answers: Rabies 8 January 2010 1:21 UTC www.ccohs.ca [Source type: FILTERED WITH BAYES]

^ Most animals can be infected by the virus and can transmit the disease to humans.

Infected bats, monkeys, raccoons, foxes, skunks, cattle, wolves, coyotes, dogs, mongoose (normally yellow mongoose)[38] or cats present the greatest risk to humans. Rabies may also spread through exposure to infected domestic farm animals, groundhogs, weasels, bears and other wild carnivores. Rodents (mice, squirrels etc) are seldom infected.[39]
.The virus is usually present in the nerves and saliva of a symptomatic rabid animal.^ The virus is usually present in the nerves and saliva of a symptomatic rabid animal.

^ Usually, transmission occurs when rabid animals, with the virus in their saliva, bite people.
  • OSH Answers: Rabies 8 January 2010 1:21 UTC www.ccohs.ca [Source type: FILTERED WITH BAYES]

^ The virus is carried in the saliva of an infected animal.

[40][41] The route of infection is usually, but not always, by a bite. .In many cases the infected animal is exceptionally aggressive, may attack without provocation, and exhibits otherwise uncharacteristic behavior.^ In many cases the infected animal is exceptionally aggressive, may attack without provocation, and exhibits otherwise uncharacteristic behaviour.

^ Infected animals may be either agitated and aggressive or paralyzed and passive.
  • Bats and Rabies 8 January 2010 1:21 UTC www.batcon.org [Source type: FILTERED WITH BAYES]

^ Many of these patients exhibit the classic behavior of hydrophobia, or fear of water, which results in spasms of the throat upon drinking or even the sight or mention of liquids.

[42]
.Transmission between humans is extremely rare.^ Transmission of rabies from horses to humans is extremely rare, but is a potential concern.
  • : rabies : Equid Blog 8 January 2010 1:21 UTC www.equidblog.com [Source type: FILTERED WITH BAYES]

^ Transmission between humans is extremely rare, although it can happen through transplant surgery (see below for recent cases), or, even more rarely, through bites, kisses or sexual relations.

^ In the United States, dogs rarely transmit rabies to humans; however, outside the United States, infected dogs are the most common source of transmission to humans.

A few cases have been recorded through transplant surgery.[43]
.After a typical human infection by bite, the virus enters the peripheral nervous system.^ After a typical human infection by bite, the virus enters the peripheral nervous system.

^ The virus is transmitted to humans by a bite, or when saliva from an infected animal comes into contact with broken skin or mucous membranes (eyes, nose, or mouth).
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ Life cycle From the source of wound of entry, the rabies virus travels quickly along the neural pathways to the central nervous system.

.It then travels along the nerves towards the central nervous system.^ Rabies is a disease of the central nervous system.
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: FILTERED WITH BAYES]

^ It then travels along the nerves towards the central nervous system.

^ The virus enters the central nervous system of the new host, causing an encephalomyelitis which is always fatal once symptoms develop.
  • Rabies in North America and Europe 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[44] .During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies.^ (The virus has never been detected in blood or blood cells.
  • Rabies Virus: Description, Vector, Mechanisms, Symptoms, etc. 8 January 2010 1:21 UTC www.tarakharper.com [Source type: Academic]

^ Cell-mediated immunity plays little role in a rabies infection.

^ Develop procedures to prevent contact with the rabies virus within the workplace.
  • OSH Answers: Rabies 8 January 2010 1:21 UTC www.ccohs.ca [Source type: FILTERED WITH BAYES]

.When the virus reaches the brain, it rapidly causes encephalitis.^ Once the virus reaches the brain, it rapidly causes encephalitis.

^ Only late in the disease, after the virus has reached the brain and multiplied there to cause an encephalitis (or inflammation of the brain), does the virus move from the brain to the salivary glands and saliva.

^ Acute rabies causes encephalitis (inflammation of brain tissue) or meningitis (inflammation of the protective membrane between the brain and the skull), according to Halstead.
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: FILTERED WITH BAYES]

.This is called the prodromal phase, and is the beginning of the symptoms.^ After the prodromal phase the encephalitic phase begins where many symptoms relate to the legend of the vampire.
  • Rabies 8 January 2010 1:21 UTC www.mnpoison.org [Source type: FILTERED WITH BAYES]

^ Initial symptoms of pain or paresthesias at the site of bite or scratch begin during the prodrome.

^ This is called the “prodromal” phase.

Once the patient becomes symptomatic, treatment is almost never effective and mortality is over 99%. Rabies may also inflame the spinal cord producing transverse myelitis.[45][46]

Prevalence

.The rabies virus survives in widespread, varied, rural fauna reservoirs.^ Prevalence The rabies virus survives in wide-spread, varied, rural fauna reservoirs.

^ On the other hand, during 2000-2007, 72% of human rabies cases were associated with suspected exposure to rabid bats or infection with bat rabies virus variants.

^ As Halstead explains, the rabies virus evolved to maximize its chances of survival through transmission from victim to victim.
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: FILTERED WITH BAYES]

It is present in the animal populations of almost every country in the world, except in New Zealand.[47] In some countries like those in western Europe and Oceania, rabies is considered to be prevalent among bat populations only.
In Asia, parts of the Americas and large parts of Africa, dogs remain the principal host. .Mandatory vaccination of animals is less effective in rural areas.^ Mandatory vaccination of animals is less effective in rural areas.

^ Accessing safe and effective rabies vaccine products in low income countries may be difficult, and vaccine derived from animal brain tissue may be the only type available.
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ Other Sections▼ HUMAN RABIES RABIES VACCINES FOR HUMAN USE WILD AND DOMESTIC ANIMALS CONCLUSIONS References CONCLUSIONS In some areas of the US, the control of sylvatic rabies remains problematic.
  • Rabies in North America and Europe 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Especially in developing countries, pets may not be privately kept and their destruction may be unacceptable.^ Especially in developing countries, pets may not be privately kept and their destruction may be unacceptable.

Oral vaccines can be safely distributed in baits, and this has successfully reduced rabies in rural areas of France, Ontario, Texas, Florida and elsewhere, like the City of Montréal, Québec, where baits are successfully used on raccoons in the Mont-Royal park area. .Vaccination campaigns may be expensive, and a cost-benefit analysis can lead those responsible to opt for policies of containment rather than elimination of the disease.^ Vaccination campaigns may be expensive, and a cost-benefit analysis can lead those responsible to opt for policies of containment rather than elimination of the disease.

^ In contrast to Europe, for a given area the principal vectors for the disease are multiple rather than a single wildlife species.
  • Rabies in North America and Europe 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Benefits and costs of using an orally absorbed vaccine to control rabies in raccoons.JAmVetMedAssoc 1992;201:1873 82.
  • The Ascension of Wildlife Rabies 8 January 2010 1:21 UTC www.fas.org [Source type: Academic]

.There are an estimated 55,000 human deaths annually from rabies worldwide, with about 31,000 in Asia, and 24,000 in Africa.^ Worldwide, it is estimated that approximately 55 000 persons die of rabies each year.

^ There are an estimated 55,000 human deaths annually from rabies worldwide, with about 31,000 in Asia, and 24,000 in Africa.

^ The World Health Organization (WHO) in 2004 estimates that as many as 55,000 deaths occur from rabies annually, with 56% in Asia and 44% in Africa.

[30] .One of the sources of recent flourishing of rabies in East Asia is the pet boom.^ One of the sources of recent flourishing of rabies in East Asia is the pet boom.

^ Immunization of pets and prompt response for bites from most suspicious animals may explain why bat-transmission of rabies has been the predominant mode of transmission in recent years.

^ More recently, four persons became infected and died from rabies after receiving solid organ donations from one infected donor.
  • Rabies (Hydrophobia) : Bureau of Communicable Diseases : NYC DOHMH 8 January 2010 1:21 UTC www.nyc.gov [Source type: FILTERED WITH BAYES]

China introduced in the city of Beijing the “one-dog policy” in November 2006 to control the problem.[48] .India has been reported as having the highest rate of human rabies in the world, primarily because of stray dogs.^ In 1996, 4 cases of human rabies were reported.

^ India has been reported as having the highest rate of human rabies in the world, primarily because of stray dogs.

^ Worldwide, more than 55,000 humans die of rabies each year, primarily in developing countries in Asia, Africa and Latin America.

[49] .As of 2007, Vietnam had the second-highest rate, followed by Thailand; in these countries too the virus is primarily transmitted through canines (feral dogs and other wild canine species).^ Rabies may also spread through exposure to infected domestic farm animals, groundhogs, weasels and other wild carnivores.

^ How can these methods be generalized from foxes and raccoons to other species, such as skunks, mongooses and dogs?
  • The Ascension of Wildlife Rabies 8 January 2010 1:21 UTC www.fas.org [Source type: Academic]

^ In some areas, these wild animals infect domestic cats, dogs, and livestock.
  • Animal Bites and Rabies, Robert Wood Johnson University Hospital, New Brunswick, NJ, 08903 8 January 2010 1:21 UTC www.rwjuh.edu [Source type: FILTERED WITH BAYES]

.Recent reports suggest that wild rabid dogs are roaming the streets.^ In recent years, 85 - 90% of reported animal rabies cases involved wild animals.
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: FILTERED WITH BAYES]

^ Other kennel owners have suggested that the so-called rabid dog can be suffering from poor treatment, hunger, thirst, fear.
  • Vaccination Liberation Information 8 January 2010 1:21 UTC www.vaclib.org [Source type: FILTERED WITH BAYES]

^ January 16, 2008 10:43 am Link The suggestion to shoot wild dogs is as useless as it is inhumane.
  • A Coffin for Rabies - Opinionator Blog - NYTimes.com 8 January 2010 1:21 UTC judson.blogs.nytimes.com [Source type: FILTERED WITH BAYES]

.Because much cheaper pre-vaccination is not commonly administered in places like Thailand, the expense for lack of preparation with far more costly post-exposure prophylaxis can hit families hard.^ Post exposure prophylaxis .
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ Pre-exposure prophylaxis .

^ Post-exposure prophylaxis .

[50]
Rabies was once rare in the United States outside the Southern states[citation needed], but as of 2006, raccoons in the mid-Atlantic and northeast United States had been suffering from a rabies epidemic since the 1970s, which was moving westwards into Ohio.[51] In the midwestern United States, skunks are the primary carriers of rabies, comprising 134 of the 237 documented non-human cases in 1996.

History

Etymology

The term is derived from the Latin rabies, "madness".[52] This, in turn, may be related to the Sanskrit rabhas, "to do violence". The Greeks derived the word "lyssa", from "lud" or "violent"; this root is used in the name of the genus of rabies lyssavirus.[53]

Impact

Because of its potentially violent nature, rabies has been known since c.2000 B.C.[54] The first written record of rabies is in the Codex of Eshnunna (ca. .1930 BC), which dictates that the owner of a dog showing symptoms of rabies should take preventive measure against bites.^ How can animal bites and rabies be prevented?
  • Animal Bites and Rabies, Robert Wood Johnson University Hospital, New Brunswick, NJ, 08903 8 January 2010 1:21 UTC www.rwjuh.edu [Source type: FILTERED WITH BAYES]

^ It is this stage that is often known as furious rabies due to the tendency of the affected dog to be hyperreactive to external stimuli and bite at anything near.

^ It should be noted that approximately half of untreated individuals bitten by rabid dogs are going to develop rabies.
  • Rabies Virus, Symptoms, Vaccine, Treatment 8 January 2010 1:21 UTC www.surviveoutdoors.com [Source type: FILTERED WITH BAYES]

If another person was bitten by a rabid dog and later died, the owner was fined heavily.[55]
.Rabies was considered a scourge for its prevalence in the 19th century.^ Skunk rabies reports were also frequent throughout the western state s by the 19th century, and they were replete with cowboy tales of "phobey cats" (5).
  • The Ascension of Wildlife Rabies 8 January 2010 1:21 UTC www.fas.org [Source type: Academic]

Fear of rabies related to methods of transmissions was almost irrational;[53] however, this gave Louis Pasteur ample opportunity to test post-exposure treatments from 1885.[56]

Society and culture

In Thailand, rabies remains a neglected disease with authorities continuing to rely on human death statistics while ignoring the financial burden resulting from an enormous increase in post-exposure prophylaxis.[50] Past attempts to conduct a mass dog vaccination and sterilization program have been limited to Bangkok city and have not been successful. .In Thailand, 20 rabies deaths were reported in 2003, compared to 200 a decade before as stepped up post exposure prophylaxis (PEP) immunoglobulin have reduced deaths.^ Post exposure prophylaxis .
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ Post-exposure rabies prophylaxis should begin as soon after exposure as possible.
  • Bats and Rabies 8 January 2010 1:21 UTC www.batcon.org [Source type: FILTERED WITH BAYES]

^ This is called rabies post-exposure treatment.
  • NJDHSS, Communicable Disease Service: Rabies 8 January 2010 1:21 UTC www.state.nj.us [Source type: FILTERED WITH BAYES]

.However, the financial burden of rabies has skyrocketed as 400,000 people received PEP, versus 90,000 in 1991. (PEP is more than 10 times more expensive to administer than pre-exposure (PREP) for those who haven't had PREP, and the cost is more than half the per capita annual income of the average citizen).^ However, this interval can vary from 10 days to more than a year.
  • Rabies: Infections of the Brain and Spinal Cord: Merck Manual Home Edition 8 January 2010 1:21 UTC www.merck.com [Source type: FILTERED WITH BAYES]

^ The cost of rabies pre-exposure vaccination makes it prohibitively expensive to administer to large numbers of people in rabies endemic areas.

^ People that had contact with the horse have received rabies post-exposure treatment.
  • : rabies : Equid Blog 8 January 2010 1:21 UTC www.equidblog.com [Source type: FILTERED WITH BAYES]

.The percentage of rabies infectivity of samples sent to diagnostic laboratories all over the country remains high, within the range of 30–40%.^ The recipients developed clinical rabies within 30 days, resulting in 100% mortality.

^ Within a few hours, diagnostic laboratories can determine whether an animal is rabid and provide this information to medical professionals.
  • Animal Bites and Rabies, Robert Wood Johnson University Hospital, New Brunswick, NJ, 08903 8 January 2010 1:21 UTC www.rwjuh.edu [Source type: FILTERED WITH BAYES]

^ Pre-exposure immunization is strongly recommended for all people in high-risk groups, such as veterinary staff, animal control officers, rabies and diagnostic laboratory workers, and travelers working in countries in which canine rabies is endemic or epizootic.
  • Rabies: Introduction - The Merck Veterinary Manual 8 January 2010 1:21 UTC www.merckvetmanual.com [Source type: FILTERED WITH BAYES]

[50] .In China, this is the case as well as governments pour resources into PEP rather than vaccination programs.^ In addition, several individuals in whom the vaccine was administered into the gluteal region (rather than the deltoid as is recommended) subsequently developed rabies.
  • Rabies Prevention 8 January 2010 1:21 UTC www.nwcphp.org [Source type: FILTERED WITH BAYES]

^ Vaccination campaigns may be expensive, and a cost-benefit analysis can lead those responsible to opt for policies of containment rather than elimination of the disease.

^ The United States Department of Agriculture (USDA) has licensed the vaccine for use by state and federal officials in government sponsored rabies control programs.
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: General]

[57]

In other animals

.Rabies is infectious to mammals.^ Rabies and animals Rabies is infectious to mammals.

^ Rabies: An infectious disease that can affect any mammal including humans and is transmitted through the saliva of an infected animal.
  • Rabies Symptoms, Diagnosis, Treatments and Causes - WrongDiagnosis.com 8 January 2010 1:21 UTC www.wrongdiagnosis.com [Source type: Academic]

.Three stages of rabies are recognized in dogs and other animals.^ Rabies is an infectious viral disease that invades the central nervous system of humans and other furbearing, warm-blooded animals.

^ Dogs, cats and cattle are potential vectors - in the US immunization of pets has lessened the risk of pets acquiring rabies from wild animals.

^ Scientific data indicate that vaccinating dogs against rabies every three years, as most states require, is unnecessary.

.The first stage is a one- to three-day period characterized by behavioral changes and is known as the prodromal stage.^ The first stage is a one to three day period characterized by behavioral changes and is known as the prodromal stage.

^ The second stage is the excitative stage, which lasts three to four days.

^ After ten (10) days, the animal may be released from the quarantine, if there is no observed behavior change, illness, or other clinical signs of rabies.
  • Rabies Control Ordinance 8 January 2010 1:21 UTC www.co.olmsted.mn.us [Source type: FILTERED WITH BAYES]

.The second stage is the excitative stage, which lasts three to four days.^ The second stage is the excitative stage, which lasts three to four days.

^ The first stage is a one to three day period characterized by behavioral changes and is known as the prodromal stage.

.It is this stage that is often known as furious rabies for the tendency of the affected dog to be hyperreactive to external stimuli and bite at anything near.^ It is this stage that is often known as furious rabies due to the tendency of the affected dog to be hyperreactive to external stimuli and bite at anything near.

^ Paralytic rabies is also known as dumb rabies or apathetic rabies because the patient is relatively quiet compared with a person with the furious form.

^ Depending on which part of the brain the virus ravages, the disease can take different forms, but the most common is known as furious rabies.
  • A Coffin for Rabies - Opinionator Blog - NYTimes.com 8 January 2010 1:21 UTC judson.blogs.nytimes.com [Source type: FILTERED WITH BAYES]

The third stage is the paralytic stage and is caused by damage to motor neurons. .Incoordination is seen owing to rear limb paralysis and drooling and difficulty swallowing is caused by paralysis of facial and throat muscles.^ Incoordination is seen due to rear limb paralysis and drooling and difficulty swallowing is caused by paralysis of facial and throat muscles.

^ Symptoms can include a high fever, temporary or permanent blindness, behavior change, depression, excessive salivation, difficulty swallowing (caused by paralysis of the facial muscles and the salivary glands, where the virus is concentrated), heart arrhythmia, abnormal aggressive or excitable behavior, colic, depression, and seizures.
  • Broward County - Animal Care and Regulation 8 January 2010 1:21 UTC www.broward.org [Source type: FILTERED WITH BAYES]

^ Victims complain of headaches, inability to sleep, irritability, muscle spasms of the throat and difficulty swallowing.

Death is usually caused by respiratory arrest.[58]
.As recently as 2004, a new symptom of rabies has been observed in foxes.^ Recently new symptoms of rabies of wild animals have been observed, namely in foxes.

^ More recently, many of the successful control measures undertaken to combat fox rabies in Europe have employed oral vaccines.
  • Rabies in North America and Europe 8 January 2010 1:21 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Probably at the beginning of the prodromal stage, foxes, who are extremely cautious by nature, seem to lose this instinct.^ Probably at the beginning of the prodromal stage foxes, who are extremely cautious by nature, absolutely lose wild instincts.

.Foxes will come into settlements, approach people, and generally behave as if tame.^ Animals come into settlements, reach for people, and behave as if tame.

.How long such "euphoria" lasts is not known.^ How long such "euphoria" lasts is not known.

.But even in this state such animals are extremely dangerous, as their saliva and excretions still contain the virus and they remain very unpredictable.^ But even in such status the animal is extremely dangerous, as its saliva and excretions still contain the virus.

^ The virus is transmitted to humans by a bite, or when saliva from an infected animal comes into contact with broken skin or mucous membranes (eyes, nose, or mouth).
  • NaTHNaC | Rabies Health Information Sheet, Travellers 8 January 2010 1:21 UTC www.nathnac.org [Source type: FILTERED WITH BAYES]

^ Rabid animals become aggressive and harbor the virus in saliva and thus transmission is frequently via animal bites.

[59]

See also

References

  1. ^ a b c d e Drew WL (2004). "Chapter 41: Rabies". in Ryan KJ, Ray CG (editors). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 597–600. ISBN 0-8385-8529-9. 
  2. ^ a b c d Cotran RS, Kumar V, Fausto N, et al. (2005). Robbins and Cotran Pathologic Basis of Disease (7th ed.). St. Louis: Elsevier/Saunders. pp. 1375. ISBN 0-7216-0187-1. 
  3. ^ "New Rabies Vaccine Shows Promise for Prevention, Treatment". Voice of America. 2009-07-08. http://www.voanews.com/english/archive/2009-07/2009-07-08-voa62.cfm?CFID=316132061&CFTOKEN=85235355&jsessionid=de30df03af76b528b1e8832253c244b5b155. Retrieved 2010-01-30. 
  4. ^ a b "Rabies Epidemiology". CDC. 2009-11-13. http://www.cdc.gov/rabies/epidemiology.html. Retrieved 2010-01-30. 
  5. ^ Schoenstadt A (2008-07-21). "Rabies Symptoms". eMedTV. http://rabies.emedtv.com/rabies/rabies-symptoms.html. Retrieved 2010-01-30. 
  6. ^ a b Jordan Lite (2008-10-08). "Medical Mystery: Only One Person Has Survived Rabies without Vaccine--But How?". Scientific American. pp. 4. http://www.sciam.com/article.cfm?id=jeanna-giese-rabies-survivor&sc=WR_20081014. Retrieved 2010-01-30. 
  7. ^ Finke S, Conzelmann KK (August 2005). "Replication strategies of rabies virus". Virus Res. 111 (2): 120–31. doi:10.1016/j.virusres.2005.04.004. PMID 15885837. 
  8. ^ Dacheux L, Reynes J-M, Buchy P, et al. (2008). "A reliable diagnosis of human rabies based on analysis of skin biopsy specimens". Clin Infect Dis 47 (11): 1410–17. doi:10.1086/592969. PMID 18937576. 
  9. ^ a b c Ly S, Buchy P, Heng NY, et al. (2009). "Rabies situation in Cambodia". PLoS Negl Trop Dis 3 (9): e511. doi:10.1371/journal.pntd.0000511. PMID 19907631. PMC 2731168. http://dx.plos.org/10.1371/journal.pntd.0000511. 
  10. ^ "Rabies: Differential Diagnoses & Workup". eMedicine Infectious Diseases. 2008-10-03. http://emedicine.medscape.com/article/220967-diagnosis. Retrieved 2010-01-30. 
  11. ^ Taylor DH, Straw BE, Zimmerman JL, D'Allaire S (2006). Diseases of swine. Oxford: Blackwell publishing. pp. 463–5. ISBN 0-8138-1703-X. http://books.google.com/books?id=3o9l77HdZkgC&lpg=PA455&vq=nipah&dq=diseases%20of%20swine&pg=PA463#v=snippet&q=nipah&f=false. Retrieved 2010-01-30. 
  12. ^ Minagar, Alireza; J. Steven Alexander (2005). Inflammatory Disorders Of The Nervous System: Pathogenesis, Immunology, and Clinical Management. Humana Press. ISBN 1588294242. 
  13. ^ Dürr S, Naïssengar S, Mindekem R, et al. (2008). "Rabies diagnosis for developing countries". PLoS Neglected Tropical Diseases 2 (3): e206. doi:10.1371/journal.pntd.0000206. PMID 18365035. PMC 2268742. http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0000206. 
  14. ^ Geison GL (1978). "Pastuer's work on rabies: Reexamining the ethical issues diagnosis for developing countries". Hastings Center Report (April): 26-. http://www.jstor.org/pss/3560403. 
  15. ^ Srivastava AK, Sardana V, Prasad K, Behari M (March 2004). "Diagnostic dilemma in flaccid paralysis following anti-rabies vaccine". Neurol India 52 (1): 132–3. PMID 15069272. http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2004;volume=52;issue=1;spage=132;epage=133;aulast=Srivastava. 
  16. ^ Reece JF, Chawla SK. (2006). "Control of rabies in Jaipur, India, by the sterilisation and vaccination of neighbourhood dogs.". Vet Rec 159 (12): 379–83. PMID 16980523. 
  17. ^ "Compendium of Animal Rabies Prevention and Control". National Association of State Public Health Veterinarians. 2007-12-31. http://www.nasphv.org/Documents/RabiesCompendium.pdf. Retrieved 2010-01-03. 
  18. ^ "World Rabies Day 2009". Alliance for Rabies Control. http://www.worldrabiesday.org/. Retrieved 2010-01-30. 
  19. ^ Rabies & Australian bat lyssavirus information sheet http://www.health.vic.gov.au/ideas/bluebook/rabies_info
  20. ^ a b "Rabies Post-Exposure Prophylaxis". CDC. 2009-12-23. http://www.cdc.gov/rabies/exposure/postexposure.html. Retrieved 2010-01-30. 
  21. ^ de Serres G, Skowronski DM, Mimault P, et al. (2009). "Bats in the bedroom, bats in the belfry: Reanalysis of the rationale for rabies postexposure prophylaxis". Clin Infect Dis 48 (11): 1493–1499. doi:10.1086/598998. 
  22. ^ Despond O, Tucci M, Decaluwe H, Grégoire MC, S Teitelbaum J, Turgeon N (March 2002). "Rabies in a nine-year-old child: The myth of the bite". Can J Infect Dis 13 (2): 121–5. PMID 18159381. 
  23. ^ Roy A, Phares TW, Koprowski H, Hooper DC (2007). "Failure to open the blood-brain barrier and deliver immune effectors to central nervous system tissues leads to the lethal outcome of silver-haired bat rabies virus infection". J. Virol. 81 (3): 1110–8. doi:10.1128/JVI.01964-06. PMID 17108029. 
  24. ^ Roy A, Hooper DC (2007). "Lethal silver-haired bat rabies virus infection can be prevented by opening the blood-brain barrier". J. Virol. 81 (15): 7993–8. doi:10.1128/JVI.00710-07. PMID 17507463. 
  25. ^ Willoughby RE, Tieves KS, Hoffman GM, Ghanayem NS, Amlie-Lefond CM, Schwabe MJ, Chusid MJ, Rupprecht CE (2005). "Survival after treatment of rabies with induction of coma". N. Engl. J. Med. 352 (24): 2508–14. doi:10.1056/NEJMoa050382. PMID 15958806. 
  26. ^ Hu WT, Willoughby RE, Dhonau H, Mack KJ (August 2007). "Long-term follow-up after treatment of rabies by induction of coma". N. Engl. J. Med. 357 (9): 945–6. doi:10.1056/NEJMc062479. PMID 17761604. 
  27. ^ Willoughby RE (2009). "Are we getting closer to the treatment of rabies?: medical benchmarks". MedScape. pp. 563–570. http://www.medscape.com/viewarticle/712839_7. 
  28. ^ Lockhart BP, Tordo N, Tsiang H (1992). "Inhibition of rabies virus transcription in rat cortical neurons with the dissociative anesthetic ketamine". Antimicrob Agents Chemother 36 (8): 1750–5. PMID 192041. 
  29. ^ "Nuevos síntomas dan aliento sobre recuperación de niño caucano contagiado por rabia" (in Spanish). El Tiempo Nación Cali. 2008-04-10. http://www.eltiempo.com/nacion/cali/2008-04-08/ARTICULO-WEB-NOTA_INTERIOR-4081557.html. Retrieved 2010-01-30. 
  30. ^ a b "Rabies". World Health Organization. December 2008. http://www.who.int/mediacentre/factsheets/fs099/en/. Retrieved 28 December 2009. 
  31. ^ Centers for Disease Control and Prevention (CDC) (December 2004). "Recovery of a patient from clinical rabies—Wisconsin, 2004". MMWR. Morbidity and mortality weekly report 53 (50): 1171–3. PMID 15614231. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5350a1.htm. 
  32. ^ Jordan Lite (2008-10-08). "Medical Mystery: Only One Person Has Survived Rabies without Vaccine—But How?". Scientific American. pp. 4. http://www.sciam.com/article.cfm?id=jeanna-giese-rabies-survivor&sc=WR_20081014. Retrieved 2008-10-16. 
  33. ^ "Teenager survives case of Rabies in Recife, Brasil(Portuguese)". 2009-09-18. pp. 1. http://g1.globo.com/Noticias/Brasil/0,,MUL1309605-5598,00.html. 
  34. ^ "Rabies Registry". http://www.mcw.edu/rabies. Retrieved 29 December 2009. 
  35. ^ Gough,Patricia M.;Jorgenson,Richard D. (July 1976). "Rabies Antibodies in Sera of Wild Birds". Journal of Wildlife Diseases Vol. 12. http://www.jwildlifedis.org/cgi/reprint/12/3/392.pdf. Retrieved 19 mar 2009. 
  36. ^ Wong, Derek. "Rabies". Wong's Virology. http://virology-online.com/viruses/Rhabdoviruses.htm. Retrieved 19 mar 2009. 
  37. ^ Campbell,James B.;Charlton,K.M. (1988). Developments in Veterinary Virology: Rabies. Kluwer Academic Publishers: Springer. p. 48. ISBN 0898383900, 9780898383904. 
  38. ^ Taylor PJ (December 1993). "A systematic and population genetic approach to the rabies problem in the yellow mongoose (Cynictis penicillata)". The Onderstepoort Journal of Veterinary Research 60 (4): 379–87. PMID 7777324. 
  39. ^ "Types of Exposure - CDC Rabies". 1600 Clifton Rd, Atlanta, GA 30333, USA: Centers for Disease Control and Prevention. 2007-09-03. http://www.cdc.gov/RABIES/exposure/types.html. Retrieved 2008-02-12. 
  40. ^ The Merck Manual, Eleventh Edition (1983), p. 183
  41. ^ The Merck manual of Medical Information. Second Home Edition, (2003), p. 484.
  42. ^ Turton, Jenny (2000). "Rabies: a killer disease". National Department of Agriculture. http://www.nda.agric.za/docs/rabies/rabies.htm. 
  43. ^ Srinivasan A, Burton EC, Kuehnert MJ, et al.. Transmission of rabies virus from an organ donor to four transplant recipients. N Engl J Med (abstract) (pdf) (accessed 12 January 2009)
  44. ^ Alan C. Jackson, William H. Wunner (2002) RabiesAcademic Press, p. 290, ISBN 0123790778
  45. ^ Joanne Lynn, M.D. (October 1997) Transverse Myelitis: Symptoms, Causes and Diagnosis The Transverse Myelitis Association
  46. ^ Larry Ernest Davis, Molly K. King, Jessica L. Schultz (2005) Fundamentals of neurologic disease Demos Medical Publishing, LLC, p.73 ISBN 1888799846
  47. ^ [1]
  48. ^ The Toronto Star “China cracks down on rabid dog menace”
  49. ^ Dugan, Emily (2008-04-30). "Dead as a dodo? Why scientists fear for the future of the Asian vulture". United Kingdom: The Independent. http://www.independent.co.uk/news/science/dead-as-a-dodo-why-scientists-fear-for-the-future-of-of-the-asian-vulture-818059.html. Retrieved 2008-10-11. "India now has the highest rate of human rabies in the world." 
  50. ^ a b c Biomed.com: Transmission dynamics of rabies virus in Thailand: Implications for disease control
  51. ^ National Association of State Public Health Veterinarians, Inc. (NASPHV) (2006). "Compendium of animal rabies prevention and control, 2006". MMWR Recomm Rep 55 (RR-5): 1–8. PMID 16636647. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5505a1.htm. 
  52. ^ Simpson DP (1979). Cassell's Latin Dictionary (5 ed.). London: Cassell Ltd.. pp. 883. ISBN 0-304-52257-0. 
  53. ^ a b Rotivel, Yolande. "Introduction (to excerpt of CDC article)". www.fas.org. Federation of American Scientists. http://www.fas.org/ahead/docs/rabies.htm. Retrieved 2009-04-25. 
  54. ^ Adamson PB (1977). "The spread of rabies into Europe and the probable origin of this disease in antiquity". Journal of the Royal Asiatic Society of Great Britain & Ireland. Royal Asiatic Society of Great Britain and Ireland 2: 140–4. PMID 11632333. http://www.jstor.org/sici?origin=sfx:sfx&sici=0035-869X%281977%292%3C140:TSORIE%3E2.0.CO;2-S. 
  55. ^ Dunlop, Robert H.; Williams, David J. (1996). Veterinary Medicine: An Illustrated History. Mosby. ISBN 0-8016-3209-9. 
  56. ^ "The Life and Times of Louis Pasteur"
  57. ^ Science Daily:China Sees Spike In Rabies Cases
  58. ^ Ettinger, Stephen J.; Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine (4th ed.). W.B. Saunders Company. ISBN 0-7216-6795-3. 
  59. ^ Dmitry Iljin "Cautiously foxes. About epidemic of rabies among foxes on the average of river Volga." http://dimas.sk6.ru/blog/our-pages/

External links


Simple English

Rabies is a viral zoonotic disease that causes acute encephalitis.

Usually, people (and animals) die from it (it is fatal). There is no cure for it. People who are treated soon after becoming infected have a chance to survive.

The disease is transmitted through the saliva and the blood. The usual form of getting is a bite of a rabid mammal. Pets, like dogs need to be vaccinated against it, in most countries.

Contents

Treatment

There is no cure for Rabies. There is a vaccine against it. The vaccine was first developed by Louis Pasteur and Emile Roux in 1885. This vaccine used a live virus grown in rabbits, and weakened (through drying it). The first person to be vaccinated was Joseph Meister (a 9 year old boy who had been bitten by a dog). Vaccines similar to this are still used today, but other vaccines (growing the virus using cell cultures) are more frequent.

There is also a form of treatment that can be done once a person has been bitten. It needs to be done within 6 days of being bitten. It starts with washing the wound. This is done to reduce the number of virus particles that enter the body. Often patients are given one dose of immounoglobulin and a certain number of vaccines, over a determined period of time, usually a month.

Other websites

Sources

Other websites

Simple English Wiktionary has the word meaning for:


Citable sentences

Up to date as of December 20, 2010

Here are sentences from other pages on Rabies, which are similar to those in the above article.








Got something to say? Make a comment.
Your name
Your email address
Message