RABIES-1

RABIES
CONTENT
INTRODUCTION
DEFINITION
PATHOPHYSIOLOGY
TRANSMISSION
PATHOGENESIS
SYMPTOMS
DIAGNOSIS
PREVENTION
TREATMENT
INTRODUCTION
The Rabies disease infects domestic and
wild animals, and is spread to people
through close contact with infected saliva
via bites or scratches.
Dogs are the source of 99% of human
rabies deaths
Once symptoms of the disease develop,
rabies is nearly always fatal.
DEFINITION
Rabies is a viral disease that
causes acute encephalitis
(inflammation of the brain)
in warm- blooded animals.
Rabies is a zoonotic disease
(a disease that is transmitted
to humans from animals)
that is caused by a virus.
DEFINITION
The organism causing rabies is called rabies virus (RV).
Rabies virus is a rod- or bullet-shaped, single-stranded,
negative-sense, unsegmented, enveloped RNA virus.
The virus genome encodes five proteins.
PATHOPHYSIOLOGY
Rabies virus causes acute infection of the CNS.
Five general stages are recognized in humans: incubation,
prodrome, acute neurologic period, coma, and death.
acute
incubation prodrome neurologic Coma Death
period
The incubation period is exceptionally variable, ranging from

fewer than 10 days to longer than 2 years,
but is usually 1–3 months.
The closer the bite to the brain the shorter the incubation.
The rabies Travels 1 cm every day
TRANSMISSION
Various carnivorous animal
species have been identified as
the source of rabies virus.
In Africa and Asia, domestic
dogs are the main reservoirs of
infection from rabies virus
In the United States, racoons,
foxes, skunks, coyotes,
possums and bats rather than
dogs spread the infection.
Transmission of the rabies virus starts when a human or animal is bit
by an animal harboring the virus in its salivary glands.
In cats and dogs the virus may be present in the saliva for 3-4
before the clinical onset and during the course of illness till death.
TRANSMISSION
Rabies virus is transmitted through direct contact with saliva or
nervous system tissue from an infected animal.
Less common routes of transmission of rabies virus include:

1. Contamination of mucous membranes (i.e., eyes, nose, mouth)
2. Aerosol transmission
3. Corneal and other organ transplantation from infected donor
Other types of contact, such as petting a rabid animal or contact

with the blood, urine or feces of a rabid animal, are not associated
with risk for infection and are not considered to be exposures of
concern for rabies.
TRANSMISSION
Types of exposures
PATHOGENESIS
OF
RABIES
SYMPTOMS IN ANIMALS
SYMPTOMS IN HUMANS
The first symptoms of rabies may be
very similar to those of the flu and
may last for days.
Later signs and symptoms may
include: Agitation, Anxiety,
Confusion, Hyperactivity, Excessive
salivation, Fear brought on by
attempts to drink fluids because of
difficulty swallowing water,
Hallucinations, Insomnia, and Partial
paralysis.
As the disease spreads through the
brain, people become more
confused and agitated. Eventually,
coma and death result.
SYMPTOMS IN HUMANS
Spasms of the muscles in the throat
and larynx occur because the
disease affects the area in the brain
that control swallowing, speaking,
and breathing.
The spasms can be excruciatingly
painful. A slight breeze or an attempt
to drink water can trigger the spasms.
Thus, people with rabies cannot drink.
For this reason, the disease is
sometimes called hydrophobia (fear
of water)
The cause of death can be blockage
of airways, seizures, exhaustion, or
widespread paralysis.
LABORATORY DIAGNOSIS
In Animals: In Human:
1. The current way to diagnose 1. Diagnosis depend mainly on the
rabies in animals is to submit the animal. The rabid animal should
brain for microscopic be isolated and observed for 2
examination Inclusion bodies weeks and if not caught the
called Negri bodies are 100% bitten person considered a
diagnostic for rabies infection, potential case.
but found only in 20% of cases. 2. Other viral causes of
2. Performing PCR or viral culture encephalitis include
on brain samples taken after herpesviruses, enteroviruses and
death. The diagnosis can also arboviruses.
be reliably made from skin 3. The most important viruses to
samples taken before death. rule out are herpes simplex virus
N.B.: It is possible to make the type 1, varicella-zoster virus, and
diagnosis on saliva, urine and CFS enteroviruses.
samples, but this is not as sensitive.
LABORATORY DIAGNOSIS
Negri bodies
PRE-EXPOSURE PROPHYLAXIS
Vaccinate your pets.
Keep your pets confined.
Protect small pets from predators.
Report stray animals to local
authorities.
Don't approach wild animals.
Keep bats out of your home.
Consider the rabies vaccine if
you're traveling or often around
animals that may have rabies.
POST-EXPOSURE PROPHYLAXIS
Provided to subjects after rabies exposure.
Consists of :
1. Cleansing with water and soup and
chemical Treatment with alcohol.
2. Anti-Rabies Serum or HRIG
(human rabies immune globulin):
 Administration of anti-rabies serum
around the wound.
 Intramuscular injection.
Antibiotics & anti-tetanus measure.
Observe the animal for 10 days.
TREATMENT
POST-EXPOSURE TREATMENT
A. LOCAL WOUND TREATMENT
Wash with soap/detergent and water preferably for 10 mins.
Apply alcohol, povidone iodine or any antiseptic
Anti-Tetanus
Ø Avoid suturing wounds
Ø Don't apply ointment, cream or wound dressing
B. ANTIMICROBIAL
Amoxicillin
Cloxacillin
Cefuroxime
*For those instances where there's no obvious signs of infection
(Amoxicillin as prophylaxis)
TREATMENT
POST-EXPOSURE TREATMENT
C. Anti-Rabies Serum or HRIG (human rabies immune globulin):
 Administration of anti-rabies serum, around the wound.
 Intramuscular injection.
D. Vaccination
There is 2 types of vaccine
a) Human diploid cell strain (HDCS) vaccine: chemically
inactivated virus given as 5 intramuscular injections
at 0, 3, 7, 14, and 28 days after the bite.
b) Duck embryo vaccine (DEV): chemically inactivated virus
given as 14 doses, however, it may cause hypersensitivity.
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RABIES

The incubation period is exceptionally variable, ranging from

Less common routes of transmission of rabies virus include:

Other types of contact, such as petting a rabid animal or contact

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