Rabies is a viral zoonotic neuroinvasive disease that causes acute encephalitis in mammals. In humans, rabies is almost invariably fatal after neurological symptoms have developed, but prompt post-exposure vaccination may prevent the virus from progressing.
Synonim : Lyssa, Tollwut, Rage, Hydrophobia
Etiology
Infection disease because of Rhabdovirus in form of like bullet have diameter 75 nm and long 180 nm. At virus surface there are its spikes. Inclusive of structured RNA virus 67% protein 26% fat, 3% carbohydrate and very sensitive to heat. Panchromatic virus Of UV and shroud of virus fat able to be bleached by detergen. At virus body there are antigen glicoprotein and antigen nucleoprotein.
Differential diagnosis
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. 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. A specific diagnosis may be made by a variety of diagnostic techniques, including polymerase chain reaction (PCR) testing of cerebrospinal fluid, viral culture, and serology. 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.
Diagnosis
Test the laboratory with the painting of antibody fluorescent whit high sensitivity and spesifity almost 100% but expensive, perception microscopicly to negries bodies but sensitivity only 30%, and tes netralize or tes flourescent quickly. Biologic test Virus can inoculated by subcutan and intramusculer to experiment animal or neuroblastoma but need about 4-21 day.
Test the laboratory with the painting of antibody fluorescent whit high sensitivity and spesifity almost 100% but expensive, perception microscopicly to negries bodies but sensitivity only 30%, and tes netralize or tes flourescent quickly. Biologic test Virus can inoculated by subcutan and intramusculer to experiment animal or neuroblastoma but need about 4-21 day.
Transmission and symptoms
Any mammal may become infected with the rabies virus and develop symptoms, including humans. Most animals can be infected by the virus and can transmit the disease to humans. Infected bats, monkeys, raccoons, foxes, skunks, cattle, wolves, dogs or cats provide the greatest risk to humans. Rabies may also spread through exposure to infected domestic farm animals, groundhogs, weasels and other wild carnivores. Rodents (mice, squirrels etc) are seldom infected.
Virus disseminate in system of nerve and gland spit and also other; dissimilar organ in body of like husk, cornea and adrenal gland.virus also can be met in milk and limfe but only a few. incoming virus especially pass the bite hurt, exhalation or eaten. Virus can enter cornea because brought by wind.Transmission between humans is extremely rare, although it can happen through transplant surgery (see below for recent cases), even more rarely, through bites, kisses or sexual relations.
After a typical human infection by bite, the virus enters the peripheral nervous system. It then travels along the nerves towards the central nervous system. During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. Once the virus reaches the brain, it rapidly causes encephalitis. This is called the "prodromal" phase. At this time, treatment is useless. Then symptoms appear. Rabies may also inflame the spinal cord producing myelitis.
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. 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", where the victim 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. The disease itself was also once commonly known as hydrophobia, from this characteristic symptom. The patient "foams at the mouth" because they cannot swallow their own saliva for days and it gathers in the mouth until it overflows. 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 the recent exception of Jeanna Giese (see below). It is neurotrophic in nature.
Any mammal may become infected with the rabies virus and develop symptoms, including humans. Most animals can be infected by the virus and can transmit the disease to humans. Infected bats, monkeys, raccoons, foxes, skunks, cattle, wolves, dogs or cats provide the greatest risk to humans. Rabies may also spread through exposure to infected domestic farm animals, groundhogs, weasels and other wild carnivores. Rodents (mice, squirrels etc) are seldom infected.
Virus disseminate in system of nerve and gland spit and also other; dissimilar organ in body of like husk, cornea and adrenal gland.virus also can be met in milk and limfe but only a few. incoming virus especially pass the bite hurt, exhalation or eaten. Virus can enter cornea because brought by wind.Transmission between humans is extremely rare, although it can happen through transplant surgery (see below for recent cases), even more rarely, through bites, kisses or sexual relations.
After a typical human infection by bite, the virus enters the peripheral nervous system. It then travels along the nerves towards the central nervous system. During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. Once the virus reaches the brain, it rapidly causes encephalitis. This is called the "prodromal" phase. At this time, treatment is useless. Then symptoms appear. Rabies may also inflame the spinal cord producing myelitis.
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. 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", where the victim 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. The disease itself was also once commonly known as hydrophobia, from this characteristic symptom. The patient "foams at the mouth" because they cannot swallow their own saliva for days and it gathers in the mouth until it overflows. 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 the recent exception of Jeanna Giese (see below). It is neurotrophic in nature.
Treatment
Post-exposure prophylaxis
Treatment after exposure, known as post-exposure prophylaxis or "P.E.P.", is highly successful in preventing the disease if administered promptly, within six days after infection. Thoroughly washing the wound as soon as possible with soap and water for approximately 5-10 minutes is very effective at reducing the number of viral particles and to be dissolve capsid virus and kill virus. "If available, a virucidal antiseptic such as povidone-iodine, iodine tincture, aqueous iodine solution or alcohol (ethanol) 70% should be applied after washing." Exposed mucous membranes such as eyes, nose or mouth should be flushed well with water. In the United States, patients receive one dose of immunoglobulin and five doses of rabies vaccine over a twenty-eight day period. One-half the dose of immunoglobulin is injected in the region of the bite, if possible, with the remainder injected intramuscularly away from the bite. This is much less painful compared with administering immunoglobulin through the abdominal wall with a large needle, which is how it was done in the past. The first dose of rabies vaccine is given as soon as possible after exposure, with additional doses on days three, seven, fourteen, and twenty-eight after the first. Patients that have previously received pre-exposure vaccination do not receive the immunoglobulin, only the post-exposure vaccinations. P.E.P. is effective in treating rabies because the virus must travel from the site of infection through the peripheral nervous system (nerves in the body) before infecting the central nervous system (brain and spinal cord) and glands to cause lethal damage. This travel along the nerves is usually slow enough that vaccine and immunoglobulin can be administered to protect the brain and glands from infection. The amount of time this travel requires is dependent on how far the infected area is from the brain: if the victim is bitten in the face, for example, the time between initial infection and infection of the brain is very short and P.E.P. may not be successful.
Pre-exposure prophylaxis
Currently pre-exposure immunization has been used on domesticated and normal non-human populations. In many jurisdictions, domestic dogs, cats, and ferrets are required to be vaccinated. A pre-exposure vaccination is also available for humans, most commonly given to veterinarians and those traveling to regions where the disease is common, such as India. Most tourists do not need such a vaccination, just those doing substantial non-urban activities. However, should a vaccinated human be bitten by a carrier, failure to receive subsequent post-exposure treatment could be fatal, although post-exposure treatment for a vaccinated human is far less extensive than that which would normally be required by one with no pre-exposure vaccination.
In 1984 researchers at the Wistar Institute developed a recombinant vaccine called V-RG by inserting the glycoprotein gene from rabies into a vaccinia virus. The V-RG vaccine has since been commercialised by Merial under the trademark Raboral. It is harmless to humans and has been shown to be safe for various species of animals that might accidentally encounter it in the wild, including birds (gulls, hawks, and owls).
V-RG has been successfully used in the field in Belgium, France, and the United States to prevent outbreaks of rabies in wildlife. The virus is stable under relatively high temperatures and can be delivered orally, making mass vaccination of wildlife possible by putting it in tasty baits. The plan for immunization of normal populations involves dropping bait containing food wrapped around a small dose of the live virus. The bait would be dropped by helicopter concentrating on areas that have not been infected yet. Just such a strategy of oral immunization of foxes in Europe has already achieved substantial reductions in the incidence of human rabies.
Before contact with animal, material suspect rabies or visit upon the endemic area rabies must conducted vaccine of Purified Vero Anti Rabies Vaccine or Human Diploid Cell Vaccine 1 ml 2 times on 0 and to 28 by intramusculer or subcutan. 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.This aspect contributes to the pathogenicity of the virus and artificially increasing BBB permeability promotes viral clearance. Opening the BBB during rabies infection has been suggested as a possible novel approach to treat the disease. People who have pre exposure vaccine but bited by a animal less than 12 month need the vaccine twice dose 0- 28 day.
But if bite happened more than 12 month after vaccine require to be given vaccine booster.
Hence special supply ( gauntlet, special masker clothes and). Operation and observation to wild cat and dog. Law execution about rabies expressly perception routinely and also pathological counselling
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