Infectious Disease Report: Rabies
Infectious Disease Report: Rabies
Infectious Disease Report: Rabies
Report: Rabies
By: Anu Gandhi and Val Riguero
What are Rabies?
Rabies virus causes an acute encephalitis
(inflammation of the brain) in all warm-blooded
hosts.
Rabies is not, in the natural sense, a disease of
humans.
The impact of rabies on public health includes an
estimate of the animal population that is affected
and the steps involved in preventing transmission
of rabies from animals to humans.
Raccoons, skunks, foxes, coyotes, and several
species of insectivorous bats have been identified
as reservoirs for the disease.
Rabies in History
Rabies cases have been reported since
before 2300 BC.
1st century AD a Roman scholar named
Aulus Cornelius Celsus gave the first
accurate description of the disease
1st scientist to test rabies infection
through inoculation of saliva was a
German scientist named Zinke in 1804
Pasteur’s Contribution
1885 he published a method for protecting
dogs against rabies
A dog exposed to rabies was protected by
inoculation with an emulsion prepared from
the dried spinal cord of a diseased rabbit
Pasteur had the chance to test this same
method on humans when Joseph Meister, a
nine-year-old boy who was bitten by a rabid
dog was brought to him in July of 1885
Joseph was injected over several days
with the emulsions prepared from
animal spinal cord material
After 2 weeks, Joseph was given an
injection of virus that had maximal
virulence when tested in a rabbit
Joseph survived as did thousands of
others treated by the same procedure.
Epidemiology
In 2001, 49 states, the District of Colombia, and
Puerto Rico reported 7,437 cases of rabies in
animals to the Center of Disease Prevention and
Control and no cases in humans were reported.
Pennsylvania reported the largest number of rabid
domestic animals (46) for any state, followed by
New York (43)
The number of rabies-related human deaths in the
U.S. has declined from 100 or more each year at
the turn of the century to an average of 1-2 each
year in the 1990’s
Morphology
Order- Mononegavirales
Nonsegmented
Negative stranded RNA
genome
“Bullet” shaped-
Rhabdovirus 180nm x75nm
400 trimeric spikes on
surface of virus
2 major structural
components
– Helical RNP core
– Surrounding envelope
Physiology
Genome encodes 5 proteins:
– Nucleoprotein- encases RNA
– Phosphoprotein- associated with ribonuceoprotein core
– Matrix protein- central protein of rhabdovirus assembly
– Glycoprotein- forms 400 trimeric spikes
– Polymerase- transcribes genomic strand of rabies RNA
Virulence
Saliva
Mucous membranes
Aerosol transmission
Corneal transplantations
Symptoms of Rabies
The first symptoms of rabies may be non-
specific flu- like signs, such as malaise, fever
or headache which may last for days.
There may be discomfort or paresthesia at
the site of exposure (bite) progressing
within days to symptoms of cerebral
dysfunction, anxiety, confusion, and
agitation which eventually progress to
delirium, abnormal behavior, hallucinations,
and insomnia.
Rabies Diagnosis in
animals
The direct fluorescent
antibody test (dFA) is the
test most frequently used to
diagnose rabies. This test
requires brain tissue from
animals suspected of being Positive dFA
rabid.
The dFA test is based on
the fact that infected
animals have rabies virus
proteins (antigen) present
in their tissues.
Negative dFA
Rabies Diagnosis in
humans
Saliva can be tested by virus isolation
or reverse transcription by polymerase
chain reaction (RT-PCR).
Serum and spinal fluid are tested for
antibodies to rabies virus.
Skin biopsy specimens are examined
for rabies antigen in the cutaneous
nerves at the base of hair follicles.
Methods of Cure
Rabies Vaccine: A killed virus vaccine
(Human Diploid Cell Vaccine, HDCV) grown
in human fibroblasts is available for safe use
in humans.
The unusually long incubation period of the
virus permits the effective use of active
immunization with vaccine post-exposure.
If rabies has not been diagnosed and the
victim is not treated with a vaccine and the
clinical disease manifests, it is nearly always
fatal, and treatment is typically supportive.
Related Studies
In the journal Antibiotics and
Chemotherapy, an article was published
which presented the results of an
experimental study of the action of
rifampicin on the process of rabies infection
in albino mice contaminated with 1-10 LD50
of the fixed rabies virus.
Exposure to rifampicin in doses of 250-500
mg/mouse resulted in survival of 66.7-
83.4% of the animals respectively while the
controls did not exceed 16.6-25%.
The infection of target cells by rabies is effected
through membrane receptors; it has been suggested
that nicotonic receptors could be used by the virus.
In a study published in Neuroscience Letters, mouse
dorsal root ganglia cells were treated with various
nicotonic antagonists (mecamailamine, d-
tubocurarin, hexametonium, etc.).
After incubation the cultures were infected with the
rabies virus, the cells were then processed for
immunodetection of rabies virus.
Treatment with mecamilamine or d-tubocurarine
reduced the % of infected neurons.
Control and Prevention