Rabies is an acute viral infection, causing progressive viral encephalomyelitis that is nearly always fatal. Transmission is usually through saliva via the bite of an infected animal, with dogs being the main transmitter of rabies to humans. Onset is generally heralded by a sense of apprehension, headache, fever, malaise and sensory changes (paresthesia) at the site of an animal bite. Excitability, aero- and/or hydrophobia, often with spasms of swallowing muscles, are frequent symptoms. Delirium with occasional convulsions follows. Such classic symptoms of furious rabies are noted in two-thirds of the cases, whereas the remaining present as paralysis of limbs and respiratory muscles with sparing of consciousness. Phobic spasms may be absent in this paralytic form. Coma and death ensue within 1–2 weeks, mainly due to cardiac failure. Diagnosis is made through specific FA staining of brain tissue or virus isolation in mouse or cell cultures. Antemortem diagnosis can be made by specific FA staining of viral antigens in frozen skin sections taken from the back of the neck at the hairline, detection of viral antibodies in serum and CSF, and specific amplification of viral nucleic acids in saliva or skin biopsies by RT-PCR. Serological diagnosis is based on neutralization tests in cell culture or in mice. Viral shedding in body secretions is intermittent and molecular studies need to be repeated if initially found negative.
Rabies has been found in Communicable Diseases
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