Rabies

Edit links
Page semi-protected
Source: Wikipedia, the free encyclopedia.
This article is about rabies in humans. For rabies in animals, see Rabies in animals. For other uses, see Rabies (disambiguation).
"Rabid" redirects here. For other uses, see Rabid (disambiguation).

Rabies
Supportive care
MedicationIncurable[5]
Prognosis>99% fatal after onset of symptoms[1]
Deaths59,000 per year worldwide[6]

Rabies is a

loss of consciousness.[1][7][8][9] Once symptoms appear, the result is virtually always death.[1] The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year.[1] The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system.[10]

Rabies is caused by

dog bites.[11] In the Americas, bat bites are the most common source of rabies infections in humans, and less than 5% of cases are from dogs.[1][11] Rodents are very rarely infected with rabies.[11] The disease can be diagnosed only after the start of symptoms.[1]

Animal control and vaccination programs have decreased the risk of rabies from dogs in a number of regions of the world.

antibodies (rVNA).[15]
Since only one member of this group reported prior vaccination for rabies, the findings of the research suggest previously undocumented cases of infection and viral replication followed by an abortive infection. This could indicate that people may have an exposure to the virus without treatment and develop natural antibodies as a result.

Rabies causes about 59,000 deaths worldwide per year,

neglected tropical disease.[19]

Etymology

The name rabies is derived from the Latin rabies, "madness".[20] The Greeks derived the word lyssa, from lud or "violent"; this root is used in the genus name of the rabies virus, Lyssavirus.[21]

Signs and symptoms

Animals with "dumb" rabies appear depressed, lethargic, and uncoordinated

The period between infection and the first symptoms (incubation period) is typically one to three months in humans.[22] This period may be as short as four days or longer than six years, depending on the location and severity of the wound and the amount of virus introduced.[22] Initial symptoms of rabies are often nonspecific such as fever and headache.[22] As rabies progresses and causes inflammation of the brain and meninges, symptoms can include slight or partial paralysis, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, terror, and hallucinations.[10][22] The person may also have fear of water.[1]

The symptoms eventually progress to delirium, and coma.[10][22] Death usually occurs two to ten days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care.[22][23]

Man with rabies displaying hydrophobia

Rabies has also occasionally been referred to as hydrophobia ("fear of water") throughout its history.[24] It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. Since the infected individual cannot swallow saliva and water, the virus has a much higher chance of being transmitted, because it multiplies and accumulates in the salivary glands and is transmitted through biting.[25]

Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies causes irrational aggression in the host, which aids in the spreading of the virus through animal bites;[26][medical citation needed] a "foaming at the mouth" effect, caused by the accumulation of saliva, is also commonly associated with rabies in the public perception and in popular culture.[27][28][29] The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness, loss of sensation, and paralysis; this form of rabies does not usually cause fear of water.[30]

Cause

Rabies is caused by a number of lyssaviruses including the rabies virus and Australian bat lyssavirus.[4] Duvenhage lyssavirus may cause a rabies-like infection.[31]

The rabies virus is the

RNA genome of the virus encodes five genes whose order is highly conserved: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G), and the viral RNA polymerase (L).[33]

To enter cells, trimeric spikes on the exterior of the membrane of the virus interact with a specific cell receptor, the most likely one being the acetylcholine receptor. The cellular membrane pinches in a procession known as pinocytosis and allows entry of the virus into the cell by way of an endosome. The virus then uses the acidic environment, which is necessary, of that endosome and binds to its membrane simultaneously, releasing its five proteins and single-strand RNA into the cytoplasm.[34]

Once within a muscle or nerve cell, the virus undergoes replication. The L protein then transcribes five mRNA strands and a positive strand of RNA all from the original negative strand RNA using free nucleotides in the cytoplasm. These five mRNA strands are then translated into their corresponding proteins (P, L, N, G and M proteins) at free ribosomes in the cytoplasm. Some proteins require post-translational modifications. For example, the G protein travels through the rough endoplasmic reticulum, where it undergoes further folding, and is then transported to the Golgi apparatus, where a sugar group is added to it (glycosylation).[34]

When there are enough viral proteins, the viral polymerase will begin to synthesize new negative strands of RNA from the template of the positive-strand RNA. These negative strands will then form complexes with the N, P, L and M proteins and then travel to the inner membrane of the cell, where a G protein has embedded itself in the membrane. The G protein then coils around the N-P-L-M complex of proteins taking some of the host cell membrane with it, which will form the new outer envelope of the virus particle. The virus then buds from the cell.[34]

From the point of entry, the virus is neurotropic, traveling along the neural pathways into the central nervous system. The virus usually first infects muscle cells close to the site of infection, where they are able to replicate without being 'noticed' by the host's immune system. Once enough virus has been replicated, they begin to bind to acetylcholine receptors at the neuromuscular junction.[35] The virus then travels through the nerve cell axon via retrograde transport, as its P protein interacts with dynein, a protein present in the cytoplasm of nerve cells. Once the virus reaches the cell body it travels rapidly to the central nervous system (CNS), replicating in motor neurons and eventually reaching the brain.[10] After the brain is infected, the virus travels centrifugally to the peripheral and autonomic nervous systems, eventually migrating to the salivary glands, where it is ready to be transmitted to the next host.[36]: 317 

Transmission

All warm-blooded species, including humans, may become infected with the rabies virus and develop symptoms. Birds were first artificially infected with rabies in 1884; however, infected birds are largely, if not wholly, asymptomatic, and recover.[37] Other bird species have been known to develop rabies antibodies, a sign of infection, after feeding on rabies-infected mammals.[38][39]

The virus has also adapted to grow in cells of

coyotes, cats, and mongooses (normally either the small Asian mongoose or the yellow mongoose).[45]

Rabies may also spread through exposure to infected

eutherians.[49]

The virus is usually present in the nerves and

modifying the behavior of its host to facilitate its transmission to other hosts. After a typical human infection by bite, the virus enters the peripheral nervous system. It then travels retrograde along the efferent nerves toward the central nervous system.[53] During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. When the virus reaches the brain, it rapidly causes encephalitis, the prodromal phase, which is the beginning of the symptoms. 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.[54][55]

Although it is theoretically possible for rabies-infected humans to transmit it to others by biting or otherwise, no such cases have ever been documented, because infected humans are usually hospitalized and necessary precautions taken. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, feces), does not constitute an exposure and does not require post-exposure prophylaxis. But as the virus is present in sperm and vaginal secretions, it might be possible for rabies to spread through sex.

organ transplants, most frequently with corneal transplantation, from infected donors.[57][58]

Diagnosis

Rabies can be difficult to diagnose because, in the early stages, it is easily confused with other diseases or even with a simple aggressive temperament.

Negri bodies are 100% diagnostic for rabies infection but are found in only about 80% of cases.[32] If possible, the animal from which the bite was received should also be examined for rabies.[65]

Some

light microscopy techniques may also be used to diagnose rabies at a tenth of the cost of traditional fluorescence microscopy techniques, allowing identification of the disease in less-developed countries.[66] A test for rabies, known as LN34, is easier to run on a dead animal's brain and might help determine who does and does not need post-exposure prevention.[67] The test was developed by the Centers for Disease Control and Prevention (CDC) in 2018.[67]

The

coxsackieviruses, echoviruses, polioviruses, and human enteroviruses 68 to 71.[68]

New causes of viral encephalitis are also possible, as was evidenced by the 1999 outbreak in Malaysia of 300 cases of encephalitis with a mortality rate of 40% caused by Nipah virus, a newly recognized paramyxovirus.[69] Likewise, well-known viruses may be introduced into new locales, as is illustrated by the outbreak of encephalitis due to West Nile virus in the eastern United States.[70]

Prevention

Further information:
Dog bite prevention

Almost all human exposure to rabies was fatal until a vaccine was developed in 1885 by Louis Pasteur and Émile Roux. Their original vaccine was harvested from infected rabbits, from which the virus in the nerve tissue was weakened by allowing it to dry for five to ten days.[71] Similar nerve tissue-derived vaccines are still used in some countries, as they are much cheaper than modern cell culture vaccines.[72]

The human diploid cell rabies vaccine was started in 1967. Less expensive purified chicken embryo cell vaccine and purified

recombinant vaccine called V-RG has been used in Belgium, France, Germany, and the United States to prevent outbreaks of rabies in undomesticated animals.[73] Immunization before exposure has been used in both human and nonhuman populations, where, as in many jurisdictions, domesticated animals are required to be vaccinated.[74]

A young girl about to receive PEP after being bitten by an animal thought to be rabid

The Missouri Department of Health and Senior Services Communicable Disease Surveillance 2007 Annual Report states the following can help reduce the risk of contracting rabies:[75]

  • Vaccinating dogs, cats, and ferrets against rabies
  • Keeping pets under supervision
  • Not handling wild animals or strays
  • Contacting an animal control officer upon observing a wild animal or a stray, especially if the animal is acting strangely
  • If bitten by an animal, washing the wound with soap and water for 10 to 15 minutes and contacting a healthcare provider to determine if post-exposure prophylaxis is required

28 September is World Rabies Day, which promotes the information, prevention, and elimination of the disease.[76]

In Asia and in parts of the Americas and Africa, dogs remain the principal host. Mandatory vaccination of animals is less effective in rural areas. Especially in developing countries, pets may not be privately kept and their destruction may be unacceptable. Oral vaccines can be safely distributed in baits, a practice that has successfully reduced rabies in rural areas of Canada, France, and the United States. In Montreal, Quebec, Canada, baits are successfully used on raccoons in the Mount-Royal Park area. Vaccination campaigns may be expensive, but cost-benefit analysis suggests baits may be a cost-effective method of control.[77] In Ontario, a dramatic drop in rabies was recorded when an aerial bait-vaccination campaign was launched.[78]

The number of recorded human deaths from rabies in the United States has dropped from 100 or more annually in the early 20th century to one or two per year due to widespread vaccination of domestic dogs and cats and the development of human vaccines and immunoglobulin treatments. Most deaths now result from bat bites, which may go unnoticed by the victim and hence untreated.[79]

Treatment

After exposure

immunoglobulin (HRIG) and four doses of rabies vaccine over a 14-day period.[82] HRIG is expensive and makes up most of the cost of post-exposure treatment, ranging as high as several thousand dollars.[83] In the UK, one dose of HRIG costs the National Health Service £1,000,[84] although this is not flagged as a "high-cost medication".[85] A full course of vaccine costs £120–180.[86] As much as possible of HRIG should be injected around the bites, with the remainder being given by deep intramuscular injection at a site distant from the vaccination site.[34]

People who have previously been vaccinated against rabies do not need to receive the immunoglobulin—only the postexposure vaccinations on days 0 and 3.[87] The side effects of modern cell-based vaccines are similar to the side effects of flu shots. The old nerve-tissue-based vaccination required multiple injections into the abdomen with a large needle but is inexpensive.[88] It is being phased out and replaced by affordable World Health Organization intradermal-vaccination regimens.[65] In children less than a year old, the lateral thigh is recommended.[89]

Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is effective in reducing the number of viral particles.[90] Povidone-iodine or alcohol is then recommended to reduce the virus further.[91]

Awakening to find a bat in the room, or finding a bat in the room of a previously unattended child or mentally disabled or intoxicated person, is an indication for post-exposure prophylaxis (PEP). The recommendation for the precautionary use of PEP in bat encounters where no contact is recognized has been questioned in the medical literature, based on a cost–benefit analysis.[92] However, a 2002 study has supported the protocol of precautionary administration of PEP where a child or mentally compromised individual has been alone with a bat, especially in sleep areas, where a bite or exposure may occur with the victim being unaware.[93]

After onset

Once rabies develops, death almost certainly follows. Palliative care in a hospital setting is recommended with administration of large doses of pain medication, and sedatives in preference to physical restraint. Ice fragments can be given by mouth for thirst, but there is no good evidence intravenous hydration is of benefit.[94]

A treatment known as the Milwaukee protocol, which involves putting a person into a

antiviral medications, has been proposed.[95] It initially came into use in 2003, following Jeanna Giese, a teenage girl from Wisconsin, becoming the first person known to have survived rabies without preventive treatments before symptom onset.[96][97] The protocol has been tried multiple times since, but has been assessed as an ineffective treatment, and concerns raised about the costs and ethics of its use.[95][98]

Prognosis

neurological symptoms have developed.[99]

Epidemiology

Main article: Prevalence of rabies
Map of rabies-free countries and territories

In 2010, an estimated 26,000 people died from rabies, down from 54,000 in 1990.[100] The majority of the deaths occurred in Asia and Africa.[99] As of 2015, India (approximately 20,847), followed by China (approximately 6,000) and the Democratic Republic of the Congo (5,600), had the most cases.[101] A 2015 collaboration between the World Health Organization, World Organization of Animal Health (OIE), Food and Agriculture Organization of the United Nation (FAO), and Global Alliance for Rabies Control has a goal of eliminating deaths from rabies by 2030.[102]

India

faith healers rather than medical services.[105] An estimated 20,000 people die every year from rabies in India, more than a third of the global total.[104]

Australia

Australia has an official rabies-free status,[106] although Australian bat lyssavirus (ABLV), discovered in 1996, is a rabies-causing virus related to the rabies virus prevalent in Australian native bat populations.

United States

Rabies cases in humans and domestic animals — United States, 1938–2018

Canine-specific rabies has been eradicated in the United States, but rabies is common among wild animals, and an average of 100 dogs become infected from other wildlife each year.[107][108]

Due to high public awareness of the virus, efforts at vaccination of domestic animals and curtailment of feral populations, and availability of

postexposure prophylaxis, incidence of rabies in humans is very rare in the United States. From 1960 to 2018, a total of 125 human rabies cases were reported in the United States; 36 (28%) were attributed to dog bites during international travel.[109] Among the 89 infections acquired in the United States, 62 (70%) were attributed to bats.[109] The most recent rabies death in the United States was in November 2021, where a Texas child was bitten by a bat in late August 2021 but his parents failed to get him treatment. He died less than three months later.[110]

Europe

Either no or very few cases of rabies are reported each year in Europe; cases are contracted both during travel and in Europe.[111]

In Switzerland the disease was virtually eliminated after scientists placed chicken heads laced with live attenuated vaccine in the Swiss Alps.[78] Foxes, proven to be the main source of rabies in the country, ate the chicken heads and became immunized.[78][112]

Italy, after being declared rabies-free from 1997 to 2008, has witnessed a reemergence of the disease in wild animals in the

Friuli Venezia Giulia), due to the spreading of an epidemic in the Balkans that also affected Austria. An extensive wild animal vaccination campaign eliminated the virus from Italy again, and it regained the rabies-free country status in 2013, the last reported case of rabies being reported in a red fox in early 2011.[113][114]

The United Kingdom has been free of rabies since the early 20th century except for a rabies-like virus (EBLV-2) in a few Daubenton's bats. There has been one fatal case of EBLV-2 transmission to a human.[115] There have been four deaths from rabies, transmitted abroad by dog bites, since 2000. The last infection in the UK occurred in 1922, and the last death from indigenous rabies was in 1902.[116][117]

Sweden and mainland Norway have been free of rabies since 1886.[118] Bat rabies antibodies (but not the virus) have been found in bats.[119] On Svalbard, animals can cross the arctic ice from Greenland or Russia.

Mexico

Mexico was certified by the World Health Organization as being free of dog-transmitted rabies in 2019 because no case of dog-human transmission had been recorded in two years.[120]

Asian Countries

Despite rabies being preventable and the many successes of the years from countries such as North America, South Korea and Western Europe, Rabies remains an endemic in many Southeast Asian countries including Cambodia, Bangladesh, Bhutan, North Korea, India, Indonesian, Myanmar Nepal, Shi Lanka, and Thailand[121]. Half the global rabies deaths occur in southeast Asia- approx. 26,000 per year.[122]

South Asia's Struggle to combat rabies Much of what prevents Asia from implementing the same measure as other countries is cost[123] . Known knowledge suggests treating wild canines is the primary source of resolving rabies, however it cost 10x more than treating individuals as they come with bites. Rabies research and treatment in general is so expensive that India and other surrounding countries are simply unable to apply many preventative measures due to financial restrictions.[124]

Thailand

In 2013 human rabies was nearly eradicated in the state of Thailand due to new measures put into place requiring the vaccination of all domestic dogs as well as programs seeking to vaccinate wild dogs and large animals. (Suwanpakdee. 2021)[125], however due to neighboring countries- Cambodia, Laos, and Myanmar- and their inability to financially combat rabies, infected animals continue to pass the boarder and infect the Thai people leading to ~100 cases a year[126]. These areas around the boarder are called Rabies Red areas and its where Thailand continuously struggles with eradication and will do so until something is done in the surrounding countries (Suwanpakdee, S.2021).[127]

Thailand has the resources and medicine necessary to tackle rabies such as implementing regulations that require all children to receive a rabies vaccination before attending schools and having clinics available for those bit or scratched by a possible rabid animal. However, it is up to the individual to take themselves to the clinic, and 10 people per year die due to their own refusal.[128]

Cambodia

Cambodia has about 800 cases of human rabies per year making Cambodia one of the top countries in human rabies incidences.[129] Much of this falls on their lack of animal care, Cambodia has hundreds of thousands of animals infected with rabies, another global high, yet little surveillance of said animals and few laws requiring pets and other household animals to be vaccinated. (Baron N., Chevalier V.,Sowath L. et al(2022). What's striking about this is Cambodia’s national net worth, they are considered a wealthy nation with the funds capable of combating rabies and vaccinating all consenting citizens. In recent years Cambodia has improved significantly in their human rabies medical practices, with clinics all over the countries being made with treatments and vaccination on hand as well as rabies related education in school classes.[130] However, they are still lacking in terms of animal surveillance and treatment which leads to bleeding into surrounding countries.[131]

History

Rabies has been known since around 2000 BC.[132] The first written record of rabies is in the Mesopotamian Codex of Eshnunna (c. 1930 BC), which dictates that the owner of a dog showing symptoms of rabies should take preventive measures against bites. If another person were bitten by a rabid dog and later died, the owner was heavily fined.[133]

In Ancient Greece, rabies was supposed to be caused by Lyssa, the spirit of mad rage.[134]

Ineffective folk remedies abounded in the medical literature of the ancient world. The physician Scribonius Largus prescribed a poultice of cloth and hyena skin; Antaeus recommended a preparation made from the skull of a hanged man.[135]

Rabies appears to have originated in the Old World, the first epizootic in the New World occurring in Boston in 1768.[136]

Rabies was considered a scourge for its prevalence in the 19th century. In France and Belgium, where

St Hubert's Key" was heated and applied to cauterize the wound. By an application of magical thinking
, dogs were branded with the key in hopes of protecting them from rabies.

It was not uncommon for a person bitten by a dog merely suspected of being rabid to commit suicide or to be killed by others.[21]

In ancient times the attachment of the tongue (the

lingual frenulum, a mucous membrane) was cut and removed, as this was where rabies was thought to originate. This practice ceased with the discovery of the actual cause of rabies.[36] Louis Pasteur's 1885 nerve tissue vaccine was successful, and was progressively improved to reduce often severe side-effects.[22]

In modern times, the fear of rabies has not diminished, and the disease and its symptoms, particularly agitation, have served as an inspiration for several works of zombie or similarly themed fiction, often portraying rabies as having mutated into a stronger virus which fills humans with murderous rage or incurable illness, bringing about a devastating, widespread pandemic.[137]

Semi-Recent Unique Cases in Human Rabies

Human to Human transmission via cornea transplant

In 1978 a patient was admitted to the ER with rapid sensory and movement loss, loss of eyesight, muscle spasms, cardiac arrest, and lung failure and soon thereafter died. He was later misdiagnosed with Guillain-Barre syndrome and was cleared for a corneal transplant that was given to a woman who soon died of the same symptoms. Both bodies were then tested for multiple different diseases before being diagnosed with rabies. This is extremely rare due to the typical transplant precautionary measure and is currently known to be the only human to human case of rabies in the United States. [139]

Recent fatal cases in US

An 84-year-old man, residing in Minnesota passed in 2023 due to rabies from a bat kept by both him and his wife, as a precautionary measure he immediately took the bat in for testing and was promptly treated for rabies however despite this timely treatment, he passed from the virus. This is through to be an extremely rare case in American medicine as human rabies has been eradicated for many years in the US, however it is thought that the treatment this man received wasn't through enough for doctors to treat him properly, without a blood sample they were unaware of how prevalent it was in his blood stream and gave him an insufficient amount of medication needed to halt the progression of the disease. [140]

25-year case in the Southwestern state of India, Goa.

a 48-year-old male in southwest India was diagnosed with rabies near 25 years after contracting the virus, the incubation period for rabies was thought to be three months tops, however his lasted near 20 years before his death. histology and immunocytochemical demonstration of rabies viral antigen led to a diagnosis which was conducted following a suit for alleged medical negligence to the forensic department. The case manifested initially with hydrophobia and aggressive behavior, although was able drink a small amount of water throughout the day during lull periods in symptom manifestation. [141]

Other animals

Main article: Rabies in animals
Two dogs with the paralytic, or dumb, form of rabies

Rabies is infectious to mammals; three stages of central nervous system infection are recognized. The clinical course is often shorter in animals than in humans, but result in similar symptoms and almost always death. The first stage is a one- to three-day period characterized by behavioral changes and is known as the prodromal stage. The second is the excitative stage, which lasts three to four days. This stage is often known as "furious rabies" for the tendency of the affected animal to be hyper-reactive to external stimuli and bite or attack anything near. In some cases, animals skip the excitative stage and develop paralysis, as in the third phase; the paralytic phase. This stage develops due to 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. Death is usually caused by respiratory arrest.[142]

See also

References

  1. ^ a b c d e f g h i j k l m n o p q r s t u "Rabies Fact Sheet N°99". World Health Organization. July 2013. Archived from the original on 1 April 2014. Retrieved 28 February 2014.
  2. ^ "Rabies - Symptoms and causes". Mayo Clinic. Retrieved 9 April 2018.
  3. ^ "Rabies". Mayo Clinic. Retrieved 5 October 2023.
  4. ^ a b c "Rabies, Australian bat lyssavirus and other lyssaviruses". The Department of Health. December 2013. Archived from the original on 4 March 2014. Retrieved 1 March 2014.
  5. ^ "Rabies diagnosis and treatment=27 June 2023". Mayo clinic.
  6. ^ a b "Rabies". CDC. 29 July 2020. Retrieved 31 January 2021.
  7. ^ "Rabies, Symptoms, Causes, Treatment". Medical News Today. 15 November 2017.
  8. ^ "Rabies, Symptoms and causes". Mayo Clinic.
  9. ^ "Animal bites and rabies". Johns Hopkins Medicine. 27 February 2020.
  10. ^
    ISBN 978-0-7216-0187-8
    .
  11. ^
    ISBN 978-0-07-148480-0
    .
  12. ISBN 978-0-08-055009-1
    .
  13. PMID 27429788
    .
  14. ISSN 2312-0053
    .
  15. PMID 22855749
    .
  16. ^ "Rabies: The Facts" (PDF). World Health Organization. Archived (PDF) from the original on 24 February 2017. Retrieved 24 February 2017.
  17. ISBN 978-92-4-120982-3. Archived
    (PDF) from the original on 20 October 2014.
  18. ^ a b "Rabies-Free Countries and Political Units". CDC. Archived from the original on 5 March 2014. Retrieved 8 May 2019.
  19. ^ "Neglected Tropical Diseases". cdc.gov. 6 June 2011. Archived from the original on 4 December 2014. Retrieved 28 November 2014.
  20. ISBN 978-0-304-52257-6
    .
  21. ^
    PMID 8903179. Archived from the original
    on 26 April 2009.
  22. ^
    PMID 25683583
    .
  23. S2CID 36979186
    .
  24. ISBN 978-0-340-76171-7
    .
  25. ^ "Rabies". AnimalsWeCare.com. Archived from the original on 3 September 2014.
  26. ^ "How does rabies cause aggression?". medicalnewstoday.com. Medical News Today. 14 October 2017. Retrieved 19 January 2023.
  27. ISBN 978-0-323-63979-8
    . Retrieved 10 May 2023.
  28. ^ "How Do You Know if an Animal Has Rabies? | CDC Rabies and Kids". Centers for Disease Control and Prevention (CDC). Retrieved 10 May 2023.
  29. Nemours KidsHealth
    . Retrieved 10 May 2023.
  30. ^ "Symptoms of rabies". NHS.uk. 12 June 2012. Archived from the original on 14 September 2014. Retrieved 3 September 2014.
  31. PMID 19636367
    .
  32. ^
    ISBN 978-0-8385-8529-0
    .
  33. PMID 15885837
    .
  34. ^ a b c d e "Rabies Post-Exposure Prophylaxis". Centers for Disease Control and Prevention (CDC). 23 December 2009. Archived from the original on 1 February 2010. Retrieved 30 January 2010.
  35. PMID 25165859
    .
  36. ^
    ISBN 978-0-8493-6760-1
    . Retrieved 31 October 2011.
  37. PMID 3286906
    .
  38. PMID 16498885
    .
  39. S2CID 11374356
    .
  40. ^ Wong D. "Rabies". Wong's Virology. Archived from the original on 3 December 2008. Retrieved 19 March 2009.
  41. ISBN 978-0-89838-390-4
    .
  42. ^ "Rabies". World Health Organization. 21 April 2020. Retrieved 3 May 2021.
  43. PMID 13858519
    .
  44. PMID 14431118
    .
  45. PMID 7777324
    .
  46. ^ "Rabies. Other Wild Animals: Terrestrial carnivores: raccoons, skunks and foxes". Centers for Disease Control and Prevention(CDC). Archived from the original on 20 December 2010. Retrieved 23 December 2010.
  47. ^ Anderson J, Frey R (2006). "Rabies". In Fundukian LJ (ed.). Gale Encyclopedia of Medicine (3rd ed.).
  48. PMID 19341950
    .
  49. ISBN 978-1-63483-487-2
    . Retrieved 20 April 2022.
  50. ^ The Merck Manual (11th ed.). 1983. p. 183.
  51. ^ The Merck manual of Medical Information (Second Home ed.). 2003. p. 484.
  52. ^ Turton J (2000). "Rabies: a killer disease". National Department of Agriculture. Archived from the original on 23 September 2006.
  53. ISBN 978-0-12-379077-4. Archived
    from the original on 8 January 2014.
  54. ISBN 978-1-4511-0012-9
    .
  55. ISBN 978-1-888799-84-2. Archived
    from the original on 8 January 2014.
  56. ^ "Rabies FAQs: Exposure, prevention and treatment". RabiesAlliance.org. Archived from the original on 24 September 2016.
  57. PMID 15784663
    .
  58. ^ "Human Rabies Prevention --- United States, 2008 Recommendations of the Advisory Committee on Immunization Practices". Centers for Disease Control and Prevention. 23 May 2008. Retrieved 11 February 2020.
  59. ISBN 978-0-911910-93-3
    .
  60. ISBN 978-92-4-140023-7
    .
  61. ^
    PMID 19787037
    .
  62. ISBN 978-0-8493-4833-4
    .
  63. PMID 12034539
    .
  64. PMID 17881871
    .
  65. ^
    PMID 19907631
    . e511.
  66. PMID 18365035
    . e206.
  67. ^ a b "New Rapid Rabies Test Could Revolutionize Testing and Treatment | CDC Online Newsroom | CDC". www.cdc.gov. 16 May 2018. Retrieved 23 May 2018.
  68. ^ "Rabies: Differential Diagnoses & Workup". eMedicine Infectious Diseases. 3 October 2008. Archived from the original on 28 November 2010. Retrieved 30 January 2010.
  69. ISBN 978-0-8138-1703-3
    . Retrieved 30 January 2010.
  70. ISBN 978-1-58829-424-1
    .
  71. PMID 348641
    .
  72. PMID 15069272. Archived
    from the original on 2 August 2009.
  73. S2CID 5959305
    .
  74. ^ "Compendium of Animal Rabies Prevention and Control" (PDF). National Association of State Public Health Veterinarians. 31 December 2007. Archived from the original (PDF) on 12 July 2010. Retrieved 3 January 2010.
  75. ^ 2007 Annual Report (PDF) (Report). Bureau of Communicable Disease Control and Prevention. 2007. Archived from the original (PDF) on 11 May 2020. Retrieved 8 March 2011.
  76. ^ "World Rabies Day". World Health Organization (WHO). Archived from the original on 31 December 2011.
  77. PMID 8969251
    .
  78. ^
    ISBN 978-0-87156-377-4
    .
  79. ^ "Rabies in the U.S." Centers for Disease Control and Prevention (CDC). 22 April 2011. Archived from the original on 31 December 2011. Retrieved 31 December 2011.
  80. ^ a b Lite J (8 October 2008). "Medical Mystery: Only One Person Has Survived Rabies without Vaccine—But How?". Scientific American. Archived from the original on 5 November 2009. Retrieved 30 January 2010.
  81. ^ "Human rabies: better coordination and emerging technology to improve access to vaccines". World Health Organization. Archived from the original on 24 February 2017. Retrieved 23 February 2017.
  82. ^ "Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabie" (PDF). Centers for Disease Control and Prevention (CDC). Archived from the original (PDF) on 25 July 2011.
  83. ^ "Cost of Rabies Prevention". U.S. Centers for Disease Control and Prevention. 11 June 2019. Archived from the original on 29 March 2016.
  84. ^ "BNF via NICE is only available in the UK". The National Institute for Health and Care Excellence. UK.
  85. ^ "Rabies immunoglobulin". Milton Keynes Formulary Formulary.
  86. ^ "Rabies - Vaccination". National Health Services (NHS). UK. 23 October 2017.
  87. ISBN 978-93-82219-02-6
    .
  88. PMID 22861358
    .
  89. ^ "Rabies". World Health Organization. Archived from the original on 15 February 2015. Retrieved 1 February 2015.
  90. ^ "Rabies & Australian bat lyssavirus information sheet". Health.vic.gov.au. Archived from the original on 18 August 2011. Retrieved 30 January 2012.
  91. ^ National Center for Disease Control (2014). "National Guidelines on Rabies Prophylaxis" (PDF). Archived from the original (PDF) on 5 September 2014. Retrieved 5 September 2014.
  92. PMID 19400689
    .
  93. PMID 18159381
    .
  94. S2CID 240895449
    .
  95. ^
    S2CID 25702043
    .
  96. ^ Jordan Lite (8 October 2008). "Medical Mystery: Only One Person Has Survived Rabies without Vaccine--But How?". Scientific American. Retrieved 16 October 2008.
  97. ^ Rodney E. Willoughby Jr., online "A Cure for Rabies?" Scientific American, V. 256, No. 4, April 2007, p. 95.
  98. PMID 26639059
    .
  99. ^ a b "Rabies". World Health Organization (WHO). September 2011. Archived from the original on 31 December 2011. Retrieved 31 December 2011.
  100. S2CID 1541253
    .
  101. PMID 25881058
    .
  102. ^ "Rabies". World Health Organization. Archived from the original on 15 February 2017. Retrieved 23 February 2017.
  103. ^ Dugan E (30 April 2008). "Dead as a dodo? Why scientists fear for the future of the Asian vulture". The Independent. London. Archived from the original on 17 May 2008. Retrieved 11 October 2008. India now has the highest rate of human rabies in the world.
  104. ^ a b Harris G (6 August 2012). "Where Streets Are Thronged With Strays Baring Fangs". New York Times. Archived from the original on 8 August 2012. Retrieved 6 August 2012.
  105. ^ "Medicine challenges Indian superstition". DW.DE. 31 December 2012. Archived from the original on 31 January 2013.
  106. ^ "Essential rabies maps". World Health Organization (WHO). Archived from the original on 17 February 2010.
  107. ^ "CDC – Rabies Surveillance in the U.S.: Human Rabies – Rabies". www.cdc.gov. Archived from the original on 18 January 2017. Retrieved 10 April 2017.
  108. ^ Fox M (7 September 2007). "U.S. free of canine rabies virus". Reuters. Archived from the original on 17 May 2017. Retrieved 11 April 2017. "We don't want to misconstrue that rabies has been eliminated – dog rabies virus has been," CDC rabies expert Dr. Charles Rupprecht told Reuters in a telephone interview.
  109. ^
    PMID 31194721
    .
  110. PMID 36480462
    .
  111. ^ "Surveillance Report - Annual Epidemiological Report for 2015 - Rabies" (PDF). European Centre for Disease Prevention and Control (ECDC). Retrieved 30 August 2018.
  112. ^ "Switzerland ended rabies epidemic by air dropping vaccinated chicken heads from helicopters". thefactsource.com. 20 November 2019. Retrieved 10 December 2019.
  113. ^ "Rabies in Africa: The RESOLAB network". 29 June 2015. Archived from the original on 3 August 2016. Retrieved 18 April 2016.
  114. ^ "Ministero della Salute: "Italia è indenne dalla rabbia". l'Ultimo caso nel 2011 - Quotidiano Sanità". Archived from the original on 3 June 2016. Retrieved 18 April 2016.
  115. ^ "Man dies from rabies after bat bite". BBC News. 24 November 2002.
  116. ^ "Rabies". NHS. 23 February 2017. Retrieved 30 August 2018.
  117. ^ "Q&A: Rabies". BBC News. 17 April 2015. Retrieved 30 August 2018.
  118. ^ Mehnert E (1988). "Rabies och bekämpningsåtgärder i 1800-talets Sverige" [Rabies and remedies in 19th century Sweden]. Svensk veterinärtidning [Swedish veterinary magazine] (in Swedish). 1988/40. Sveriges veterinärförbund: 277–88.
  119. ^ "Fladdermusrabies" [Bat rabies]. Statens Veterinärmedicinska Anstalt [State Veterinary Medical Institution] (in Swedish). Retrieved 28 October 2022.
  120. ^ "Cómo México se convirtió en el primer país del mundo libre de rabia transmitida por perros" [How Mexico became the first country in the world free of rabies transmitted by dogs]. BBC News (in Spanish). 12 November 2019. Retrieved 12 November 2019.
  121. ^ World Heath Organization. Rabies in the South-East Asia Region. 2024.https://www.who.int/southeastasia/health-topics/rabies#:~:text=In%20the%20South%2DEast%20Asia%20Region%2C%20rabies%20is%20endemic%20in,Nepal%2C%20Sri%20Lanka%20and%20Thailand.
  122. ^ Hicks, R. (2021) Rabies is Spreading in South Asia Fueled by Inequality and Neglect. https://www.eco-business.com/news/rabies-is-spreading-in-southeast-asia-fuelled-by-inequality-and-neglect/#:~:text=Rabies%20is%20endemic%20in%20eight,control%20in%20the%20regional%20bloc.
  123. ^ Abbas, S. S., & Kakkar, M. (2014). Rabies control in India: a need to close the gap between research and policy. Bulletin of the World Health Organization, 93, 131-132. https://www.scielosp.org/article/bwho/2015.v93n2/131-132/en/
  124. ^ Chowdhury, F. R., Basher, A., Amin, M. R., Hassan, N., & Patwary, M. I. (2015). Rabies in South Asia: fighting for elimination. Recent patents on anti-infective drug discovery, 10(1), 30–34. https://doi.org/10.2174/1574891x10666150410130024
  125. ^ Suwanpakdee, S. (2021). Current characteristics of animal rabies cases in Thailand and relevant risk factors identified by a spatial modeling approach. Natural Library of Medicine. National Center for Biotechnology Information. 15(12) https://doi.org/10.1371/journal.pntd.0009980
  126. ^ CDC. (2024) Center for Disease Control and Prevention. Travelers' health. Thailand https://wwwnc.cdc.gov/travel/destinations/traveler/none/thailand#:~:text=Rabid%20dogs%20are%20commonly%20found,rabies%20treatment%20is%20often%20available.&text=Since%20children%20are%20more%20likely,for%20children%20traveling%20to%20Thailand.
  127. ^ Suwanpakdee, S. (2021). Current characteristics of animal rabies cases in Thailand and relevant risk factors identified by a spatial modeling approach. Natural Library of Medicine. National Center for Biotechnology Information. 15(12) https://doi.org/10.1371/journal.pntd.0009980
  128. ^ CDC. (2024) Center for Disease Control and Prevention. Travelers' health. Thailand https://wwwnc.cdc.gov/travel/destinations/traveler/none/thailand#:~:text=Rabid%20dogs%20are%20commonly%20found,rabies%20treatment%20is%20often%20available.&text=Since%20children%20are%20more%20likely,for%20children%20traveling%20to%20Thailand.
  129. ^ Baron N., Chevalier V.,Sowath L. ,Veasna D. ,Dussart P.,Fontenille D.,Peng Y.S.,Martínez-López B. (2022).Accessibility to rabies centers and human rabies post-exposure prophylaxis rates in Cambodia: A Bayesian spatio-temporal analysis to identify optimal locations for future centers. PLOS.Neglected Tropical Diseases https://doi.org/10.1371/journal.pntd.0010494
  130. ^ Center for Disease Control.(2024)Travelers' Health. Cambodia.https://wwwnc.cdc.gov/travel/destinations/traveler/none/cambodia#:~:text=Rabid%20dogs%20are%20commonly%20found,rabies%20treatment%20is%20often%20available.&text=Since%20children%20are%20more%20likely,for%20children%20traveling%20to%20Cambodia.
  131. ^ Hicks, R. (2021) Rabies is Spreading in South Asia Fueled by Inequality and Neglect. https://www.eco-business.com/news/rabies-is-spreading-in-southeast-asia-fuelled-by-inequality-and-neglect/#:~:text=Rabies%20is%20endemic%20in%20eight,control%20in%20the%20regional%20bloc.
  132. S2CID 27354751
    .
  133. ISBN 978-0-8016-3209-9
    .
  134. ^ "Rabies: an ancient disease". Gobierno de México.
  135. ISBN 978-0-08-091902-7. Archived
    from the original on 28 April 2016. Retrieved 8 January 2016.
  136. ISBN 978-0-8493-6760-1
    . The first major epizootic in North America was reported in 1768, continuing until 1771 when foxes and dogs carried the disease to swine and domestic animals. The malady was so unusual that it was reported as a new disease
  137. ^ Than K (27 October 2010). "'Zombie Virus' Possible via Rabies-Flu Hybrid?". National Geographic. Archived from the original on 13 September 2015. Retrieved 13 September 2015.
  138. Biblioteca Virtual Miguel de Cervantes
    .
  139. ^ Anderson LJ, Williams LP Jr, Layde JB, Dixon FR, Winkler WG. 1984 Nosocomial rabies: investigation of contacts of human rabies cases associated with a corneal transplant. Am J Public Health. 74(4):370-2. doi: 10.2105/ajph.74.4.370
  140. ^ Sudhakar. S (2023). Rabies patient becomes first fatal case in US after post-exposure treatment, report says. University Nebraska Medical Center. Global Center for Health Security. https://www.unmc.edu/healthsecurity/transmission/2023/04/04/rabies-patient-becomes-first-fatal-case-in-us-after-post-exposure-treatment-report-says/
  141. ^ Shankar, S. K., Mahadevan, A., Sapico, S. D., Ghodkirekar, M. S., Pinto, R. G., & Madhusudana, S. N. (2012). Rabies viral encephalitis with probable 25 year incubation period!. Annals of Indian Academy of Neurology, 15(3), 221–223. https://doi.org/10.4103/0972-2327.99728
  142. ISBN 978-0-7216-6795-9
    .

Further reading

  • Pankhurst, Richard. "The history and traditional treatment of rabies in Ethiopia." Medical History 14, no. 4 (1970): 378–389.

External links

The offline app allows you to download all of Wikipedia's medical articles in an app to access them when you have no Internet.
Wikipedia's health care articles can be viewed offline with the Medical Wikipedia app.
Wikimedia Commons has media related to Rabies.
Wikisource has the text of the 1911 Encyclopædia Britannica article "Hydrophobia".
Look up rabies in Wiktionary, the free dictionary.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Rabies&oldid=1220753859"
This page is based on the copyrighted Wikipedia article: Rabies. Articles is available under the CC BY-SA 3.0 license; additional terms may apply.Privacy Policy