RABIES

(Hydrophobia/ Lyssa)
Rabies- is a specific, acute viral infection communicated to man by the saliva of an infected animal.

Etiologic Agent

Rhabdovirus

It is a bullet- shaped filterable virus with a strong affinity to CNS.

The organism is sensitive to sunlight, ultraviolet light, ether, formalin, mercury and nitric acid. It
is resistant to phenol, merthiolate and common antibacterial agents.

Incubation Period

1. One week prior to seven and a half months in dog.

2. Ten days to fifteen years in human
3. Incubation period depends on the following factors:
a. Distance of the bite to the brain.
b. Extensiveness of the bite.
c. Species of the animal
d. Richness of the nerve supply in the area of bite.
e. Resistance of the host.

Period of communicability:

The patient is communicable from three to five days before the onset of symptoms until the entire
course of illness.

Mode of Transmission:

An infected animal carries the rabies virus in its saliva and transmits it to humans by biting. In
some cases, the virus spreads when the saliva comes in contact with the person’s mucus membranes such
as those of the mouth and eyelids or broken skin like in cuts, scratches or open wounds.

Pathogenesis:

1 From the site of the bite, organism proceeds to the CNS through the exoplasm of the peripheral nerves.

2. Experimental studies have shown that the virus stays for some time in the inoculation site and that the
multiplication of the virus occurs in the myocytes.

3. It has been observed that the period between inoculation and nerve invasion is the only time when
prophylactic vaccine is effective.

4. Once the virus infects the individual, the spread is both centripetal and centrifugal.

5. After infection of the CNS, the virus spreads through the peripheral nerves to the salivary glands and
other organs such as the lungs, adrenals, kidneys, bladder and testicles (priapism)

Pathology:
 1. The rabies virus causes widespread changes throughout the CNS.
2. Histologic findings include neural necrosis and mononuclear cellular infiltration, esp. in the
thalamus, hypothalamus, pons and medulla.
3. The cranial nerve nuclei are extensively damaged.
4. Neural changes are present in the spinal cord, especially in the posterior horn.
5. Negri bodies are most abundant in the hypocampus, basal ganglia, pons and medulla and are
found in the degenerating neurons of the salivary glands.

CLINICAL MANIFESTATIONS;

1. PRODROMAL/INVASION PHASE
a. The phase is characterized by fever, anorexia, malaise, sore throat, copious salivation,
lacrimation, perspiration, irritability, hyperexcitability, apprehensiveness, restlessness, mental
depression, melancholia,

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