RABIES

Presented by Group 1

MICROBIOLOGY 2: VIROLOGY
 RABIES
Caused by various Lyssavirus strains, it's a deadly viral
disease.
Results in approximately 55,000 annual deaths globally,
with children under 15 comprising 40% of fatalities.
Dogs account for 99% of human rabies deaths
FAMILY RHABDOVIRIDAE

Genus: Lyssavirus
Species: Rabies virus
Rhabdo- “bullet-shaped”
ssRNA: minus strand
Helical
Causes rabies (literally means “madness”)
Broad range of hosts
Infects all types of mammals
Street virus Isolated from humans and animals
Virus fixe (Pasteur) only infects brain tissue
The genus Lyssavirus has 7 genotypes

Human pathogens: Genotype 1-7

Genotype 1: classic, worldwide type; Dogs and Foxes
Genotype 2-7: bats

Children are at risk

More common during the summer where there are no
classes
Acute infection of the CNS (very fatal)
 MODE OF TRANSMISSION

Bite
Scratch of a rabid animal (dogs or cats) - inoculation of virus
found on the animal’s claws (due to claw licking)
Organ transplant (corneal transplants)
Exposure of mucosal surfaces to animal’s or patient’s body fluids
Inhalation of aerosolized virus; inoculation through intact mucous
membrane
Virus is widely distributed in the nervous system, saliva, urine,
lymph, milk and blood of infected animals
 PATHOGENESIS

G glycoprotein – peplomer; virulence factor

Responsible for the neuroinvasiveness of the virus
Receptor: acetylcholine receptors
Initial site of infection – connective tissue and muscle where bite
occurred (replication)
Virus moves slowly upward into the brain via the nerve fibers
Proximity, severity, and immune status of the bite to the CNS
determine incubation period
Dissemination to other organs also occurs
Rabies is fatal once clinical disease is seen
Only 2 reported cases with recovery
 CLINICAL MANIFESTATION IN DOGS
STAGE SYMPTOMS
Increased alertness or apathy Fever,
PRODOME STAGE papillary dilatation
Increased muscular tone

Unusual restlessness
Biting at inanimate objects, aimless
EXCITEMENT STAGE running
Difficulty in swallowing
Change in bark or growl
 STAGE SYMPTOMS

Dog unable to take food or swallow

PARALYTIC STAGE water (hydrophobia)
Paralysis of the jaw and tongue,
drooling saliva
Paralysis of hindquarters

Within 3-7 days after the initial

DEATH symptoms
Forms of rabies in dogs:

a. Furious rabies – also known as

excitatory rabies; more common
b. Dumb type – opposite of furious type;
lethargy and docility
 SYMPTOMS

Initial symptoms mimic flu;

progresses to CNS changes like
hallucinations, hydrophobia,
and coma.
CLINICAL MANIFESTATION IN HUMANS
STAGE SYMPTOMS
2-3 days
Fever, vomiting, loss of appetite,
PRODOMAL PHASE headache, pain at the site of bite
Autonomic nervous system is
affected Salivation and sadness
are noted
Restlessness and irritability
ANGER STAGE Aggressive
Seizures may develop
Lasts for 2-4 days
 STAGE SYMPTOMS

Paralysis beginning in the bitten

NEUROLOGICAL STAGE OR area
PARALYTIC STAGE Difficulty in swallowing;
uncontrolled movement,
confusion, delirium
Hydrophobia, aerophobia
Anxiety and hyperactivity
Followed by coma and death
 DIAGNOSIS
DOGS
Specimen: brain tissue (autopsy)

Gold standard – Direct fluorescent

antibody test (fastest and most sensitive)
Impression smears are made from brain
tissue (hippocampus, pons, cerebellum,
and medulla oblongata)
Seller’s test (direct microscopic
examination)
Mouse inoculation test
RT-PCR
 DIAGNOSIS
HUMANS
Detect Negri bodies, eosinophilic
cytoplasmic inclusions, in neurons.
Fluorescent antibody and ELISA
methods are available for the rapid
detection of rabies in brain tissue and are
the preferred methods
Culture - suckling/young adult mice,
murine neuroblastoma
PCR
Serology (Serum Rapid Fluorescent Focus
Inhibition Test) or EIAs - most sensitive
 PREVENTION

Vaccinate dogs, cats, and ferrets against rabies as required by law.

Ensure their vaccinations are current at all times.
Keep pets under control and supervise them to prevent exposure to
rabid animals.
Avoid contact with stray or unknown animals, especially if they
appear wild or aggressive.
If bitten, scratched, or exposed to an animal, wash the wound
thoroughly and seek medical attention promptly.
 PREVENTION

Pre-exposure prophylaxis – for high-risk individuals (e.g., veterinarians)

Post-exposure prophylaxis by vaccination - 100% effective

Vigorous cleaning of the wound, providing human rabies

immunoglobulin, and administering three-injection series of the rabies
vaccine
Vaccines available in the Philippines (active immunization):
PVRV: Purified Verocell Rabies Vaccine
PVRV: Purified Verocell Rabies Vaccine
PDEV: Purified Duck Embryo Vaccine
PCECV: Purified Chick Embryo Cell Vaccine
 PREVENTION

Passive immunization:
Rabies Immune Globulin (either HRIG [human rabies immune globulin] or
ERIG [equine rabies immune globulin])
Dose depends on body weight

Regimen of vaccination (WHO Standard Intramuscular Regimen)

5 doses at day 0, 3, 7, 14, 28
Administered at deltoid area or anterolateral aspect of the thigh of
infants
Contraindication: allergy to eggs
 TREATMENT

No successful treatment after symptoms appear.

Postexposure prophylaxis, including wound cleaning, immunoglobulin,

and vaccination, is 100% effective if administered promptly.

Two human vaccines are available for high-risk individuals.

Sources:
https://en.wikipedia.org/wiki/Rabies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571590/
https://www.ncbi.nlm.nih.gov/books/NBK8618/#:~:text=Rabies%20virus%20causes%20acute%20infection,is%20
usually%201%E2%80%933%20months.
THANK YOU!!!
Presented by GROUP 1

Agaton
Balmes
Diamante
Mahan
Pastrana
Sausa
Virgo