2. INTRODUCTION
• Highly fatal disease of CNS
• Caused by Lyssavirus type 1
• Zoonotic disease of warm blooded animals
• Transmitted to humans by bites of rabid animal
• Long and variable IP with short period of illness
• no treatment, only prevention
3. RABIES VIRUS
• Rhabdovirus
• Lyssavirus-type 1
• Bullet shaped virus
• Size is 180 x 75 nm
• Has Lipoprotein envelop
• Knob like spikes /Glycoprotein G
4. RABIES VIRUSES ARE SENSITIVE
TO COMMON CHEMICALS
• The virus is sensitive to Ethanol Iodine Soap /
Detergents Ether, Chloroform, Acetone Destroyed at 500
c in 1 hour at 600 c in 5 minutes.
5. Types of Rabies virus
• STREET VIRUS Definition: the
virus recovered from naturally
occurring cases of rabies is called
“street virus”
• Sources: it is naturally occurring
virus. It is found in saliva of
infected animal.
• Incubation period is long i.e. 20 to
60 days
• It is pathogenic for all mammals.
• Cannot be used for preparation of
vaccine.
• FIXED VIRUS Definition: the
virus which has a short, fixed and
reproducible incubation period is
called “fixed virus’’
• Sources: it is prepared by
repeated culture in brain of rabbit
such that its I.P. is reduced &
fixed.
• Incubation period is constant
between 4-6 days
• It can pathogenic for humans
under certain conditions
• Is used for preparation of
antirabies vaccine
6. EPIDEMIOLOGY
• 87 countries contain Rabies, but more cases are
reported in Asia. In Indo-Pakistan rabies is a major public
health problem mainly due to presence of a large no: of
stray dogs. More than 30,000 people died of Rabies
every year in Asia. Every year 10 million people require
treatment and protection from Rabies which is great
Financial loss.
7. EPIDEMIOLOGY
• North America 4 - 8
• Europe 10 - 20
• Latin America 200 - 400
• Africa 500 - 1,000
• Asia 30,000 - 40,000
• Rabies free areas, Australia, New zealand, Taiwan,
Cyprus, Iceland, Ireland, Japan, U.K., Finland, Norway,
Sweden
9. INCUBATION PERIOD
• Normally 3 - 8 wks
• May be short that is 4 days or may be prolonged for years.
• Depends on-
• site of bite
• Severity of bite
• Number of wounds
• Amount of virus injected Species of biting animal
• Protection provided by clothing Treatment taken
11. Sign & Symptoms
• Headache
• fever,
• sore throat
• Nervousness
• confusion
• Pain or tingling at the site of
the bite
• Hallucinations
• Hydrophobia
• Paralysis
• Coma and death
• Bizarre behavior, Agitation,
Seizures, Difficulty in drinking,
Patients will be able to eat
solids, Afraid of water -
Hydrophobia.
• Spasms of Pharynx produces
choking, Death in 1 -6 days.
• Respiratory arrest / Death /
Some may survive.
13. CATEGORY OF BITES (WHO)
• Category I:
• Licks on unbroken skin
• Touching/ feeding animals
• Category II:
• Nibble, cuts, scratches without oozing of blood.
• Category III:
• Licks on mucous membrane or broken skin
• Bites with breach of skin, bleeding
14. DIAGNOSIS
• History
• Signs and symptoms
• Clinical examination
• Detection of antigen by taking skin biopsy using
immunofluorescence.
• virus isolation from saliva & other secretions.
• CSF analysis and CT scan
• ELISA
• PCR
15. TREATMENT
• No established treatment for rabies.
• Isolation of the patient
• Post-exposure prophylaxis
• Antianxiety drugs and sedatives
• Muscle relaxants with curare like action
• Ensure hydration and diuresis
• Cardiac and respiratory support
16. TREATMENT
• 1.POST-EXPOSURE PROPHYLAXIS
• To reduce viral load by elimination from the wound
• To neutrilise the virus at site of entry
• To prevent nerve infection
• To induce systemic immunity
• Includes
• wound treatment
• observation of the animal
• immunization
• advice to patient
17. TREATMENT
• The first human was successfully vaccinated for rabies in
1885 after being bitten by a rabid dog. vaccination is
normally only given to people who are exposed to a
rabid animal or those who are at an increased risk of
being exposed, such as veterinarians and animal care
workers.
18. TYPE OF VACCINE
• NERVOUS TISSUE VACCINE (NTV):
• Derived from adult animal nervous tissue eg. Sheep
• Derived from suckling mouse brain
• Type: Killed viral vaccine Dose: Schedule: 14 doses.
• Duck Embryo Vaccine (DEV):
• Type: Killed viral vaccine Schedule: 14 doses OD not
available in Pakistan.
• CELL CULTURE VACCINES:
• Type: Killed viral vaccine
• Schedule: on 0, 3, 7, 14, 28 day, booster on day 90
19. PREVENTION
• Regist:,licensing & taxation of dog.
• Yearly mass vaccination of dog
• Destruction of stray dogs
• Facilities for diagnosis of rabies in dogs
• Destruction of wildlife where the animals are known to be
the reservoir of infection.
• Publicity
