Microbiology : 2 Semester

MICROBIOLOGY (2nd SEMESTER)
DR. ELIZABETH P. QUILES
You have a light inside of you that brightens the world and a smile so infectious that
captures the heart of anyone. ❤
RABIES VIRUS (May 28, 2021)
Characteristics of Rabies Virus

 Single-stranded, negative sense RNA virus, enveloped
 Rod or bullet-shaped
 The only medically important Rhabdoviridae
 Has wide host range
 Only one serotype
Structure
RNA encodes 5 proteins
1. Nucleoprotein (N)
 Major structural proteins that protects the RNA from ribonuclease
digestion & maintains the RNA in configuration for transcription.
2. Large & Small non-structural proteins (L)
3. Non-structural proteins (NS)
 Constitute the RNA dependent-RNA Polymerase
4. Matrix protein (M protein)
5. Glycoprotein (G protein)
 Viral attachment proteins that plays a major factor in a
neuroinvasiveness and pathogenicity of rabies.
 Generates neutralizing antibodies.
Reactions to Environmental Conditions

Can survive:
 4°C for weeks
 -70°C for years
Inactivated by:
 CO2
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Killed by:
 Ultraviolet
 Sunlight
 X-ray
 Heat (1 hour at 50°C)
 Lipid solvents (ether, sodium deoxycholate)
 Trypsin
 Detergents
 Extremes pH
Sources of Infection
Major sources:
 saliva in bite of rabid animal
Minor sources:
 aerosols in bat caves containing rabid bats
 Rats & rodents do not transmit rabies

 Foxes, wolves, coyote, jackass (high susceptibility to rabies virus)
 Dogs, Sheep, Horse, Goats & non-human primates (moderate susceptibility
to rabies)
Rabies is ENDEMIC in the Philippine

98.5 % cases is due to domestic dogs
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Rabies
 Acute, rapidly progressive fatal encephalitis
 55,000 deaths annually
 affects all warm-blooded animals
 Worldwide distribution affects all warm-blooded animals
 Enters the body through breaks in the skin or direct contact with mucosal surfaces
 Cellular receptor → nicotinic acetylcholine receptor (found in muscles)
Mode of Transmission:
1. bites of rabid animals
2. non-bites - scratching, licking of open skin, inhalation, corneal & organ
transplantation
Incubation Period: 6 days to 6 months (6 years)
Factors that determine the length of Incubation Period:
A. Site of the bite
 the nearer is in the central nervous system=the shorter is the incubation period
B. Severity of the bite
 the more severe & more numerous of bile=the shorter the incubation period
C. Condition of the animal prior to the bite
 it provokes the animal=it salivates a lot
D. Condition of the victim
 is there any underlying disease condition that may shorten the incubation period
E. Amount of virus in the inoculum
 the bigger the size of the inoculum= the shorter would be the incubation period
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2 Forms
1. Dumb or paralytic → extreme bradycardia, paresthesia, flaccid paralysis
 30% of cases
 bat infected
2. Furious or fulminant form → hydrophobia, aerophobia, CNS lability
Prodromal Phase
 Non-specific symptoms
 Usually last for 2-10 days
 Malaise, anorexia, headache, photophobia, nausea & vomiting
 Fever
 Paresthesia (itching) at the bite site
Acute Neurologic Phase

 Last for 2-7 days
 NS dysfunction → nervousness, apprehension, hallucinations & bizarre behaviour
 General sympathetic overactivity → lacrimation, pupillary dilatation, increased
salivation & perspiration
 Painful throat muscle spasms → Hydrophobia or aerophobia
 Once symptoms develop → rabies encephalitis is almost always fatal and cause of
death is CARDIOPULMONARY ARREST
 Hydrophobia: is the result of the painful spasm of the throat and the
laryngeal muscle on site of water.
Laboratory diagnosis:
 Animals is observed for 10 days for any signs of encephalitis, rabies or unusual
behaviour.
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Diagnosis
A. Histopath → Negri bodies
B. direct Immunofluorescenses → highly specific & sensitive
C. Culture - hazardous
D. Serology – late results (antibodies)
Withdrawal phase: last for 2 to 10 days

Symptons:
 Myalgia  Fever
 Anorexia  Nausea & vomiting
 Headache  Paresthesia
 Photophobia  Itchy
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Rabies Prevention
Post-exposure prophylaxis Pre-exposure prophylaxis
After a bite/exposure Before a bite/exposure
Vaccine, immunoglobulin or both Vaccine for individuals at risk of
exposure
Active immunization
 Purified verocell rabies vaccine (PVRV)
 Purified duck embryo vaccine (PDEV)
 Purified chick embryo vaccine (PCEV)
 Human diploid cell vaccine (HDCV)
Passive immunization:
 Equine rabies immunoglobulin (ERIG)
 Human rabies immunoglobulin (HRIG)
Local wound care

 allow wound to bleed & wash thoroughly with soap & running water
 do not suture lacerations
 do not apply creams or occlusive dressings
 ATS & antibiotics
Categories of Exposure
Category 1:
 feeding/touching the animal
 licking of intact skin
 exposure to symptomatic patients by sharing of eating & drinking utensils
 casual contact to symptomatic patients (talking to, visiting, feeding, routine health
care delivery)
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Category II
 Nibbling of uncovered skin with or without bruising or hematoma
 Minor/superficial abrasions/scratches with or without bleeding, including induced
bleeding
Category III
 Licks on broken skin & mucous membranes
 Exposure to rabies patients through bites, contamination of mucous membranes,
open skin, mouth-mouth resuscitation
 Unprotected handling of infected carcass
 Ingestion of raw infected meat
 All category Il on head & neck
 Exposure to bats
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Category 1
 Wash exposed skin immediately with soap and water
 No vaccine or RIG needed
 PrEP may be considered for high risk persons
Category II
 Wash wound with soap and water
 Start vaccine immediately
 Complete vaccination regimen until Day 7 regardless of status of biting animal
 RIG is not indicated
Category III
 Wash wound with soap and water
 Start vaccine and RIG immediately
 Complete vaccination regimen until D7 regardless of status of biting animal
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Microbiology : 2 Semester

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Microbiology : 2 Semester

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MICROBIOLOGY (2nd SEMESTER)

DR. ELIZABETH P. QUILES

RABIES VIRUS (May 28, 2021)

Characteristics of Rabies Virus

Reactions to Environmental Conditions

 Rats & rodents do not transmit rabies

Rabies is ENDEMIC in the Philippine

Acute Neurologic Phase

Withdrawal phase: last for 2 to 10 days

Local wound care

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