Rabies:

Introduction RHABDOVIRIDA:
Bullet shapted, enveloped viruses with SS RNA genome are known as Rhabdovirus.
• Rhabdoviridae contains two genera :
i. Vesiculovirus containing vesicular stomatitis virus.
ii. Lyssavirus containing Rabies virus.
Rabies virus # is a unsegmented, linear negative, Neurotropic, RNA virus which causes
(Lyssavirus direct zoonosis(That infection which transfers from animals to human particularly carnivorous such as dogs, cats, jackals and
serotype 1) wolves) including man called as RABIES.
Genome codes for 5 proteins.
1)Glycoprotein (G)
2)Nucleocapsid (N)
3)Polymerase (L)
4)Matrix (M)
5)Nucleocapsid small (NS)
1. Glycoprotein (G) 2. Nucleocapsid (N) 3. Polymerase (L) 4. Matrix (M) lies 5. Nucleocapsid
Structural – Group specific viral RNA replication between core and small protein (NS)
component of common to all Lyssa & transcription. envelope, packages associated with
surface spikes – viruses.Associated RNA & proteins. nucleocapsid, acts as
produces with RNA to form polymerase.
neutralizing ribonucleoprotein
antibodies. ( RNP )
 # Virus excreted in the saliva of rabid animals is called as ‘street virus’ which is pathogenic for all mammals and
has long variable incubation period.
# In most of the world, dog is the most important vector.
# Not form Negri bodies and not multiply in extraneural tissues.
# Rabies is dead end infection.
#Most effective natural barrier to rabies - water.
# Mode of • Animal bites - MC
transmission • Licks on abraded skin and abraded or unabraded mucosa.
: • Respiratory (aerosol) transmission.
• Person to Person - rare
• Also by corneal and organ transplants.
Incubation # Highly variable depending on the site of bite (i.e. actual distance that the virus has to travel to
period : reach to CNS), severity of bite etc.
Clinical • Virus spreads centripetally from site of infection (striated muscle) than ascends through nerve associated
features tissue space, and than spreads centrifugally in peripheral autonomic nerves to many tissues.
• Salivary gland invasion is crucial for transmission of virus.
• Most characteristic pathologic finding in CNS is the formation of cytoplasmic inclusions called Negri Bodies (composed of
finely fibrillar matrix and rabies virus particles) within neurons of Ammons horn, cerebral cortex,
brain stem, hypothalmus, purkinje cells of the cerebellum and dorsal spinal ganglia.
Stages: # It has four stages :
Prodrome: b. Acute Neurologic Phase: c. Coma:
Early & non-specific 1)Furious. Sets within 10 days
Malaise, fatigue & headache 2)Paralytic Lasts for days,
Anorexia, fever & chills 1. Furious: Respiratory arrest.
Cough & sore throat Hyperactivity, disorientation, hallucination & abnormal Death.
Nausea, vomiting & diarrhoea. behavior.
Wound site has Agitation, thrashing, running & biting, alternating with
Pain periods of calmness.
Tingling More than 50% have hydrophobia.
Numbness # Spasm of pharynx, larynx & diaphragm leading to
Hyperaesthesia choking.
Paraesthesia #Due to sensory stimuli or spontaneous.
# 2. )Paralytic: symmetrical.
#Occurs in 20% of cases # Disorientation & stupor.
#No hyperactivity
#Paralysis maximum in bitten #extremity, diffuse or
Diagnosis : # Immunofluorescence of infected tissue (corneal impression
smear, skin biopsy or brain) and by virus isolation from saliva and other secretions.

Prevention # Types of Vaccine :

ii. Duck embryo vaccine (DEV)

iii. Cell culture vaccine(Human diploid cell (HDC) vaccine and it is used for both pre and post of Non human origin .
The WHO recommended that culture of HDC line should be
replaced by culture of animal cell line.)
PROPHYLAXIS a) Post – exposure b) Pre – exposure
: a. Post – exposure:
#Cleaning of wound with detergents.Vaccination with Human Diploid Cell vaccine( HDCV) on day 0,3,7,14 & 28
#And Human Rabies immunoglobulin (HIRG) (20 IU / Kg body wt) Active & passive immunization .
# Post - exposure prophylaxis – Combined administration of single dose of antirabies serum with a course of
vaccine, and local treatment of wound is the best specific prophylactic treatment after exposure of man to
rabies.
b) PRE – EXPOSURE:
Preexposure prophylaxis – given to laboratory staff working with rabies virus, veterinarians etc.
• Cell culture vaccines on 0, 7, 28 days.
• If titre of neutralizing antibody in serum taken after 1 month of 3rd dose, is less than 0.5 iu/ml than administer booster until
antibodies become demonstrable.