RABIES

A CASE STUDY BY HANNAH IGNI

 Causes

Affected Organ

Signs and Symptoms

R
A Complications
BI
ES Treatment

Prevention
 Causes

• Rabies Infection is caused by the rabies virus.

• Rabies Virus is spread through saliva of infected
animals.
• Infected Animals can spread the virus by biting
another animal or person.
• In rare cases, rabies can be spread when infected
saliva gets into an open wound or the mucous
membranes, such as the mouth or eyes.
• This could occur if an infected animal were to lick an
open cut.
 Causes

High-risk animals include:

o bats
o raccoons
o foxes
o skunks
o woodchucks
o non-domesticated (wild) dogs

Domestic animals like cats, dogs, and cattle can

become rabid if bitten, so it is important to vaccinate
them against rabies. 
 Affected Organ

• Rabies virus affects the central nervous system including the

brain and spinal cord of humans and animals.
• During the incubation period, which is the time between
exposure to the virus and the appearance of symptoms, the
virus travels along nerves towards the brain.
 This process takes at least 10 days, but may
(uncommonly) take as long as 1 year.
• The infection causes inflammation of the brain and
spinal cord that can lead to encephalopathy and, later,
death.

Encephalopathy is any type of disease that changes the

brain's function or structure.
 Signs and Symptoms

After a bite or other rabies exposure, the rabies virus has to

travel through the body to the brain before it can cause
symptoms; this time between the exposure and the
appearance of symptoms is called the incubation period,
and it may last for weeks to months.
 Flu-like symptoms. The first symptoms of rabies may be
very similar to those of the flu including general weakness
or discomfort, fever, or headache; these symptoms may
last for days.
 Signs and Symptoms

 Hydrophobia and aerophobia. Hydrophobia and

aerophobia are pathognomonic for rabies and occur in 50%
of patients; attempting to drink or having air blown in the
face produces severe laryngeal or diaphragmatic spasms
and a sensation of asphyxia; this may be related to a violent
response of the airway irritant mechanisms; even the
suggestion of drinking may induce hydrophobic spasm.
 Psychologic symptoms. As the disease progresses, the
person may experience delirium, abnormal behavior,
hallucinations, insomnia, anxiety, confusion, and agitation.
 Complications

As the virus continues to attack the CNS, there are two different types of
the disease that can develop: furious rabies and paralytic rabies.
• Furious rabies. People who develop furious rabies will be
hyperactive and excitable and may display erratic behavior.
Other symptoms include: insomnia, confusion,
hallucinations, excess salivation or foaming of the mouth,
problems swallowing, fear of water.
• Paralytic rabies. This form of rabies takes longer to set in.
People with the infection slowly become paralyzed, will
eventually slip into a coma, and die. According to the WHO,
20 percent of human rabies cases are paralytic.
 Treatment

• Preexposure prophylaxis. Preexposure, active prophylaxis or

immunization is recommended for veterinarians, veterinary
students, persons who regularly explore or hike in caves, laboratory
workers who are exposed to rabies virus or who handle specimens
considered high risk for rabies, and persons who visit countries
where rabies is a significant problem.
 Postexposure approach to an animal bite. Washing and wound
debridement at the time of a bite is essential, along with careful
cleaning of the wound for longer than 10 minutes; generally, leave
wounds to heal by secondary intention.
 Treatment

• Seek immediate treatment by a doctor after a bite or

contact with an infected animal. The sooner treatment is
started, the more likely a person will avoid developing the
disease. Once symptoms appear, the rabies vaccine and
immunoglobulin are not effective and death is almost certain.
• Postexposure prophylaxis. This is the most common treatment
of rabies.
• The first step in treating rabies and to reduce the likelihood
of developing symptoms is to wash the wound with soap
and water.
• The next critical step to prevent rabies includes a dose
of immunoglobulin against the rabies virus followed by a
strict schedule of injections of the rabies vaccine.
 Treatment

• The immunoglobulin provides immediate protection against

the virus to "bridge the gap" until the vaccine starts working.
• The vaccine helps the person's immune system produce
antibodies against the potentially lethal virus. The vaccine
protects individuals for approximately 2 years.

What is the difference between rabies vaccine and

HRIG?
• A course of rabies vaccines (given into the shoulder muscle) works to
develop long term immunity, but this may take seven days to begin
providing protection.
• For this reason, HRIG is usually given into the wound or site of injury
to provide immediate short term protection while the rabies vaccines
start to work.
 Treatment

Source: WHO Guide for Rabies Pre and Post Exposure Prophylaxis in Humans (Updated 2014)
 Prevention

You can prevent being infected with the rabies virus by

remembering these tips:
 do not feed wild animals and stay at a safe distance when
observing them
 supervise children and teach them not to approach or touch
animals they do not know
 stay away from animals showing signs of rabies
 do not bring home wild animals
 if you suspect an animal is rabid, stay away from it and contact
the local authorities
 if you have pets or livestock, make sure to vaccinate them
against rabies
THANK
YOU