Virus
Rabies
search
Rabies
See Also
Dog Bite
Rabies Prophylaxis
Rabies Vaccine
Epidemiology
Worldwide: Responsible for 59,000 deaths worldwide per year
Children under age 15 years account for 40% of cases
U.S.
Eight human cases of Rabies per year
Up to 8000/year in U.S. of documented cases of Rabies in animals
Pathophysiology
Transmitted by bite of infected mammals
Saliva
, brain and other nerve tissue are infectious
Blood, urine, and stool are not infectious
Highest risk animals
Bats
See Bat Bite
Responsible for most U.S. cases of Rabies (87% of cases 1980-2015)
Dogs
See
Dog Bite
Worldwide, these are main vector for infection
Responsible for 11 of 31 U.S. human Rabies cases 2003-2016
Rabies is less common in dogs (70 cases/year in U.S.)
Cats
See
Cat Bite
Most common domesticated animal with Rabies in U.S. (257 cases of cats with Rabies in 2012)
Raccoons
Skunks
Foxes
Coyotes
Bobcats
Woodchucks
Ferrets
Symptoms
Early
Local radiating
Paresthesia
from bite site
Malaise
Nausea
Pharyngitis
Late
Restlessness
Hallucination
s
Aerophobia and hydrophobia are pathognomonic
Signs
Early
Wound
Inflammation
Hyperesthesia at wound site
Late
Dysarthria
Hoarseness
Aphonia
Dysphagia
for fluids
Shallow or irregular breathing
Seizure
Delirium
Opisthotonos
stimulated by lights or noises
Hyperactive
Deep Tendon Reflex
es
Nuchal Rigidity
Abnormal
Babinski Reflex
(Up-going toes)
Terminal signs
Flaccid Paralysis
Hospitalization <1 week after symptom onset
Coma
within one week of encephalopathy signs
Death
Labs
Saliva
Contains virus
Microscopic exam
Brain and spinal cord of suspected infected animal
Live Observation of suspected infected mammal
Management
See
Rabies Prophylaxis
See
Dog Bite
Prevention
Rabies Vaccine
For
Rabies Postexposure Prophylaxis
and preexposure prophylaxis
Rabies
Immunoglobulin
Rabies Postexposure Prophylaxis
Avoid bat exposure
Remove bat roosts from home
Bats trapped within a home living space are more likely to be sick (disabled navigation)
Pets should be vaccinated against Rabies
In U.S., of pets causing a bite evaluated in ER, only 45% of dogs and 8% of cats were vaccinated against Rabies
Test for Rabies in pets who succumb to illness quickly
References
Swaminathan and Hope in Herbert (2018) EM:Rap 18(12): 11-2
Messenger (2002) Clin Infect Dis 35:738-47 [PubMed]
Wilde (2003) Clin Infect Dis 37:96-100 [PubMed]
Type your search phrase here