Rabies
Definition
A viral disease that causes acute inflammation of the brain
Spread by dogs with rabies disease
Etiology
Rabies virus - a Lyssavirus
Inoculated by rabid dog bite ( or Bat), contact with the saliva of the animal)
The virus multiplies in the muscle at the site of bite and then gets access to the peripheral nerve and then reaches CNs
Clinical Features
The disease is diagnosed only after the symptoms develop
Fever
Headache
Tingling at the site of dog bite
Excessive saliva
Violent movements
Uncontrolled excitement
Fear of water - hydrophobia
Inability to move parts of the body
Partial paralysis
Anxiety
Insomnia
Confusion
Agitation
Hallucination
Delirium
Coma
Once symptoms start the result is always death
Icubation period usually one to three months
The time depends on the distance the virus must travel to reach the CNS
Lab Investigation
Fluorescent antibody test (FAT)
Treatemet
Wash the bite area with soap and providone iodine well for 15 mts to decrease the virus load
Post exposure prphylaxis is effective; Get vaccinated with Antirabies vaccine as soon as possible.
Anti rabies immunoglobulin may be administered
Follow Milwaukee protocol - induced coma for about a month to decrease damage to a functioning brain and for the immune system to recognize the infection.
Given Ketamine, midazolam, ribavirin and amantadine
Prevention
Animal control
Animal vaccination
Humans vaccinated if at risk of contracting the disease
