rabies virus
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Epidemiology
- transmission can occur through the saliva of animals
- animal hosts:
- only 50% of patients with rabies have known exposure; thus diagnosis should be considered in any patient with encephalitis
- case report of rabies from organ transplantation[6]
- outbreak among ferret-badgers 2012, Taiwan
Pathology
- retrograde axonal transport of the rabies virus to the CNS resulting in viral encephalitis
- putative receptor: acetylcholine receptor (muscarinic receptor)[2]
- from the CNS, the virus further spreads to other organs; the salivary glands receive high concentrations of the virus, thus allowing for transmission of rabies virus through saliva
- fatality can occur within anywhere from 2 days to 5 years from the time of initial infection
Genetics
- enveloped with anti-sense single stranded RNA genome
- RNA is tightly bound by viral nucleoprotein
- RNA genome of the virus encodes 5 genes; these genes code for nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G) & viral RNA polymerase (L)
- all transcription & replication events take place in the cytoplasm inside a viral inclusion body, the Negri body
Laboratory
- rabies virus serology
- rabies virus RNA
- rabies virus antigen in tissue
- Rabies virus in brain by light microscopy
- rabies virus identified by culture
- see ARUP consult[5]
Complications
- usually, but not always fatal[6]
Management
- see rabies
More general terms
Additional terms
- animal bite
- human diploid cell rabies vaccine (Imovax, Imovax ID, HDCV)
- rabies immune globulin (RIG, Hyperab Imogam)
- rabies vaccine adsorbed (RVA, RabAvert)
- rabies; hydrophobia
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Jump up to: 2.0 2.1 Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 769
- ↑ Jump up to: 3.0 3.1 Journal Watch 24(1):3, 2004 MMWR Morb Mortal Wkly Rep 52:1102, 2003 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5245a4.htm
- ↑ Rupprecht CE et al Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices MMWR March 19, 2010 / 59(02);1-9 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20300058 <Internet> http://cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm corresponding NGC guideline withdrawn Jan 2016
- ↑ Jump up to: 5.0 5.1 ARUP Consult: Rabies Virus The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/browse-all-topics
- ↑ Jump up to: 6.0 6.1 6.2 Gilbert AT et al. Evidence of rabies virus exposure among humans in the Peruvian Amazon. Am J Trop Med Hyg 2012 Aug; 87:206. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22855749
Willoughby RE Jr. Resistance to rabies. Am J Trop Med Hyg 2012 Aug; 87:205. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22855748 - ↑ Centers for Disease Control and Prevention (CDC) CDC confirms rabies death in organ transplant recipient http://www.cdc.gov/media/releases/2013/s0315_rabies_organs.html
- ↑ Wu S et al Centers for Disease Control and Prevention (CDC) Notes from the Field: Wildlife Rabies on an Island Free from Canine Rabies for 52 Years - Taiwan, 2013. MMWR. February 28, 2014 / 63(08);178-178 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6308a4.htm
- ↑ Rabies, Centers for Disease Control (CDC) http://www.cdc.gov/rabies/