Rabies

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Rabies
Rabies in Humans

Rabies is a lethal disease caused by a viral infection, which is transmitted through the saliva of certain animals.

Causes

Rabies is caused by a virus, which belongs to the Rhabdoviridae family and the Lyssavirus genus. The virus can get into human body through the bites of sick savage or pet animals (cat, dog, fox, wolf, etc.). The rabies virus persists in the sick animal's saliva and the disease is transmitted when the saliva enters through skin lesions (in some cases, when a sick animal licks wounded skin). Once in the body, the virus travels through the peripheral nerves into the brain, where it causes inflammation.

Signs and Symptoms

The incubation period of rabies (the time from the entering of the virus to the beginning of the disease) is long enough – from one week to three months, in some cases even up to one year or more. During this time, certain signs of rabies may become visible at the bite site: swelling and redness; the patient may feel fatigue, malaise and weakness.

The signs of rabies, which are divided into two stages, usually occur after the incubation period. During the first stage of rabies (hydrophobia) the patient might be wandering around; also, he/she has dilated pupils, is anxious, paranoid and might have hallucinations and delirium. The patient's skin can get bluish, the voice might become hoarse, heavy sweating and swallowing disorder might occur. The swallowing disorder manifests itself in dripping saliva as well as inability to swallow liquids. As a result, later water phobia begins. The patient may have extremely high fever, reluctant to any treatment.

During the second stage of rabies the patient usually calms down, but highly significant dysphagia still remains. The flow of saliva as well as seizures are becoming more intense and can lead to paralysis. The outcomes of rabies are often fatal (the respiratory center becomes paralyzed and the patient usually dies from respiratory failure).

Diagnostics

In order to determine whether an animal has rabies, some laboratory tests of its brain (to detect the rabies virus) are performed. The examination of an infected human is more difficult. Special methods are used to find the virus in the infected tissues. Another method is to contaminate laboratory mice with the patient’s saliva.

Blood tests might show non-specific inflammation.

Treatment

Anti-rabies treatment is quite specific - the patient is hospitalized in a specific dark ward, adequate diet is prescribed (when the patient cannot swallow, special intravenous solutions are given). Also, intravenous anti-rabies immunoglobulin (anti-rabin) is administered. Finally, symptomatic treatment is given - muscle relaxants, sedatives and etc.

Prophylaxis

A crucial step in rabies prevention is vaccination.  Animal bitten people are vaccinated on the first, then the third, seventh and the twenty-eighth day.  A special immunoglobulin is injected into the wound and around it.

Prognosis

Rabies has a particularly poor prognosis. After the appearance of the symptoms, regardless of the treatment, these patients almost always die. However, rabies is quite rare because of mass vaccination of bitten people. If the patient is vaccinated immediately after the bite, the disease does not occur.

   

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