4. Rabies
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natashabihola94. Rabies
Uploaded by
natashabihola9RHABDOVIRUSES
Dr. Sachin Patel
Rhabdoviruses
• A Bullet shaped virus/ Enveloped
• Contains ss RNA virus
• Rhabdoviridae – infects mammals.
• Important virus
Lyssa virus- Rabies virus
Rabies virus
• Bullet shaped virus
• Size is 180 x 75 nm
• Has Lipoprotein envelop
• Knob like spikes /Glycoprotein S
• Genome un-segmented
• Linear negative sense RNA
Rhabdovirus
Resistance
• The virus is sensitive to
Ethanol
Iodine
Soap / Detergents
Ether, Chloroform, Acetone
Destroyed at 50 c in 1 hour
at 60 c in 5 minutes.
Host Range
• Animals effected Cats, Cattle, Foxes, and
BATS
• Intermediate effect on Humans and Dogs,
• Fowl are resistant,
Man’s best friend - But can
spread Rabies
Bats too can spread Rabies
Rabies
• Rabid Dog biting Humans lead to Rabies
• Hydrophobia Fear of Water
• Saliva of Rabid dogs Transmit virus
First successful Vaccination
• Pasture’s success – Vaccination
Fixed virus from Rabbit injected into Joseph
Meister
Transmission
• Abrasions or scratches on skin.
• Mucous membrane exposed to saliva.
• Most frequently via deep penetrating bite
wounds.
• Other routes.
Inhalation in bat infected caves.
Ingestion of dead /infected animal meat
Corneal transplantation
Pathogenesis of Rabies
• Bite by Rabid dog or other animals
• Virus are carried in saliva virus deposited on the
wound site.
• If untreated 50% will Develop rabies.
• Rabies can be produced by licks and corneal
transplantation.
• Virus multiply in the muscle ,connective tissue,
nerves after 48 – 72 hours.
• Penetrated nerve endings.
Pathogenesis
• Virus travels through axoplasam toward
the spinal cord, at the rate of 3 mm/hour,
• Towards the brain
• Spread from brain centrifugally to various
parts of the body.
• Multiplies in the salivary glands and shed
in the saliva.
• Cornea, facial tissues skin.
Pathogenesis
• Incubation 1 – 3 months.
• May be average from 7 days to 3 years.
• Stages of the disease.
Prodrome
Acute encephalitis.
Coma / Death.
Clinical Findings
• Bizarre behavior.
• Agitation
• Seizures.
• Difficulty in drinking. - Hydrophobia
• Patients will be able to eat solids
• Afraid of water - Hydrophobia.
• Even sight of sound disturbs the patient.
• But suffer with intense thirst.
• Spasms of Pharynx produces choking
• Death in 1 -6 days.
• Respiratory arrest / Death / Some may survive
Laboratory Diagnosis
• Clinical differentiation other cases of Encephalitis.
• Post mortem Diagnosis by
By demonstration of Negri bodies.
Isolation of virus fro Mice brain
inoculation.
tissue culture on culture lines
W 138, BHK,
PCR emerging method.
IF methods corneal impression method.
Diagnostic methods
• Antigen detection by specific Immuno
fluorescence.
Ante-mortem - Conjunctival, skin biopsy from
nape of neck.
Postmortem impression from surfaces of
salivary glands Hippocampus,
Histological examination
ELISA specific antibody detection.
PCR
Negri bodies
in Brain Tissue
Prophylaxis
• Before exposure to infection
In Veterinary surgeons animal handlers.
Specific Prophylaxis
After exposure to Dog bite.
Local treatment
Cauterization,
Scrub with Soap and clean.
Use cetavalon, tincture of Iodine
Antirabic serum Don't suture
Preexposure vaccination
• Indicated in
Laboratory workers.
Veterinarians and technical staff.
Bat handlers.
Vaccines
• Semple vaccine
Contain 5 % suspension of infected Sheep brain
material , ( Infected with fixed virus )
Inactivated with Phenol at 370c
Vaccines available after inactivation with Beta
propiolactone Used in India
Not Used in Developed countries because of Neural
complications.
Dosage of Neural Vaccines
Bite Semple Vaccine BPL vaccine
Class I 3 ml x 7 days 2 ml x 7 days
Class II 5 ml x14 days 3 ml x10 days
Class III 10 ml x14days 5 ml x10 days
Given subcutaneously into anterior abdomen wall
Complication Neuroparlytic complications
Only few countries use it
Cell culture Vaccines in
India
1 Human diploid cell vaccine.
2 Purified chick embryo cell vaccine
[Link] Vero cell vaccine
Human Diploid Cell
Vaccine
• Koprowsky, Viktor, Plokin
• Inactivated in Betaproprionate.
• No serious side effects.
• Human Diploid cell vaccines purified .
• Sub Unit vaccines in
progress/developed.
Human Diploid Cell Vaccines
• Dosage
• Preexposure prophylaxis
0 – 7 – 21 – or 28 – 56 days
A booster after 1 year,
Repeat once in 5 days,
Post exposure Prophylaxis
Six doses
0 -3 -7-14 – 30 - 90 days
Given IM or SC in the Deltoid region
Don't inject inGluteal region.
Passive Immunization
• Human Rabies Immunoglobulin HRIG
• High Risk bitten on face and neck
• Given a dose of 20 IU /Kg wt
• Half at the site of bite and rest IM route.
• Active immunization should be initiated
with passive immunization.
Epidemiology
• No Danger of Nursing Rabies patients but do
take precautions
• Any animal bite can cause Rabies except Mice
• BATS in caves in spread the disease by
respiratory disease.
• India around 30,000 die every year with Rabies.
• Vaccination of the Dogs and Licensing of the
Dogs