83. Rabies (diagnosis, prevention, control, zoon.).

Question 1

Diagnosis?

Answer 1

Rabies (Lyssa, Tollwut)

Rhabdoviridae, Lyssavirus, Rabies virus (with serotypes!)

Diagnosis

• Epidemiology ʹ clinical signs ʹ post mortem lesions ʹ histology
• Laboratory diagnosis
• Detection of the virus (IF (95-99% sensitive), PCR (<95%), virus isolation + IF)
• Infection of mice (9-28 days
• 9-20 days (12-13): virulent virus
• 5-6 days: fix virus
• Detection of antibodies (VN, ELISA) - vaccine control
• dont use ELISA no immune response if infection, so don’t use for diagnosing but to measure antibody titre
• antibody titre

Question 2

Prevention, control- Notifiable disease

Answer 2

Prevention, control - Notifiable disease

• Extermination of rabid animals/suspected
• Animals bitten by rabid animals (herbivorous / carnivorous)
• Animals suspected of infection:
• Herbivore: emergency slaughter or vaccine post exposition
• Carnivore: exterminate or observe 90 days (if owner can prove they have regular vaccines)
• Observation of carnivorous animals (suspected to be infected, problematic) Æ observe for 14 days (shed few
• days before the clinical signs show)
• Eradication of urban rabies (list of dogs + vaccination) (HUN: eradicated in 1937)
• Vaccination: dog: at 3 months, booster 4-6 month, yearly; cat?
• Both preventative and post exposition
• Rabies free countries: quarantine, vaccination (0.5 IU/ml Atb titre) ʹ VN test
• Sylvatic rabies
• Kill foxes
• Oral vaccination
• SAD B-19 (attenuated, heat resistant, harmless virus)
• Vaccinia virus vector ʹ live Bait; Control (marker, antibody) ʹ chicken head/block (buljong)
• Disperse 15-20 dose/km2 (airplane) ʹ they will eat!
• 1992 along the Austrian border; 1994 West-Transdanubia; 1996 Transdanubia; 2001 MidHungary; 2004 East-Hungary; 2011 60 km wide zone: Southern and Eastern border

Question 3

Prevention of bat rabies?

Answer 3

Prevention of bat rabies

• Vaccines: genotype 1 vaccine
• Dog, cat, farm: produced in cell culture (EU)
• inactivated (lower titre), adjuvated (NO side effects)
• Fox: live attenuated, vector vaccine
• (PAST) Brain vaccines (Pasteur, Semple, Hempt - myelin)
• Egg vaccines (LEP, HEP)
• NOW- Tissue culture vaccines (fix virus, Flury, SAD, ERA, Vnukovo-32)
• Subunit vaccines
• Recombinant virus vaccines (PO, SC, IC)
• Application:
• Prevention:
• dog, 3 or 6 month, booster 4-6 weeks monovalent
• vaccine, yearly
• Cat: recommend, also can in horses
• post exposition (Rabisin 1. (4x), 7. (3x), 21. (3x) days = 10 doses total
• Dogs, farm animal after first 2 days
• Takes virus longer to reach brain, so have enough time to get high enough Atb titre against virus

Question 4

Public health impact?

Answer 4

Public health impact

• Infection:
• Bite, saliva, wound (carnivorous, bat, farm animals)
• Transplantation: Germany 3/6 cases (2005), US 3/3 (2004)
• Aerogenic (urine of bat ʹ cave)
• Clinical signs: general unwell, aggressiveness, spasm, paralysis, Death
• Prevent: Information, wound toilette, vaccination
• Survival:
• 5 persons showed clinical signs, vaccinated
• 1 person non-vaccinated, USA, infected from a bat (2004) +2
• Milwaukee protocol
• ~70,000 death/year worldwide
• Vaccination of humans
• Prevention: vaccine: 0, 7, 21/28 (0, 30, 60) day + 5 years
• Post exposition:
• Vaccine: 0, 3, 7, 14, 30 day
• Human hyper immune serum + vaccine: 0, 3, 7, 14 days(USA)
• Immune deficient people: hyper immune serum, serological control
• Vaccines: Verorab (Vero cells), Rabivac (human diploid cell), Rabipur (chicken embryo
• fibroblast

Question 5

Bat rabies 1: europe, australia

Answer 5

Bat rabies I: Europe, Australia

• N EU: DK, D, NL, PL; Hungary: 1999
• Infection rate: 5-20%
• Europe: EBLV-1 (Gt 5), EBLV-2 (Gt 6), W. Caucasic; Australia: ABLV (Gt &)
• Insect and fruit eating bats limits spread to other species
• Colonises: marten, sheep, cat; no spreading
• Transmission to other species is uncommon
• Spreading with aerosols was not observed
• Clinical signs are rare: changed behaviour (attack, navigation issues), paralysis, often asymptomatic
• Humans can be infected if bitten or contact
• Prevent: vaccine!

Question 6

Bat rabies 2 vampire bat Gt 1?

Answer 6

Bat rabies II: Vampire bat Gt 1

• LatAM: Mexico ʹ North-Argentina
• Desmodus rotundus: bird, amphibians, reptiles, rodents, farm animals, human
• Diphylla ecaudata: bird
• Diaemus youngii: bird
• Prefers farm animals (BO) infect with blood sucking (local anaesthetic) ʹ regurgitate blood
• 1st genotype but it can be differentiated from classical strains
• Clinical signs: change behaviour, paralysis
• Public: Ho infect by contact/bite
• Vaccination (post expo); avoiding contact with bats, avoid wound