Neurological Infection: Rabies

Question 1

Name of the virus involved?

Answer 1

Lyssavirus Rabies

Question 2

How is it transferred and from which animals?

Answer 2

• How: Bites or contamination of wounds through saliva or neural tissue from animal to human
• Animals
  
  • Skunk
  • Bats
  • Foxes
  • Racoons
  • Monkeys
• Developing countries: dogs, monkeys,

Question 3

Pathogenesis?

Answer 3

Saliva from infected organism travels post bite through the peripheral nervous system towards the CNS. Once in the brain it causes encephalitis and affects spinal cord–> encephalomyelitis.

Question 4

Clinical Features?

Answer 4

• Symtoms from CNS infection
  
  • brain: seizures, confusion, deliriums and hallucination
  • Brainstem: painful contraction of pharyngeal muscles when swallowing liquid lead to hydrophonia and foaming of mouth.
  • Brainstem: cranial nerve dysfucntion

Question 5

Investigation?

Answer 5

• Premortem: direct immunoflurescence or PCR of saliva, CSF, or skin biopsy. Not sensitive enough so might need ot repeat.
• Post mortem: immunofluoresence of brain tissue–> Negri bodies
• Capture Animal and monitor.

Question 6

Treatment?

Answer 6

Post exposure prophylaxis

• Works if CNS symptoms haven’t ensued
• Clean wound with soap and running water to reduce viral particles
• Passive immunisation: Human Rabies Immunoglobulin injected at wound site and rest IM
• Active immunisation