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Rabies

Rabies
Rabies has the highest mortality rate of any human disease once the symptoms have fully materialised. It occurs in most animals in nature from dogs and cats, to horses and rats, to skunks and bats. It is equally fatal to animals and humans. The virion is RNA containing enveloped particle, rounded on one end and flattened on the other to give the appearance of a bullet.

The virus enters the tissue during a bite, skin wound, or abrasion from an infected animal. Though, disease associated with saliva, the urine, lymph, blood or milk may be equally infectious. In 1978, a woman died of rabies in Boise, Idaho, due to cornea transplant from an infected person. The incubation period for rabies varies according to the number of virions introduced to the wound and the wound's proximity to the central nervous system. It may vary from six days to one year, and generally shorter in children than in adults. The virus multiplies in the muscle tissue and then spreads rapidly to the neural pathways. Early signs of rabies are tingling, burning or coldness at the bite site along with fever and headache. Later, due to increased muscle tone, patient becomes alert, aggressive and show unusual behaviour.

Due to paralytic effect in pharyngeal muscles, difficulty in swallowing is felt. Salivation becomes profuse and saliva drips from the mouth as it cannot be swallowed. This symptom together with brain degeneration increases the persons reactions to the sight, sound or thought of water. Traditionally, the disease has been called hydrophobia, meaning "fear of water". The paralysis spreads and death occurs within a few days by respiratory inhibition. Dogs are usually infectious for ten days before they show rabies symptoms.

Due to this a dog may be held for observation after a bite. If ten days pass without any event it may be assumed that the dog was not contagious at the time of bite. If the dog dies immediately after the bite, its brain tissue sample could be inoculated to laboratory mice that should show symptoms within three weeks if the dog was rabid. A person suffered from animal bite should precautionary treated as if the animal were rabid. The wound is flushed thoroughly with soap and any antiseptic be applied. Serum containing anti rabies antibodies should be injected to the base of wound. Thus an interferon is helpful. A tetanus shot may also be given if not given during last ten years or so.

A combination of vaccine and antibodies are then injected to neutralise the virus before it reaches the central nervous system. Early vaccines contained viruses from chick embroys or rabbit nerve tissue. But these were found to be allergic. Later, a vaccine was produced from viruses cultivated in duck embryo tissue inactivated with propiolactone. Duck embryo vaccine (DEV) was injected into the abdominal fat at a 45° angle on each 14 successive days or more, if needed. This virus is absorbed slowly from among the fat cells and exposes the body to virus for a longer period.

The injections were painful due to the sensitivity of abdominal muscles. Recently, a new rabies vaccine, Merieux human diploid cell vaccine, is shown to produce high amount of antibodies after only three injections in the arm. The viruses are cultivated in human embryonic lung cells, and since human tissue is used, allergic responses are minimum. This vaccine, licensed in 1980 in U.S.A. is now used in other countries including India. It is an expensive vaccine. Rabies in animals occurs in two forms:

1. Furious Form -. Characterised by violet symptoms as the animal becomes wide eyed, drools, and attacks anything in sight. It becomes paralysed, lapses into coma, and dies.
2. Dumb Form - Recognised by deep lethargy and dies suddenly of paralysis.

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