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- $Unique_ID{BRK04164}
- $Pretitle{}
- $Title{Rabies}
- $Subject{Rabies Hydrophobia Lyssa Cerebral Malaria Guillain-Barre Syndrome
- Herpes Simplex Encephalitis Tetanus Typhoid}
- $Volume{}
- $Log{}
-
- Copyright (C) 1991 National Organization for Rare Disorders, Inc.
-
- 846:
- Rabies
-
- ** IMPORTANT **
- It is possible that the main title of the article (Rabies) is not the
- name you expected. Please check the SYNONYM listing to find the alternate
- names and disorder subdivisions covered by this article.
-
- Synonyms
-
- Hydrophobia
- Lyssa
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Cerebral Malaria
- Guillain-Barre Syndrome
- Herpes Simplex Encephalitis
- Tetanus
- Typhoid
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Rabies is an infectious disease that can affect all species of
- warmblooded animals, including man. This disorder is transmitted by the
- saliva of an infected animal and is caused by a virus (Neurotropic
- lyssavirus) that affects the salivary glands and the central nervous system.
- The symptoms may lead to serious complications if the virus is not treated
- immediately.
-
- Symptoms
-
- The symptoms of Rabies usually develop within 20-60 days after a bite or
- scratch from an animal infected with the rabies virus. The incubation period
- is the time between the exposure and the appearance of the first neurologic
- symptoms. The incubation period is usually shorter when the sight of
- exposure is closer to the brain. The initial symptoms may be a general
- feeling of discomfort or uneasiness, nervousness, anxiety, insomnia,
- depression, loss of appetite, fever, chills, cough, sore throat, headache,
- nausea, vomiting, and pain at the site of exposure. Serious neurological
- symptoms usually present themselves two to ten days after the initial
- symptoms. There are two types of syndromes that may develop during this
- neurological period: furious and/or paralytic (sluggishness and early
- paralysis).
-
- The hyperactive or "furious" syndrome is usually characterized by
- thrashing, agitation, biting, spasms of the pharynx and larynx, choking,
- gagging, fear of water (hydrophobia), hyperventilation (very rapid
- breathing), and an alteration in the rhythm of the heart beat (cardiac
- arrhythmias). In about twenty percent of the patients a "paralytic" syndrome
- may occur. This syndrome is characterized by paralysis that starts at the
- bottom of a limb and moves upward (especially in the extremity that has been
- bitten), increased blood pressure, rapid heart rate, confusion,
- hallucinations and disorientation. During this time the patient may have
- increased periods of hyperactivity, stiffness in the back of the neck, and an
- abnormal increase in the number of cells in the cerebrospinal fluid ending
- with the onset of coma or respiratory failure.
-
- Causes
-
- Rabies is caused by a lyssavirus (a form of virus that causes encephalitis)
- that affects the saliva and nervous system. Most cases of rabies in humans
- are caused by a bite or scratch from an infected animal. In at least two
- known cases of rabies has been contracted by breathing the air caves where
- there was a large number of infected bats. There have also been six recorded
- cases of rabies acquired by humans after cornea transplants from donors who
- had undiagnosed rabies.
-
- Affected Population
-
- Rabies in humans has been almost completely eliminated in most developed
- countries. The vaccinations of domesticated animals and elimination of stray
- dogs has helped control this problem. In the 1980's the U.S. Centers for
- Disease Control had one case per year reported. In the United States rabies
- is found primarily among wild animals such as skunks, foxes, bats, and
- raccoons. There were 49 cases of human rabies reported in the U.S. between
- 1960 and 1986. Only 7 of the 49 cases were acquired by exposure to rabid
- domesticated animals. The remainder were from wild animals.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Rabies.
- Comparisons may be useful for a differential diagnosis:
-
- Cerebral Malaria is a serious complication of falciparum malaria. This
- disorder is usually seen in infants, pregnant women, and travelers who are not
- immune to parasites of certain regions. It is caused by a communicable
- parasite and is spread through the bite of the Anopheles mosquito. The
- symptoms may be fever of up to 104 F, severe headache, drowsiness, confusion,
- or delirium. (For more information on this disorder choose "Malaria" as your
- search term in the Rare Disease Database).
-
- Herpes Simplex Encephalitis is a sporadic disease caused by a
- complication of the Herpes Simplex Virus infection. The symptoms of Herpes
- Simplex Encephalitis may be fever, headache, convulsions, disorientation,
- delusions, personality changes, and coma. Paralysis may occur in less than
- half of the cases. Antiviral therapy is the treatment of choice. The
- prognosis is improved when the treatment is given during the early stages of
- the disease. (For more information on this disorder, choose "Herpetic
- Encephalitis" as your search term in the Rare Disease Database).
-
- Tetanus (Lock Jaw) is a neurologic syndrome caused by the microorganism
- Clostridius tetani. This microorganism usually enters the body through
- wounds, injections, or skin ulcers. The incubation period of tetanus is
- usually seven to twenty one days. Symptoms of this syndrome may be a closed
- mouth (Lock Jaw), low-grade fever, fear, restlessness, difficulty swallowing,
- stiffness, alteration in the rhythm of the heart beat, muscle spasms, and
- convulsions. These symptoms usually last for three to four weeks. Although
- tetanus is a treatable disease, vaccination is recommended during infancy and
- every few years thereafter.
-
- Typhoid is a bacterial infection caused by the bacterium Salmonella
- Typhi. Contaminated food of water is the source of typhoid is most cases.
- The major symptoms of this infection may include high fever, headache, loss
- of appetite, fatigue, abdominal pain, diarrhea, delirium, intestinal
- bleeding, rash, and in rare untreated cases, heart failure. (For more
- information on this disorder, choose "Typhoid" as your search term in the
- Rare Disease Database).
-
- Therapies: Standard
-
- The most effective treatment for Rabies is immediate treatment of the wound
- followed by immunization with the rabies vaccine. The wound should be
- cleansed thoroughly with soap and water and medical attention sought
- immediately. If the wound has broken the skin, a tetanus shot should be
- given. If the patient has been bitten by a wild animal that has escaped, or
- a domestic animal that shows signs of rabies, a series of vaccinations to
- prevent rabies is prescribed before the onset of symptoms. Once the disease
- presents itself in the patient there is no effective treatment to stop the
- progression.
-
- Therapies: Investigational
-
- A vaccine absorbed into an aluminum salt for both pre-exposure and post-
- exposure to rabies was licensed in the state of Michigan in 1988. Plans for
- this vaccine to be distributed in other states are being made. This vaccine
- is produced and distributed by the Michigan Department of Public Health.
-
- This disease entry is based upon medical information available through
- June 1991. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Rabies, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH National Institute of Allergy and Infectious Diseases
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5717
-
- Centers for Disease Control (CDC)
- 1600 Clifton Road
- Atlanta, GA 30333
- (404) 329-3534
-
- References
-
- INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and
- Co., 1987. Pp. 1587-89.
-
- CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H.
- Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 2200-02.
-
- PRINCIPLES OF NEUROLOGY, 4th Ed.: Ronald D. Adams, and Maurice Victor,
- Ed., McGraw-Hill, Inc., 1989. Pp. 605-6.
-
- CONTROLLING RABIES: MAD DOGS AND FRIENDLY SKUNKS. Ken Flieger; FDA
- Consumer; (June 1990). Pp. 23-6.
-
- DRUG EVALUATIONS SUBSCRIPTIONS: Vol. 3: Department of Drugs, Division of
- Drugs and Toxicology; American Medical Association., 1990. Immu. Chap. 4
- Pp. 27-30.
-
-