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Extraneural organ involvement in human rabies.
A C Jackson1, H Ye, C C Phelan
1Department of Medicine, Queen's University, Kingston, Ontario, Canada. jacksona@post.queensu.ca
Summary
Human rabies virus (RVA) spreads from the central nervous system to many organs, including the gastrointestinal tract, heart, and adrenal glands. This study confirms frequent extraneural organ involvement in fatal human rabies cases.
Area of Science:
- Neurology
- Virology
- Pathology
Background:
- Human rabies is a fatal neurological disease caused by the rabies virus.
- Following central nervous system infection, the virus spreads centrifugally to systemic organs.
Purpose of the Study:
- To investigate the distribution and frequency of rabies virus antigen (RVA) in extraneural organs in human rabies cases.
- To determine if extraneural organ infection is associated with an inflammatory response.
Main Methods:
- Postmortem examination of tissue sections from 14 human rabies cases.
- Utilized histochemical staining and immunoperoxidase staining to localize RVA.
- Examined organs including the gastrointestinal tract, heart, tongue, larynx, adrenal glands, salivary glands, skin, and pancreas.
Main Results:
- RVA was detected in nerve plexuses of multiple organs, including the gastrointestinal tract.
- RVA was found in muscle fibers of the heart, tongue, and larynx, and frequently in the adrenal medulla.
- Infection of extraneural organs, such as salivary glands, skin hair follicles, and occasionally pancreatic islets, was observed, sometimes with inflammation.
Conclusions:
- Centrifugal spread of rabies virus to extraneural organs is a frequent occurrence in human rabies.
- The presence of RVA in various systemic organs highlights the widespread nature of the infection beyond the central nervous system.