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Rabies re-examined.

Charles E Rupprecht1, Cathleen A Hanlon, Thiravat Hemachudha

  • 1Rabies Section, WHO Collaborating Centre for Reference and Research on Rabies, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. CYR5@CDC.GOV

The Lancet. Infectious Diseases
|July 30, 2002
PubMed
Summary

Rabies is a fatal viral encephalitis transmitted by animal bites, primarily from dogs. Prevention through wound care, vaccination, and immunoglobulin is crucial, as diagnosis and treatment remain challenging.

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Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Rabies is a severe, progressive, and incurable viral encephalitis caused by neurotropic RNA viruses (Lyssavirus).
  • Rabid dogs are the primary global hazard, with transmission mainly through bites, leading to central nervous system infection.
  • Disease onset can occur months or years after exposure, complicating diagnosis.

Purpose of the Study:

  • To review the epidemiology, pathogenesis, diagnosis, and prevention of rabies.
  • To highlight the challenges in antemortem diagnosis and the current reliance on palliative care.
  • To emphasize the importance of prevention and public health strategies in controlling this zoonotic disease.

Main Methods:

  • Review of existing literature on rabies epidemiology, viral characteristics, and transmission.
  • Analysis of clinical presentation, diagnostic challenges, and pathogenetic mechanisms.
  • Evaluation of current prevention strategies, including prophylaxis and vaccine technologies.

Main Results:

  • Rabies virus spreads from peripheral wounds to the central nervous system and then to salivary glands.
  • Antemortem diagnosis is difficult without a clear bite history or typical symptoms.
  • Effective prevention includes wound management, rabies vaccination, and rabies immunoglobulin administration.

Conclusions:

  • Rabies remains a significant public health challenge despite advances in prevention and control.
  • Canine rabies elimination is feasible, and new vaccine technologies aid wildlife disease management.
  • Increased awareness and consistent application of preventive measures are essential to combat rabies neglect.

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