Human Rabies: a 2016 Update.

Area of Science:

• Veterinary Medicine
• Infectious Diseases
• Neurology

Background:

• Rabies is a severe zoonotic viral disease, typically transmitted to humans through bites from infected animals, with dogs being the primary global vector.
• The disease manifests in encephalitic and paralytic forms, presenting distinct clinical features depending on the source, such as dogs or bats.
• Current neuroimaging techniques offer non-specific findings for rabies diagnosis.

Approach:

• Confirmatory diagnosis relies on laboratory tests, including detecting neutralizing anti-rabies virus antibodies in serum or cerebrospinal fluid.
• Rabies virus antigen or RNA can be identified in tissue samples or bodily fluids for definitive diagnosis.
• Post-exposure prophylaxis, involving wound cleansing, rabies vaccine, and rabies immune globulin, is crucial for prevention.

Key Points:

• Rabies is almost invariably fatal once clinical symptoms appear, with very few documented survivors.
• The Milwaukee protocol, involving therapeutic coma, has been demonstrated as ineffective and is no longer recommended.
• Understanding the fundamental mechanisms of rabies pathogenesis is essential for developing innovative therapeutic strategies.

Conclusions:

• Rabies prevention through post-exposure prophylaxis is highly effective.
• There is an urgent need for novel treatments for rabies due to its high fatality rate.
• Further research into the basic science of rabies is critical for advancing treatment options.