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Rage

The rabies is a disease of animals or man, which can be transmitted from one species to another, caused by a virus, after penetrating a skin wound or through the mucous, is fixed in the nervous system center, generating an acute encephalomyelitis, almost always fatal.

It is found all over the world, due to the existence of a multiple animal reservoir that is difficult to eradicate.

They are currently rabies-free places: Australia, New Zealand, Japan, Hawaii, Taiwan, the United Kingdom, Ireland and the Nordic countries.

There are two kinds of rabies:

  • Urban, made up of unimmunized domestic dogs and cats.
  • Jungle (permanent reservoir), made up mainly of foxes, wolves, jackals, coyotes, monkeys and bats.

The predominant wild reservoir on each continent is different. Thus, in Europe and Asia it corresponds to the fox and the wolf; in America, the skunks, raccoons and bats, and in Africa, the jackal and the mongoose.

Causes of rabies

Produced by a rhabdovirus.

The rabies virus is fragile and inactivated by heat, ultraviolet radiation, sunlight, extreme values ​​of acid-base balance, and most antiseptics and disinfectants.

The rabies virus

It can remain stable for some time in freezing, drying and rotting conditions.

The virus enters the skin through a wound or through the mucous membranes.

The main transmission mechanism is by bite, from the saliva of the rabid animal, although it could also originate by licking.

Other more exceptional mechanisms are: through the transplantation of infected tissues (cornea) and by inhalation from aerosolized viruses in laboratories that work with infected tissues or in caves from bat secretions.

The virus replicates in striated muscle cells and in connective tissue near the entrance gate. The peripheral nervous system is affected at the neuromuscular junctions. The virus then spreads down the peripheral nerve, reaching the central nervous system. It replicates in the gray matter and diffuses centrifugally to the vegetative nerves to reach other tissues (in particular, salivary glands, adrenal medulla, kidney, liver, lung, skeletal muscle, skin and heart).

Salivary gland infection facilitates disease transmission.

Symptoms of rabies

Four periods are recognized:

Incubation period

It lasts between 3 weeks and 2 months. The time depends on: the location of the wound (minor in the head), the depth, the interposed clothing, the stress and the administration of corticosteroids.

Prodromal period

Lasts 1-2 days, with fever , headache, muscle aches, nausea, vomiting, paresthesia, and twitching in the area of ​​inoculation.

Period of arousal (acute neurological)

Lasts 1-3 days. It includes hyperactivity, excitement, disorientation, hyperreflexia, hyperesthesia, hallucinations, seizures, and behavioral disturbances. In addition, there are muscle spasms, laryngeal spasm, paralysis and autonomic alterations, fever, mydriasis , hypersalivation or sweating.

The evolution is rapid until producing encephalitis of the brainstem, with respiratory and cardiovascular alterations and death. If he does not die, move on to the next period.

Paralytic period

It lasts 1 day. There is paralysis of the extremities and cranial nerves, as well as alterations of the autonomic nervous system (pupillary involvement, postural hypotension, increased perspiration, lacrimation and salivation). Generalized muscular paralysis develops and death occurs due to apnea of ​​bulbar origin.

How is it diagnosed?

The specific diagnosis of rabies depends on:

  • Isolation of the virus in infected secretions (saliva, CSF) or in tissues (brain).
  • The determination of antibodies against the virus in serum and CSF.
  • The pathological study, which demonstrates the presence of Negri inclusion bodies.

Treatment of rabies

Therapeutic measures are based on intensive supportive care aimed at preserving cardiorespiratory function, as there is no specific therapy for clinical rabies.

Wound treatment consists of proper wound cleaning. Passive immunization with human gamma globulin and active immunization with rabies vaccination with inactivated virus should be done, administering 5 to 6 doses intramuscularly.

How can I avoid it?

The measures available for the prevention of rabies are based on active immunization (vaccination) and passive immunization (human anti-rabies gamma globulin).

Human anti-rabies gamma globulin provides a timely and rapid supply of antibodies, of great importance in severe cases, and as a complementary measure to vaccination.

Pre-exposure prophylaxis

It consists of the rabies vaccination of groups with high occupational risk (veterinarians, laboratory personnel, zoos, speleologists …) or of travelers to certain jungle areas. The vaccination schedule consists of 3 doses on days 0, 7 and 28, with single booster doses at 3 years if the epidemiological risk persists.

Post-exposure prophylaxis

The following factors should be taken into consideration:

  • Presence of rabies in the area where the animal comes from.
  • Nature of exposure or type of contact.
  • Species to which the offending animal belongs.
  • Availability of the animal for observation or for laboratory analysis.
  • Clinical status of the animal.

The goal is to minimize the presence of the virus in the wound and to provide the affected patient with a high neutralizing antibody titer as soon as possible.

Post-exposure prophylaxis includes the following measures:

  • Local treatment of the wound. It must be quick, by washing with soap and water, and subsequent application of antiseptics. Tetanus and antimicrobial prophylaxis should be carried out, and surgical suturing of the wound avoided.
  • Vaccination.
  • Human anti-rabies gamma globulin.

They should go to the doctor:

  • People with increased risk of contagion by profession (veterinarians, cavers, zoo workers …) or travelers to jungle areas to carry out prevention before exposure to the virus.
  • People exposed to clinical cases of rabies.
  • After an animal bite.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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