Rabies

Abstract

Rabies is a viral encephalitis caused by the virus belonging to the family Rabdoviridae genus lyssavirus. It is still a public health problem/threat in many countries of the world and the Middle East is no exception. Regarding, rabies is absent in countries like Japan, the UK, Denmark, Greece, Sweden, Qatar and Kuwait (in the Middle East). Rabies exposure in humans or livestock occurs by animal bite or scratch. Concerning this, exposure through non-biting routes (e.g., Inhalation, transplantation) has been reported. The estimated global incidence of human rabies is around 55,000 deaths per year. Rabies is found in both domestic and wild animals. In most of the developing countries (Asian and African) where domestic animal control programs are not extensively developed, dogs and cats are considered as dominant biting animals, resulting in transmission of the disease to humans; in contrast in Latin America the canine rabies control program has resulted in declined transmission of the disease. In Latin America and also the USA, the frugivorous, insectivorous, and vampire bats could transmit rabies to human. The incubation period of rabies in humans is typically between 1 and 2 months, which might vary from one week, up to 19 years. Two-thirds of the patients present the furious form of the disease and the rest show paralytic (dumb) manifestation. Signs of animal rabies are known as aggressiveness, combative behavior, irritability, etc. The standard laboratory test of rabies for postmortem diagnosis is fluorescent antibody test. In the intra vitam diagnosis of the disease in human using saliva, urine, hair follicle, and cerebrospinal fluid, a positive result would confirm the disease, but the negative might not necessarily rule out the infection. Pre- and post-exposure prophylaxis of humans against rabies is provided by administration of cell culture rabies vaccines (HDCV, PCEC, PHKCV, PVRV) and rabies immunoglobulins (equine or human origin), according to the World Health Organization guidelines.