References: http://www.who.

int/rabies/en/ Rabies: A neglected zoonotic disease Rabies is a zoonotic disease (a disease that is transmitted from animals to humans), which is caused by a lyssavirus. Transmission of the virus is achieved by entering the body through wounds (e.g. scratches) or by direct contact with mucosal surfaces from an infected animal (e.g. bites), it cannot cross intact skin. There are two clinical manifestations of rabies furious and paralytic. Furious rabies is most common form of human rabies. Rabies is known to be present in more than 150 countries and territories and on all continents except Antarctica. It is estimated that more than 60 000 deaths occur annually from rabies with more human deaths occur in Asia than anywhere else in the world (30 000 deaths per annum), with Africa not far behind in numbers (23 700 deaths per annum). Some 84% of deaths from rabies occur in rural areas, with 4 out of every 10 deaths being a child. Underreporting in many developing countries is likely to lead to underestimation of the scale of the disease burden; therefore, field data to validate these estimates in a number of regions are needed to address the lack of accurate data. Rabies is a vaccine-preventable disease. Countries embarking on rabies elimination programmes have experienced successful marked reductions and eventual elimination of rabies. Mass canine vaccination programs constitute a large part of a rabies elimination programmes that should cover at least 70% of the canine population. Safe, effective vaccines can be used for pre-exposure immunization in people as well. Use of the intradermal vaccine has a cost savings of 60-80% in comparison to the intramuscular vaccine, and may be a more cost-effective option for rural areas where the disease is endemic. Rabies is a zoonosis (a disease that is transmitted from animals to humans) that is caused by a virus. It is known to be present in more than 150 countries and territories of all continents except Antarctica. Rabies is a 100% preventable disease. Around 60,000 people die annually from rabies despite the fact that we have all of the tools to prevent and manage the disease. Children are the most effected by the disease, with four out of every ten deaths by rabies being a child under the age of 15. Furthermore, rabies is a wide-spread disease and potentially threatens over 3 billion people in Asia and Africa, where the people most at risk live in rural areas where human vaccines and immunoglobulin are not readily available or accessible.

Burden

~60 000
Risk

people die of rabies every year, mostly in Asia and Africa

High

risk of contracting rabies in rural areas in endemic countries

Vaccination Costs

6080%
vaccination

savings associated with intradermal vs intramuscular standard

rabies
rabies - Dictionary definition and meaning for word rabies Definition (noun) an acute viral disease of the nervous system of warm-blooded animals (usually transmitted by the bite of a rabid animal); rabies is fatal if the virus reaches the brain Synonyms : hydrophobia , lyssa , madness

http://mnemonicdictionary.com/word/rabies

madness
madness - Dictionary definition and meaning for word madness

Definition (noun) obsolete terms for legal insanity Synonyms : insaneness , lunacy

lyssa
lyssa - Dictionary definition and meaning for word lyssa Definition (noun) an acute viral disease of the nervous system of warm-blooded animals (usually transmitted by the bite of a rabid animal); rabies is fatal if the virus reaches the brain

hydrophobia
hydrophobia - Dictionary definition and meaning for word hydrophobia Definition (noun) a symptom of rabies in humans consisting of an aversion to swallowing liquids -Morbid fear of water

Etiology
Rabies is caused by various negative-sense RNA viruses of the Lyssavirus genus, which belongs to the Rhabdoviridae family. The genus is composed of 12 recognized species: rabies virus, image Lagos bat virus, image Mokola virus, Duvenhage virus, Aravan virus, Irkut virus, Khujand virus, European bat lyssavirus types 1 and 2, West Caucasian bat virus, Australian bat lyssavirus type 1 and, most recently, Shimoni bat virus. [15] Two recently discovered species have also been proposed: Ikoma virus and Bokeloh bat lyssavirus. [16] [17] Rabies is usually transmitted to humans following a bite from an infected animal. Rabies virus is the form carried by dogs and accounts for most human rabies globally. Nonbite exposures are also possible and include being scratched, being licked over an open wound or mucous membrane, or being exposed to infected brain tissue or CSF. There are a few reported cases of rabies being transmitted by organ transplantation.

Pathophysiology

The incubation period is variable. It is usually 2 weeks to 3 months but with a range from 5 days to 7 years. Shorter incubation periods are associated with severe bites and bites to the head and face. The nicotinic acetylcholine receptor at the motor end plate mediates virus entry to myocytes, where initial replication takes place. [18] The virus enters the nervous system through unmyelinated sensory and motor terminals and is transported by fast retrograde axonal transport, crossing new synapses roughly every 12 hours. Once the virus has entered the immune nervous system, it is sequestered from the immune system and immunization will not be effective. Clinical symptoms begin once the virus infects the spinal cord and progress rapidly as the virus spreads through the CNS. [19] The rabies virus exits the CNS through motor, sensory, and autonomic nerves, and replicates locally in salivary and lacrimal glands in order to be transmitted to the next host. Many aspects of rabies pathophysiology remain a mystery. It is unclear how rabies causes paralysis. [20] The pathophysiologic differences between the encephalitic and paralytic forms of rabies may involve differences in the host inflammatory response. [21]The cause of death in rabies is unknown because wild-type viruses are not cytopathic, apoptotic, or inflammatory. Atypical, less severe forms of neurological illness are beginning to be reported, suggesting a continuum of rabies severity. [3] [4] [5]