The following information is taken DIRECTLY FROM (http://www.cdc.gov/rabies/spec

Question

The following information is taken DIRECTLY FROM (http://www.cdc.gov/rabies/specific_groups/doctors/index.html)

"Patient history, duration and progression of illness, and laboratory tests for other common etiologies of encephalitis will help determine if rabies should be on the differential diagnosis list for a patient. Patient history is important to identify a possible exposure to the virus and other encephalitides; however, rabies should never be ruled out based solely on the absence of definite exposure history.

Rabies should be considered in patients with signs or symptoms of encephalitis or myelitis, including autonomic instability, dysphagia, hydrophobia, paresis, and paresthesia, particularly if a nonspecific prodrome preceded the onset of these signs by three to four days. Progressive worsening of neurologic signs is characteristic of rabies and should be considered as a positive indicator for rabies.

Laboratory tests to rule out common encephalitides (herpes, enteroviruses, arboviruses) should be performed. Negative results of these tests would increase the likelihood of rabies as the diagnosis. If a patient presents with symptoms similar to the ones described above, but the neurologic status does not change and the illness continues for longer than three weeks, rabies is unlikely as the diagnosis."

Part 1: A person thinks they have rabies but have not been bitten by any animals in the last year. Their primary physician states "Since you have not been bitten, it is IMPOSSIBLE that you have rabies." Based on the information above, would you agree with the doctor? Why or why not? (1 pt)

Part 2: What other viruses have similar symptoms as that of the rabies virus? (1 pt)

Part 3: Does the onset and progression of neurological signs/symptoms help clinicians diagnose rabies? Why or why not? (1 pt)

Rabies virus causes an acute encephalitis in all warm-blooded hosts and the outcome is almost always fatal. The first symptoms of rabies may be nonspecific and include lethargy, fever, vomiting, and anorexia. Signs progress within days to cerebral dysfunction, cranial nerve dysfunction, ataxia, weakness, paralysis, seizures, difficulty breathing, difficulty swallowing, excessive salivation, abnormal behavior, aggression, and/or self-mutilation.

Part 4: If contracting the rabies virus is "almost always fatal," how could the virus continue to spread in the population if it kills the animals it infects? In other words why do you think the virus continues to spread even though it can cause death of its host in as few as 10 days?(2 pts)

Explanation / Answer

1) Yes, we agree with the doctor. Rabies virus spreads only when a rabies infected animal bites or scratches other animal or human.

2) Encephalitis which is caused by herpes simplex virus, Flu caused by influenza virus, The said viruses have similar symptoms as that of rabies virus such as fever, headache, nausea, anxiety, muscle weakness etc.,

3) Yes, patients usually suffer from serious neurologic symptoms within 2 to 10 days after onset of initial symptoms.

4) The virus established its disease in warm blooded and cold blooded species. Though the rabies cases are reportedly decreased still the virus prevails. Rabies virus has become resistant that it could able to survive in most of the animals which act as carrier for rabies virus (mostly dogs) and thus spreads the disease. Hence prevention is better than elimination that is taking a rabies vaccine is better.

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