Viral disease of the brain and central nervous system that can afflict all mammals. The rabies virus belongs to the lyssavirus group of viruses. Rabies is an example of a zoonotic infection, a disease passed to humans by animals. It is transmitted through infected saliva, most commonly from the bite of an infected animal. Characteristic symptoms are aggression, fever, and an irrational fear of water (hydrophobia). Once infection has occurred, the disease can only successfully be treated during the incubation period; it is almost invariably fatal once symptoms have developed. The main treatment is prevention by vaccination. Louis Pasteur was the first to produce a preventative vaccine, and the Pasteur Institute was initially founded to treat the disease.
Rabies has a highly variable incubation period, generally shorter the closer the site of infection is to the brain. The average incubation period is 2–12 weeks, but it can be as short as four days or as long as a year in unusual cases. Injection of rabies vaccine and antiserum, if administered before symptoms appear, may save someone bitten by a rabid animal from developing the disease; this treatment is called post-exposure prophylaxis.
The first symptoms to appear are common to many less serious infections. These include fever, chills, vomiting, fatigue, lack of appetite, insomnia, headaches, a sore throat, and irritability. The initial symptoms can last for 2–10 days, before rabies progresses to the advanced stage, when the characteristic symptoms of the disease appear.
There are two types of advanced rabies: furious and dumb or paralytic. Individuals who develop furious rabies display highly aggressive behaviour and suffer from hallucinations and delusions. They also develop a high fever and sweat and produce saliva profusely. However, the main characteristic of furious rabies is a fear of water severe enough to produce muscle spasms at the sight, sound, or even mention of water or any other liquid. This phobia is rare in individuals who develop dumb or paralytic rabies. This type is characterized by muscle weakness and paralysis that spreads throughout the body, usually starting at the hands and feet. In both types, symptoms last for a few days before the individual falls into a coma and dies, usually of heart or lung failure.
In the UK, no human rabies has been transmitted since 1902. The UK and Ireland are the only countries in the European Union to quarantine all incoming pets (for a six-month period) except those with an identification chip and vaccination record.
The best control measure for rabies is vaccination of wild animals, usually by the distribution of bait. The European Union (EU) has an ongoing public health programme to eradicate the disease in all member states and neighbouring countries, at an annual cost of around €20 million. The EU has co-funded national rabies eradication programmes to a level of around 75% since 2010. It also supports eradication programmes in the western Balkan states. The disease has been eliminated in western and central Europe.
Childhood Infections – Rabies
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