Rabies – epidemiology, pathogenesis, public health concerns and advances in diagnosis and control: a comprehensive review

Abstract

Rabies is a zoonotic, fatal and progressive neurological infection caused by rabies virus of the genus Lyssavirus and family Rhabdoviridae. It affects all warm-blooded animals and the disease is prevalent throughout the world and endemic in many countries except in Islands like Australia and Antarctica. Over 60,000 peoples die every year due to rabies, while approximately 15 million people receive rabies post-exposure prophylaxis (PEP) annually. Bite of rabid animals and saliva of infected host are mainly responsible for transmission and wildlife like raccoons, skunks, bats and foxes are main reservoirs for rabies. The incubation period is highly variable from 2 weeks to 6 years (avg. 2-3 months). Though severe neurologic signs and fatal outcome, neuropathological lesions are relatively mild. Rabies virus exploits various mechanisms to evade the host immune responses. Being a major zoonosis, precise and rapid diagnosis is important for early treatment and effective prevention and control measures. Traditional rapid Seller's staining and histopathological methods are still in use for diagnosis of rabies. Direct immunofluoroscent test (dFAT) is gold standard test and most commonly recommended for diagnosis of rabies in fresh brain tissues of dogs by both OIE and WHO. Mouse inoculation test (MIT) and polymerase chain reaction (PCR) are superior and used for routine diagnosis. Vaccination with live attenuated or inactivated viruses, DNA and recombinant vaccines can be done in endemic areas. This review describes in detail about epidemiology, transmission, pathogenesis, advances in diagnosis, vaccination and therapeutic approaches along with appropriate prevention and control strategies.

Rabies, a Vaccine Preventable Disease: Current Status, Epidemiology, Pathogenesis, Prevention and Control With Special Reference to India

“…Various studies have documented prevalence of rabies as 61.4% in cattle and buffaloes, 48.7% in goats, 48% in dogs, 45% in horses and 21.9% in cats (WHO, 2005;Sudarshan et al, 2006;Singh et al, 2017). Rabies outbreaks in domestic and wild animals in India are reported round the year with all such cases traced back to the bite of rabid dogs (Singh et al, 1990;Singh et al, 1995).…”

“…Detailed pathogenesis of rabies virus has been recently reviewed by Singh et al (2017). The sequence of events in the disease process involves: 1) replication of the virus in the peripheral tissues, 2) spread along the peripheral nerves and the spinal cord to the brain, 3) dissemination within the central nervous system (CNS) and its 4) centrifugal spread along nerves to various tissues and organs.…”

“…The Essen schedule (1-1-1-1-1, 5 visits) consist of 5 doses of i.m. injection of CCV on days 0, 3, 7, 14 and 28 for postexposure prophylaxis (NICD, 2007;NCDC, 2015;Singh et al, 2017). As rabies is 100% fatal, there is no contraindication to PEP.…”

“…Due to highly fatal nature of rabies, rabid animal bite must be considered as a "medical emergency" and "life-saving" post-exposure prophylaxis must be provided immediately. Persons who come for treatment even months after a possible rabies exposure should be considered as recent event and treated immediately (NICD, 2007;NCDC, 2015;Singh et al, 2017). The observation period for biting dogs and cats is 10 days.…”

Casos notificados de raiva em bovinos na região norte do brasil no período 2005-2017

“…A raiva é uma encefalomielite causada por vírus RNA (ácido ribonucleico) do gênero Lyssavirus e família Rhabdoviridae que acomete mamíferos, sendo datada a primeira descrição oficial da doença no século XXIII a.C. (CIFUENTES JIMENEZ et al 2017;NOKIREKI et al 2017;SINGH et al 2017).…”