RABIES


  RABIES

It belongs to the family Rhabdoviridiae, genus: lyssa virus and the species rabies lyssavirus. It is rod or bullet shaped enveloped virus. it is a single stranded RNA virus. usually it affects all warm blooded animals, especially foxes, dogs, jackals, wolves, rabbits and bats are highly susceptible to this infection. However, man has been often infected by dog bite. As it affects neuron it is called neurotropic virus. its transmission mainly occurs through saliva of animals but rarely through contact with human saliva.

 Morphology: The virus consists of envelope and nucleocapsid.

Envelope: It is an outer layer comprising with lipids, it contains peplomers  or spikes with the size of 10nm length. Obviously the spikes play a vital role in attachment of virus to the host cell. Moreover, envelope is lined by a layer of matrix proteins.

Nucleocapsid: It is an internal structure, which has been found to be shown with single stranded negative sense RNA, this measure approximately about 60nm X 1sent in 80nm. RNA polymerase enzyme also present in RNA.

Genome: Viral genome encodes the protein are associated with either ribonucleic protein complex or viral envelope.

Resistance : This virus is sensitive to ethanol, chloroform, acetone, phenol,formalin, UV rays and sunlight. It dies at room temperature it is also inactivated by heat at 60o C for one hour. It is resistant to dryness cold and decay.

Antigenic properties: Glycoprotein-G provides antigen properties, it includes complement fixing antibodies.

Nucleoprotein : Also it has hem agglutinating activity. It is used in preparation of vaccine  it induces antibody.

Pathogenesis:-

Source : infected dogs (saliva)

                 Infected animal and human being

Mode of transmission :-

Dog bite: Virus is being transmitted by dog bite

 Licking:  Even licking by dog is enough to initiate the infection, virus can transmit through minute pores on the skin.

Pathogenesis; sequential events

Rabid Dog bite

Introduce small amount of saliva

Penetration of virus and its entry due to endocytosis through endosome transport pathway. Inside the endosome low ph. Value induces the membrane fusion virus starts replication. Multiplication of virus at inoculated site of muscle and connective tissue.

Virus then binds on receptors of neuromuscular junction.

Centripetal spread of virus along the peripheral nerve.

Virus travels on axon.

Reaches to  dorsal root ganglia of spinal cord.

Ascending towards central nervous system

Once it reaches CNG, disseminates into hippocampus cerebellum.

From CNG-centrifugal spread takes place.

Reaches to  salivary  gland by means of sensory and autonomic nerves.

Spread to vital organ, kidney, heart, retina, and crania.

Viremia does not occur.

Shedding of Virus in saliva.

Clinical Symptoms : Fever, headache, excess salivation , muscle spasms, paralysis and mental confusion are the symptoms can be found, apart from this dizziness, fatigue, loss of appetite are also characterized Gastro intestinal symptoms such as nausea or vomiting resulted.

Hydrophobia: it is otherwise as fear of water. It is the clinical condition in which the patient cannot drink water due to spasm of throat muscle; it develops , when the function of brain steam respiratory neurons are arrested due to the infections of rabies.

Lab diagnosis:-

Sample collection- Blood, Wound swab, saliva CSF and Biopsy

Culture :- Chick embryo is used for cultivation of viruses. Inoculate the sample into yolk sac then observe the growth

Tissue culture:- it is performed in chick embryo fibroblast, hamster kidney cells.

Immunofluorescence test:  Viral antigen is taken, (it could be specimen ) add anti rabies Abs tagged with isothiocyanate if fluorescence developed that indicates positive if not,  the test result in negative.

Demonstration of negri body: in this, following stain can be used

H and E stain

Sellers stain (basic fuschin and methylene blue in methanol)

Negri bodies appear as round, purplish pink color with basophilic inner granules.

Viral RNA detection : RT-PCR can be used to amplify the genes of rabies virus RNA from the brain tissue. It is the most appropriate method employed in detection of virus.

Prevention  rabies vaccine:-  Vaccine are effective in human and other animals to prevent infection pet animal and dog must be vaccinated in preventing the spread of rabies to humans.

Rabies vaccine may be safely used in all age groups. Human rabies- specific immunoglobulin (HRIG ) is available and is derived from the plasma of immunized human donors for passive immunization. HRIG is used after high-risk exposure to rabies and is given at the same time as rabies vaccine (at a different site) to give rapid protection until the rabies vaccine becomes effective. It is infiltrated in and around the cleansed wound, or intramuscularly into the antero-lateral thigh. It can be given for the up to seven days after starting the vaccination course (active immunisatiob). The dose is HRIG 20 IU/kg body weight.


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