| Disease/Syndrome |
Rabies |
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| Category |
Infection, Occupational |
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| Acute/Chronic |
Acute-Severe |
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| Synonyms |
Hydrophobia |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: Patients may have paresthesias and pain, and later weakness, at the site of the bite wound. The two forms of rabies are "furious" and "paralytic," both ending in coma in 2-14 days. Patients have increased salivation and sweating. Cardiac arrhythmias and myocarditis may precipitate congestive heart failure. Opisthotonus is observed in patients with both rabies and tetanus, but rabies patients lack the persistent rigidity caused by tetanus toxin. Rabies from bite wounds to the face can cause retinitis and choroiditis. [Guerrant, p. 839-49, 1562] About 80% of cases are furious rabies. The other 20% are paralytic rabies, which affects the spinal cord and causes ascending flaccid paralysis. Patients with paralytic rabies do not have hydrophobia, hyperactivity, and seizures. In the differential diagnoses with paralytic rabies are Guillain-Barre syndrome, poliomyelitis, and transverse myelitis. [PPID, p. 2049-53] Leukocytosis (increased white blood cells) is a common finding. [Wallach, p. 986] EPIDEMIOLOGY: Animals infected include wild and domestic Canidae: dogs, foxes, coyotes, wolves, and jackals; also bats, skunks, raccoons, mongooses, and other mammals. Rabies prophylaxis is rarely called for following bites by rabbits, opossums, squirrels, chipmunks, hamsters, guinea pigs, gerbils, rats, or mice. Infection has been reported after saliva contact with a break in the skin. Airborne transmission has been reported in bat caves and in the laboratory. [CCDM, p. 438-47] ". . . rabies transmission to laboratory personnel has been reported in vaccine production and research facilities after exposure to high-titered infectious aerosols. Theoretically, rabies may be transmitted to health care personnel from exposures to saliva from infected patients, but no cases have been documented after these types of exposures." [Guidelines for Infection Control in Health Care Personnel. CDC. 1998] "During 1990--2000, a total of 24 (75%) of 32 U.S. human rabies cases were caused by bat-associated rabies virus variants. In 22 (92%) of these cases, no documentation of a bite existed; however, this does not mean that a typical bite exposure did not take place. Instead, such a history was not uncovered during presentation or case investigation." [MMWR. January 23, 2004 / 53(02);33-35] TREAT AND PREVENT: Give prophylactic treatment to all patients with suspected rabies exposure. Immunizations should be offered to long-term travelers in endemic areas and to others in high-risk jobs. [CCDM] |
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| Latency/Incubation |
3 weeks to 2 months; range or 9 days to 7 years; |
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| Diagnostic |
Viral culture; Fluorescent antibody (FA) stain of tissue; Antibody titer of serum and CSF; |
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| ICD-9 Code |
071 |
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| Available Vaccine |
Yes |
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| Scope |
Most of the estimated 70,000 deaths/year occur in Asia and Africa; Only 56 deaths were reported in S. America in 2001. In 1958-2000, there were 57 deaths in the US with almost all infections bat-associated by strain analysis. [CCDM, p. 438-9] |
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| Reference Link |
CDC - Rabies |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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