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Questions and Answers

What is the name of the antibiotic prophylaxis used for high-risk individuals?

  • Metronidazole
  • Doxycycline
  • Amoxicillin
  • Amoxicillin + clavulnic acid (correct)

    • What is the purpose of post-exposure prophylaxis?

  • To observe and kill suspected rabid animals
  • To vaccinate animals
  • To treat rabies
  • To prevent the spread of rabies (correct)

    • What is the type of vaccine used for human rabies immunoglobulin?

  • Inactivated cell culture vaccine
  • Live attenuated vaccine
  • Inactivated neural tissue vaccine (correct)
  • Recombinant vaccine

    • What is the name of the virus that causes West Nile Encephalitis?

    <p>West Nile virus</p> Signup and view all the answers

    What is the common vector of West Nile virus?

    <p>Culex pipiens</p> Signup and view all the answers

    What is the genus of the West Nile virus?

    <p>Flavivirus</p> Signup and view all the answers

    What is a common clinical manifestation of West Nile Encephalitis?

    <p>Asymptomatic</p> Signup and view all the answers

    What is a rare complication of West Nile Encephalitis?

    <p>Guillain-Barré Syndrome</p> Signup and view all the answers

    What is the family of the West Nile virus?

    <p>Flaviviridae</p> Signup and view all the answers

    What is the site of rabies vaccine injection?

    <p>Intramuscular</p> Signup and view all the answers

    What is the term for a group of viral CNS infections that develop over a period of time?

    <p>Chronic</p> Signup and view all the answers

    What is the primary mode of transmission for Rabies?

    <p>Bite from rabid animals</p> Signup and view all the answers

    What is the fatality rate of Rabies after the development of symptoms?

    <p>Near 100%</p> Signup and view all the answers

    What is the shape of the Rabies virus?

    <p>Bullet-shaped</p> Signup and view all the answers

    What type of RNA does the Rabies virus have?

    <p>Linear SS-RNA of negative sense</p> Signup and view all the answers

    What is the primary source of transmission for Meningitis?

    <p>Enteroviruses</p> Signup and view all the answers

    What is the characteristic of CSF in Meningitis?

    <p>Lymphocytosis and increased protein</p> Signup and view all the answers

    What is the term for a post-infectious Spongiform encephalomyelitis?

    <p>Post-infectious Spongiform encephalopathy</p> Signup and view all the answers

    What is the genus of the Rabies virus?

    <p>Lyssa virus</p> Signup and view all the answers

    What is the family of the Rabies virus?

    <p>Rhabdoviridae</p> Signup and view all the answers

    What is the characteristic of the viremic stage in Rabies?

    <p>It is absent in all cases</p> Signup and view all the answers

    What is the characteristic of Neurons in Rabies Encephalomylelitis?

    <p>Eosinophilic inclusions</p> Signup and view all the answers

    What is the duration of the incubation period in Rabies?

    <p>20-90 days to several months</p> Signup and view all the answers

    What is the factor that determines the length of the incubation period in Rabies?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of the Prodromal phase in Rabies?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of the Furious stage in Rabies?

    <p>All of the above</p> Signup and view all the answers

    What is the laboratory test used for Ante-mortem diagnosis of Rabies?

    <p>Antigen detection by IF</p> Signup and view all the answers

    What is the characteristic of Post-mortem diagnosis of Rabies?

    <p>Brain histopathology with Negri bodies</p> Signup and view all the answers

    What is the method of wound cleaning and debridement in Rabies management?

    <p>Less than 20 minutes</p> Signup and view all the answers

    What is the purpose of Pre-exposure prophylaxis in Rabies management?

    <p>To prevent the disease in high-risk individuals</p> Signup and view all the answers

    Study Notes

    Viral Neurological Syndromes

    • Meningitis
    • SSPE (Subacute Sclerosing Panencephalitis)
    • Encephalitis
    • Progressive multifocal Leucoencephalopathy
    • Post-infectious Spongiform Encephalomyelitis
    • Acute Flaccid Paralysis
    • HIV Encephalopathy

    Acute CNS Infections

    • Meningitis:
      • Causes: Enteroviruses, Mumps, Lymphocytic choriomeningitis virus (LCMV), HSV-2
      • CSF: Lymphocytosis, normal or increased protein, normal or decreased glucose
    • Encephalitis:
      • Causes: HSV-1, Rabies, Enterovirus 71, Arboviruses (West Nile virus, Tick-born EV, Western Equine Encephalitis, Eastern Equine Encephalitis, California Encephalitis, La Cross Encephalitis)

    Rabies

    • "Rabies" is derived from the Latin word "to rage"
    • Acute, fatal, zoonotic viral infection of the CNS
    • Main modes of transmission: bite from rabid Carnivores (dogs, cats) and bats
    • Fatality rate: near 100% after development of symptoms

    Rabies Virus

    • Family: Rhabdoviridae
    • Genus: Lyssa virus
    • Hosts: Man, Dogs, Raccoons, Bats, others
    • Structure: Bullet shape, 75 nm width, 180 nm length, Enveloped, Nucleocapsid with helical symmetry, Linear SS-RNA of -ve sense non-segmented

    Rabies: Transmission

    • Bite of rabid animal
    • Rarely: corneal transplantation from patient died of rabies, exposure to aerosolized secretion from rabid bats in caves

    Rabies: Pathogenesis

    • No viremic stage
    • Mononuclear infiltration, perivascular cuffing of lymphocytes or polymorphonuclear cells or inflammation around a blood vessel
    • Neurons: cytoplasmic eosinophilic inclusions (Negri bodies)

    Rabies: Stages of the Illness

    • Incubation Period: 20-90 days to several months, depending on size and depth of bite, number of bites, amount of saliva inoculated, proximity to CNS, and age
    • Prodromal Phase: 10-20 days, fever, pharyngitis, malaise, anorexia, nausea, vomiting, diarrhea, insomnia, depression, pain at the site of the bite
    • Neurologic Phase: Furious stage (hyperexcitation, hallucination, confusion, bizarre behavior, excessive salivation, lacrimation, hydrophobia, aerophobia) or Paralytic stage (local or diffuse paralysis)

    Rabies: Lab Diagnosis

    • Ante mortem: Antigen detection (IF in skin biopsy, corneal impression), Viral isolation (saliva, CSF, animal inoculation), RT-PCR (saliva and CSF), Antibody detection (Serum, CSF)
    • Post mortem: Brain histopathology (Negri bodies)

    Rabies: Management and Prevention

    • Wound cleaning and debridement
    • Antibiotic prophylaxis (Amoclan)
    • Post-exposure prophylaxis: Human Rabies Immunoglobulin, Rabies Vaccine (inactivated, HDCV, Neural tissue vaccine, Vero-cell vaccine)
    • Pre-exposure prophylaxis: Vaccination for high-risk individuals (veterinarians, lab workers, zookeepers)
    • Animal control: Vaccination of domestic animals, observation, and killing of suspected rabid animals

    West Nile Encephalitis

    • Caused by West Nile virus
    • Family: Flaviviridae
    • Genus: Flavivirus
    • Transmission: Bite of Culex pipiens mosquito
    • Clinical manifestations: 3 patterns - Asymptomatic, West Nile fever, West Nile encephalitis
    • Other manifestations: Aseptic meningitis, Chorioretinitis, Hepatitis, Pancreatitis, Nephritis, Guillain-Barré Syndrome

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