Rabies Notes 2024 PDF

Rabies Judd Aiken https://www.etymonline.com/word/rabies Rabies One of the most deadly zoonotics ~60,000 deaths world-wide Majority children Developing Countries 95% of human cases due to dog bites ~99% of human deaths occur in Africa and Asia...

Rabies Judd Aiken https://www.etymonline.com/word/rabies Rabies One of the most deadly zoonotics ~60,000 deaths world-wide Majority children Developing Countries 95% of human cases due to dog bites ~99% of human deaths occur in Africa and Asia dog rabies is poorly controlled Tools to eradicate rabies available Mesopotamians Eshnunna Code (2300 BC) owner of rabid dog responsible for containment of the animal Babylonian king, Adadapla-iddina (1068-1047 BC) constructed a temple to the goddess Gula healer and protector from rabies Aristotle (384-322 BC) “Dogs suffer from the madness. This causes them to become irritable and all animals they bite to become diseased.” Columella (60 AD) describes shepherds cutting tails of puppies as a preventative measure for rabies Zoonotic---transmission primarily rabid dogs Rabies All continents, except Antarctica Asia, Africa & India ~59,000 human deaths/year Europe and Americas Few human deaths Few transmissions from dogs vaccination Primarily via wildlife Bats, foxes, skunks, raccoons Source: WHO Canada: Dog importation (CFIA) https://inspection.canada.ca/importing-food-plants-or-animals/pets/eng/ Rabies Part 2 Judd Aiken [email protected] Micrograph from F. A. Murphy, University of Texas Medical Branch, Galveston, Texas. Rabies Virus RNA Virus Rhabdoviridae 12 kb negative sense RNA genome Species-specific variants Bat, skunk, fox Environmentally Labile Inactivated by: Heat (50 C 15 min) Sunlight Desiccation Source: The Lancet https://doi.org/10.1016/S1473-3099(02)00287-6  Peripheral nervous system to brain 3-12 weeks Virus replicates rapidly in the brain Subsequent centrifugal spread to salivary glands and saliva* Clinical Symptoms death within 1 week Treatment PRIOR to clinical signs https://basicmedicalkey.com/ *Little/no transmission during preclinical phase Case Detection as a Means to Control Rabies in Dogs? Long incubation Periods Long Preclinical Clinical Rabies difficult to detect Live Attenuated Vaccine--- Pasteur Chicken Cholera Bacterial disease of chickens Pasteur observed that old bacterial cultures lost virulence Protected chickens from cholera Louis Pasteur, 1857  First Rabies Vaccine Pasteur (1885) Passaged canine rabies in rabbits Attenuated, yet still virulent Spinal cord of rabies-infected rabbit Ground When dried --- less virulent Canine Vaccine series of increasingly virulent samples Louis Pasteur, 1870 First Rabies Vaccine Joseph Meister Repeatedly bitten by a rabid dog (July 4, 1885) 13 inoculations over 3 weeks Progressively more virulent samples Meister did not develop rabies Note: treatment post-infection!  1911 Rabies Vaccine Philadelphia drug company -- H. K. Mulford "physicians who have had no previous experience may successfully apply it” Vaccination Protocol 25 injections of rabies vaccine 3 injections on day 1 2 injections on day 2 2 injections on day 3 1 injection each day for 18 days Each dose slightly more virulent https://americanhistory.si.edu/ Rabies vaccine Dogs prevent infection Humans post-bite  A dose of human rabies immune globulin (HRIG) Rabies Provides immediate antibodies Postexposure Prophylaxis rabies vaccine (PEP) On the day of the rabies exposure Followed by additional vaccinations Days 3, 7, and 14. Source: cdc  Rabies 29 million doses of PEP administered world-wide/ Postexposure year (WHO) It is estimated that there would be ~ 3 million Prophylaxis deaths in absence of PEP (PEP) Source: cdc R0 < 1 a disease will die out on its own. for every sick individual, < 1 new infection will arise. If R0 =1 an existing infection causes one new infection. maintain stable (non-growing) rate (no epidemic) If R0 >1 An existing infection causes more than one new infection Spread in population causing an epidemic Rabies R0 : >1 in dogs Dogs are social Dogs interact with their teeth What is R0 of Rabies in Humans? Zero! Humans are a dead-end host Rabies can not be decreased by only treating humans First Rabies Case in Canada? Charles Lennox, 4th Duke of Richmond (1764-1819) 1809 print after portrait by John Hoppner (British Museum) Cairn erected in 1926 along Old Richmond Road. Location spot where the Duke of Richmond LL: Lord Lieutenant of Ireland died. (Aug. 28, 1819) Rabies virus reservoirs (Canada) artic foxes red foxes skunks raccoons bats Rabies Canada: 2024  2021 Five deaths (rabies) in U.S. 80-year-old Illinois man, not vaccinated longstanding fear of vaccines. Idaho man and a Texas boy not vaccinated belief that no bat bite or scratch broke their skin. Minnesota man bitten by a bat. Vaccinated an undiagnosed immune system problem hampered their effectiveness The fifth victim was bitten by a rabid dog while traveling in the Philippines (died in New York)