1. RABIESRABIES
• It is an acute
• Highly fatal viral dis: of CNS
Transmitted to man by:
• Bites
OR
• Licks of rabid animals

2. • Primarily a Zoonotic disease of warm
blooded animal
• such as :-
• Dogs,
• wild cats,
• Jackals,
• wolves etc.

5. Source of InfectionSource of Infection
• Saliva of Rabid animal

6. Host FactorsHost Factors
• All warm blooded animals including man.
• Rabies in man is a dead-end infection.

7. Mode of TransmissionMode of Transmission
1. ANIMAL BITES
2. LICKS
3. AEROSOL
4. PERSON TO PERSON

8. AgentAgent
(LYSSAVIRUS type I)(LYSSAVIRUS type I)
Rhabdoviridae type IRhabdoviridae type I
• It is Bullet shaped Neurotropic RNA
virus

9. Bullet shaped

10. Types of Rabies virusTypes of Rabies virus
STREET VIRUS
Definition: the virus
recovered from
naturally occurring
cases of rabies is
called “street virus”
Sources: it is naturally
occurring virus. It is
found in saliva of
infected animal.
FIXED VIRUS
Definition: the virus
which has a short, fixed
and reproducible
incubation period is
called “fixed virus
Sources: it is prepared
by repeated culture in
brain of rabbit.

11. RESERVOIR OF INFECTIONRESERVOIR OF INFECTION
1) URBAN RABIES:
From Dogs and
cats.

12. 2)2) WILD LIFE RABIESWILD LIFE RABIES::
From jackals and foxes.From jackals and foxes.

13. 3)3) BAT RABIESBAT RABIES::
Vampire bats which live on the blood of animals andVampire bats which live on the blood of animals and
men. These are one of the main causes of the death ofmen. These are one of the main causes of the death of
bovine, around 0.5 to 1 million per year.bovine, around 0.5 to 1 million per year.

14. • History of Rabies Virus
• Man described the disease in 2300 B.C.
• The origin “rabhas”, meaning “to do
violence” comes from ancient Indian
Sanskrit dating 3000 B.C.

15. History of the Rabies VirusHistory of the Rabies Virus
•Outbreak of rabies in Europe
in 20th
century spawned the
Vampire myth- linked to bats.
•Rabies epidemic in 13th
century France.
•Rabies is commonly spread
by bats and wolves and other
wildlife like foxes.

16. History of the Rabies VirusHistory of the Rabies Virus
• Since Roman times, man established the
link between the infectivity of a rabid dogs
saliva and the spread of the disease.
• Because there is no cure for rabies, those
that had been bitten by a rabid dog would
commonly commit suicide to avoid the
painful death that would inevitably follow.

17. History of the Rabies VirusHistory of the Rabies Virus
• Louis Pasteur was the first person to
diagnose that rabies targeted the CNS.
• Also determined that nervous tissue of an
infected human or animal also contained
the virus.
• In 1890 created the rabies vaccine and
saved 9 year old Joseph Meister after he
had been bit by a rabid dog.

18. EpidemiologyEpidemiology
87 countries contain Rabies, but more
cases are reported in Asia.
In Indo-Pakistan rabies is a major
public health problem mainly due to
presence of a large no: of stray dogs.
More than 30,000 people died of
Rabies every year in Asia. Every year
10 million people require treatment
and protection from Rabies which is
great Financial loss.

19. • Estimated Annual Human Rabies Cases
2005
• North America 4 - 8
• Europe 10 - 20
• Latin America 200 - 400
• Africa 500 - 1,000
• Asia 30,000 - 40,000

20. • FREE RABIES ZONE:
• Australia,
• China,
• Iceland,
• Ireland,
• Japan,
• New Zealand etc

21. • INCUBATION PERIOD:
• normally it is 3 - 8 wks
• may be short that is 4 days
• or may be prolonged for years.

22. PATHOGENESISPATHOGENESIS

25. CLINICAL PICTURECLINICAL PICTURE
1. Prodromal symptoms
Headache, malaise, sore throat, low
fever, pain at the site of bite
2. Excitation Symptoms
sensory sys: involvement
Aero phobia, excitation of N.S.
Motor sys: inv:
increase reflexes, muscle spasm,
Symp:inv: dilatation of Pupils. increase perspiration, salivation,
and Lacrimation,
Mental changes: fear of death, anger, irritability and depression

26. Hydrophobia ( Fear of water)
sight or sound of water may produce
spasm
the duration of illness is 2-3 days may
be prolonged to 5-6 days
Stage of paralysis & coma
DEATH / Recovery

28. (summary(summary))
Transmission of RabiesTransmission of Rabies
Cl:PictureCl:Picture
• The rabies infection and the symptoms that
accompany it is classified by five stages:
1. Incubation (1-3 months)
2. Prodromal, where first symptoms occur
3. Acute neurological phase
4. Coma
5. Death or recovery

29. DIAGNOSISDIAGNOSIS
1. History
2. Sign and symptom
3. Examination
4. Detection of Antigen by taking Skin
Biopsy using Immunofluorescence
by virus isolation from Saliva &
other secretions.

30. Control MeasuresControl Measures
• Notification
• Isolation
• Disinfection
• Immunization

31. Prevention of human rabiesPrevention of human rabies
post Exposure prophylaxispost Exposure prophylaxis
1. General consideration:- Aim is to neutralize virus before entering CNS
2. LOCAL WOUND TREATMENT
a, Cleansing of wound(soap & water)
b, Chemical treatment:
• Either Alcohol 400-700 ml /liter
• Tincture Iodine
• No more treatment with Ammonium
compound
• No Carbolic acid and Nitric acid as it leave
very bad scar

32. c, Suturing
d, Anti Rabies Serum
e, Antibiotic and ATS
f, Observe the animal for 10 days

33. • 3, Immunization
• 1,NERVOUS TISSUE VACCINE (NTV
2, Human diploid cell vaccine
(HDCV)

34. Vaccines for immunizationVaccines for immunization
Definition:
it is fluid or dried preparation of
Rabies “Fixed” virus grown in the
Neural tissue of
Rabbits,
Sheep,
Goats,
Mice or Rats
OR in embryonated duck eggs
OR in cell culture

35. Type of VaccineType of Vaccine
NERVOUS TISSUE VACCINE (NTV)
a. Derived from adult animal nervous
tissue eg. Sheep
b. Derived from suckling mouse brain
Type: Killed viral vaccine
Dose: 2.5 ml S/C (Ant.
Abdominal wall)
Schedule: 14 doses

36. Type of Vaccine (conti)Type of Vaccine (conti)
Duck Embryo Vaccine (DEV)
Type: Killed viral vaccine
Dose: 1 ml S/C ( Ant. Abdominal wall)
Schedule: 14 doses OD
not available in Pakistan

37. Type of Vaccine (conti)Type of Vaccine (conti)
CELL CULTURE VACCINES
a. Human diploid cell vaccine (HDCV)
b. Second generation tissue culture
vaccine (non- Human)
Type: Killed viral vaccine
Dose: 1 ml IM
Schedule: on 0, 3, 7, 14, 28 day,
booster on day 90

38. PASSIVE IMMUNIZATIONPASSIVE IMMUNIZATION
• Horse Anti Rabies serum: 40 iu / kg at
0 day
• Human rabies immunoglobin (HRIG):
20 iu / kg around the wound and rest in
IM on 0 day
• Booster doses are essential whenever
anti rabies serum is given with the
vaccine

39. Classification Of ExposuresClassification Of Exposures
1. Class I (slight Risk) 07 injection
a. Licks on healthy unbroken skin.
b. Scratches without oozing of blood.
2. Class II (Moderate Risk) according to the Schedule plus one
booster dose after 3 week
a. Licks on fresh cuts.
b. Scratches with oozing of blood.
c. All bites except those on head, neck, face, palms and fingers.
d. Minor wounds less than 5 in number.
3. Class III (Severe Risk) according to the Schedule plus Two
booster dose one after one week and another 2 week
a. all bites or scratches with oozing of blood on neck, head,
face, palms and fingers.
b. Lacerated wounds on any part of the body.
c. Multiple wounds 5 or more in number.
d. Bites from wild animals.

40. IMMUNITYIMMUNITY
• Duration of Immunity is upto 06
month
• If again bite by rapid animal than
dose according to blood titre
if more than 0.5 i.u. / ml than only two
dose 0, 3 day
if less than 0.5 i.u. / ml than 0, 3, 7
day

41. General measuresGeneral measures
• Regist:,licensing & taxation of dog.
• Muzzling of dogs
• Yearly mass vaccination of dog
• Destruction of stray dogs
• Facilities for diagnosis of rabies in dogs
• Destruction of wildlife where the animals
are known to be the reservoir of infection.
• Publicity

42. Pre-Exposure Prophylaxis
• It is done in persons who have high risk of
repeated exposures.
Animal Handlers
Wildlife officers
Veterinarians
Lab: staff working with rabies virus
Protected by:- Cell-culture vaccine 1ml I/M
OR 0.1ml I/D ( 0,7& 28day)
Post-exposure R/ of persons
(who have been vaccinated previously)
HDC vaccine (1ml I/M 0,3 & 7 day 0

43. Rabies in DogsRabies in Dogs
• Incubation period: 3-8 wks.
• Clinical features: Rabies in dogs may manifest
itself in two forms.
a. Furious Rabies.
This the typical mad-dog syndrome characterized by.
i. change in behavior.
ii. Tendency to run away from home, wander aimlessly
and biting humans and animals.
iii. Change in voice due to paralisis of laryngeal muscles.
iv. Excessive salivation & foaming at the angle of the
mouth.
v. Paralysis of the whole body leading to coma & death.

44. b. Dumb Rabies.
i. The excitative or irritative stage is
lacking.
ii. The disease is predominantly paralytic.
iii. Dog withdraws itself from being seen or
disturbed.
iv. It elapses into a stage of sleepiness
and dies in about 3 days.