4. Early Symptoms
• nonspecific
• lethargy, fever
• constantly lick, bite and chew at the site
where they were bitten
• Constant irritability/changes in attitude
and behavior
• Experience a loss of appetite
• Exhibit strange behaviors, such as turning
in circles
5. Late Symptoms
• Progress within days
• Acquire a change in voice, hypersalivation
• Hypersensitive to touch, light and sound
• May eat unusual things and hide in dark places
• Aggression and/or self-mutilation
• Difficulty breathing, difficulty swallowing
• Cerebral & cranial nerve dysfunction, ataxia,
weakness, paralysis, seizures
• Sudden death
7. Clinical picture of Rabies in Man
• Rabies in man is known as Hydrophobia
• 3 stages :
– Prodromal Stage
– Stage of widespread excitation & stimulation of all
parts of nervous system
– Late stage
8. Prodromal Stage
- Headache, Sore throat,
malaise & slight fever
lasting 3-4 days
- 80% patients complain
of pain and tingling at
site of bite
9. Stage of widespread excitation &
stimulation of nervous system
• Excitation and stimulation in order of :
Sensory motor sympathetic mental
• In Sensory involvement : intolerant to noise, bright
light or cold draught of air (aerophobia)
• AEROPHOBIA
– Pathognomic of Rabies
– Elicited by fanning a current acrosss face which
cause spasms of pharyngeal and neck muscles
10. Stage of widespread excitation &
stimulation of nervous system
• In motor involvement : increase reflexes and
muscle spasms
• In sympathetic involvement : dilatation of pupils,
increased perspiration, salivation & lacrimation
• Mental changes : fear of death, anger, irritability
& depression
11. Late stage
• Sight & sound of water provoke spasms of
muscles of deglutition
• Hydrophobia
– Pathognomic of Rabies
– Absent in animals
12. Progression of disease
• Duration of illness : 2-3 days but may be
prolonged to 5-6 days in exceptional cases
• Patients may die of one of convulsions or pass
onto stage of paralysis & coma
• Intensive care may allow patient an occasional
patient to survive
