Full text loading...
Chapter 94 : Rabies Virus*
This chapter contains the latest information on taxonomy of the genus Lyssavirus. Since the previous edition, there are three new Lyssavirus species, Shimoni bat virus, Bokeloh bat lyssavirus, Ikoma lyssavirus, and a proposed new lyssavirus, Lleida bat virus. The genetic diversity within the genus has a significant impact on the success of postexposure prophylaxis with current biologics. A description of the morphology and structure of the agent, the structural proteins of diagnostic significance, and the epidemiology and transmission of the disease are also presented. Although rare in affluent countries, more than 55,000 human cases of rabies occur annually. A section on the clinical significance of disease describes signs and symptoms at different stages. Although the successful treatment of a teenager from Wisconsin in 2004 has broadened treatment options, specific rabies antiviral treatment does not exist, and prognosis remains poor. Electronic resources for physicians and public health professionalsare provided, including the most current information concerning rabies diagnosis, experimental treatment protocols and consultation. Rabies prevention, including pre- and postexposure prophylaxis, is discussed according to the Advisory Committee on Immunization Practices (ACIP) guidelines for the United States. Presented are laboratory methods to confirm or rule out rabies in antemortem and postmortem humans and animals. Descriptions of the tests for detection of virus, antigen, antibodies, and nucleic acids and methods for virus (antigenic and genetic) typing are included. The interpretation of test results, sample requirements, and storage and transport conditions are mentioned. The information is provided to laboratory and public health professionals as a resource for information concerning rabies and other lyssaviruses.