Rabies history and symptoms: Difference between revisions
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# Encephalitic ("furious") rabies- more common (80% cases) | # Encephalitic ("furious") rabies- more common (80% cases) | ||
# Paralytic ("dumb") rabies | # Paralytic ("dumb") rabies | ||
* | * Occasionally atypical cases with following features have been reported:<ref name="pmid12849514">{{cite journal |vauthors=Hemachudha T, Laothamatas J, Rupprecht CE |title=Human rabies: a disease of complex neuropathogenetic mechanisms and diagnostic challenges |journal=Lancet Neurol |volume=1 |issue=2 |pages=101–9 |year=2002 |pmid=12849514 |doi= |url=}}</ref><ref name="pmid15614231">{{cite journal |vauthors= |title=Recovery of a patient from clinical rabies--Wisconsin, 2004 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=53 |issue=50 |pages=1171–3 |year=2004 |pmid=15614231 |doi= |url=}}</ref> | ||
** Sensory or motor deficits | ** Sensory or motor deficits | ||
** Choreiform movements of the bitten limb (during the prodromal phase) | ** Choreiform movements of the bitten limb (during the prodromal phase) | ||
| Line 82: | Line 85: | ||
** Myoclonus | ** Myoclonus | ||
** Seizure | ** Seizure | ||
* Following factors influence the course of disease: | |||
** The depth and extent of bite | |||
** Proximity to head | |||
** Amount of secretions encountered at the site of bite | |||
=== (a) Encephalitic ("furious") rabies: === | === (a) Encephalitic ("furious") rabies: === | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms[edit | edit source]
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History[edit | edit source]
The following points need to be asked about while taking a history from patients with suspected rabies:
- Details about the interaction with the animal
- Any unusual behavior by the animal
- Whether the animal is available or not for testing
- Vaccination status of the animal[1]
Symptoms[edit | edit source]
The symptoms depend upon the stage of the disease at which it presents. It may present at any one of the following stages:
- Incubation period
- Prodromal period
- Acute neurologic period (Clinical rabies)
- Coma
Incubation period
- During this period, the patient is asymptomatic as the virus has not entered the CNS yet.
- Antibody response may not be observed during this period as the virus is still isolated from the immune system.
- The duration of incubation period varies. The average duration is 20-90 days but can range from a few days to many years.[2][3][4][5]
- Following factors are found to be associated with a shorter incubation period:
- Bite on head or face (richly innervated areas)
- Multiple bites transferring heavy inoculum
- Deep and large woundsInadequate rabies prophylaxis, or an unknown new exposure may lead to a longer incubation period.
- It is hypothesized that a latent viral infection and/or slow replication may be associated with it.[6][5][7]
Prodromal period
- In this stage, the patient presents with non-specific signs and symptoms and rabies usually remains unsuspected at this stage
- It usually lasts from a few days to a week (3-9days)[8]
- Pathognomic presentation involves following symptoms at the inoculation site:[9]
- Pain
- Paresthesia
- Itching
- Tingling or burning
- Numbness
Common symptoms include:
- Low-grade fever
- Chills
- Malaise
- Myalgias
- Weakness
- Fatigue
- Anorexia
- Sore throat
- Nausea, vomiting
- Headache
- Anxiety
- Agitation
- Insomnia
- Depression
Less common symptoms:
- Photophobia
Acute neurologic period (Clinical rabies)
- Clinical rabies has two forms, both of them evolving from prodromal symptoms
- Encephalitic ("furious") rabies- more common (80% cases)
- Paralytic ("dumb") rabies
- Occasionally atypical cases with following features have been reported:[8][10]
- Sensory or motor deficits
- Choreiform movements of the bitten limb (during the prodromal phase)
- Focal brainstem signs
- Cranial nerve palsies
- Myoclonus
- Seizure
- Following factors influence the course of disease:
- The depth and extent of bite
- Proximity to head
- Amount of secretions encountered at the site of bite
(a) Encephalitic ("furious") rabies:
(b) Paralytic ("dumb") rabies:
Coma
References[edit | edit source]
- (name of the system)
- ↑ "Compendium of animal rabies prevention and control, 2004: National Association of State Public Health Veterinarians, Inc. (NASPHV)". MMWR Recomm Rep. 53 (RR-9): 1–8. 2004. PMID 15215738.
- ↑ Knobel DL, Cleaveland S, Coleman PG, Fèvre EM, Meltzer MI, Miranda ME, Shaw A, Zinsstag J, Meslin FX (2005). "Re-evaluating the burden of rabies in Africa and Asia". Bull. World Health Organ. 83 (5): 360–8. doi:/S0042-96862005000500012 Check
|doi=value (help). PMC 2626230. PMID 15976877. - ↑ Noah DL, Drenzek CL, Smith JS, Krebs JW, Orciari L, Shaddock J, Sanderlin D, Whitfield S, Fekadu M, Olson JG, Rupprecht CE, Childs JE (1998). "Epidemiology of human rabies in the United States, 1980 to 1996". Ann. Intern. Med. 128 (11): 922–30. PMID 9634432.
- ↑ Rupprecht CE, Hanlon CA, Hemachudha T (2002). "Rabies re-examined". Lancet Infect Dis. 2 (6): 327–43. PMID 12144896.
- ↑ 5.0 5.1 Boland TA, McGuone D, Jindal J, Rocha M, Cumming M, Rupprecht CE, Barbosa TF, de Novaes Oliveira R, Chu CJ, Cole AJ, Kotait I, Kuzmina NA, Yager PA, Kuzmin IV, Hedley-Whyte ET, Brown CM, Rosenthal ES (2014). "Phylogenetic and epidemiologic evidence of multiyear incubation in human rabies". Ann. Neurol. 75 (1): 155–60. doi:10.1002/ana.24016. PMC 4118733. PMID 24038455.
- ↑ Smith JS, Fishbein DB, Rupprecht CE, Clark K (1991). "Unexplained rabies in three immigrants in the United States. A virologic investigation". N. Engl. J. Med. 324 (4): 205–11. doi:10.1056/NEJM199101243240401. PMID 1985241.
- ↑ Hemachudha T, Ugolini G, Wacharapluesadee S, Sungkarat W, Shuangshoti S, Laothamatas J (2013). "Human rabies: neuropathogenesis, diagnosis, and management". Lancet Neurol. 12 (5): 498–513. doi:10.1016/S1474-4422(13)70038-3. PMID 23602163.
- ↑ 8.0 8.1 Hemachudha T, Laothamatas J, Rupprecht CE (2002). "Human rabies: a disease of complex neuropathogenetic mechanisms and diagnostic challenges". Lancet Neurol. 1 (2): 101–9. PMID 12849514.
- ↑ "Imported human rabies in a U.S. Army soldier - New York, 2011". MMWR Morb. Mortal. Wkly. Rep. 61 (17): 302–5. 2012. PMID 22552206.
- ↑ "Recovery of a patient from clinical rabies--Wisconsin, 2004". MMWR Morb. Mortal. Wkly. Rep. 53 (50): 1171–3. 2004. PMID 15614231.