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- A rapidly progressive CNS infection caused by an RNA rhabdovirus affecting mammals, including humans
- Generally considered to be 100% fatal once symptoms develop
- System(s) affected: nervous
- Synonym(s): hydrophobia (inability to swallow water)
- Most cases are in developing countries.
- Estimated 55,000 deaths worldwide per year
- Typically only 1 to 3 cases per year in the United States, with 1/3 of those being due to exposure outside of the United States
- Predominant age: any
- Predominant sex: male = female
Etiology and Pathophysiology
Lyssavirus, an RNA virus in the family Rhabdoviridae
- Rabies virus is a neurotropic virus present in saliva of infected animals.
- Transmission occurs via bites from infected animals or when saliva from an infected animal comes in contact with an open wound or mucous membranes.
- Bats are most common reservoir in the United States.
- Professions or activities with exposure to potentially infected (wild or domestic) animals (e.g., animal handlers, lab workers, veterinarians, cave explorers)
- Most U.S. cases are associated with bat exposure.
- Internationally, rabies is widespread in both domestic and feral dogs.
- Human-to-human transmission has occurred through transplantation of cornea, solid organs, and other tissues.
- Travel to countries where canine rabies is endemic
- Preexposure vaccination for high-risk groups (veterinarians, animal handlers, and certain laboratory workers)
- Consider preexposure vaccination for travelers to areas (such as North Africa) that have increased risk of rabies from domestic animals.
- Immunization of dogs and cats
- Contact animal control and avoid approaching or handling wild (or domestic) animals exhibiting strange behaviors.
- Avoid wild and unknown domestic animals.
- Seek treatment promptly if bitten, scratched, or in contact with saliva from potentially infected animal.
- Prevent infection by prompt postexposure treatment.
- Consider postexposure prophylaxis for individuals in direct contact with bats, unless it is known that an exposure did not occur.
- Hospital contacts of patients infected with rabies do not require postexposure prophylaxis unless there has been exposure through mucous membranes or an open wound (including a bite) to saliva, CSF, or brain tissue from the infected patient.