Is a viral encephalomyelitis caused by rabies virus. The onset of illness is gradual but there is no specific treatment other than supportive care once clinical symptoms develop. Rabies is almost always fatal, death resulting from respiratory paralysis. Worldwide, more than 55,000 people die of rabies each year (WHO, 2010)
Incubation period may range from 4 days to 19 years although in more than 93% of exposure, the onset is within a year of exposure. Tingling and numbness sensation around site of wound, fever, headache and malaise are early symptoms. The disease may then present with hydrophobia, hallucinations and maniacal behaviour progressing to paralysis and coma, or as an ascending flaccid paralysis and sensory disturbance.
Infection is usually via the bite or scratch of a rabid animal, most frequently a dog. In some parts of the world, other animals such as bats, cats and monkeys are important sources of exposure. In parts of Europe (including the UK) are found in insectivorous bats and have occasionally caused human disease. On rare occasion, transmission of virus through an individual’s mucous membranes with direct contact to infected animals has occurred.
Rabies in animals occurs in all continents except Antarctica, although individual countries and islands are reported to be rabies-free. In Asia, Africa, Central and South America, classical rabies virus is endemic and present in both wild animals and domestic dogs. In Mexico and South Central America, bats usually carry the classical virus. Rabies continues to be reported in domestic animals imported from rabies endemic countries. Rabies remains prevalent in Eastern Europe and Turkey.
There are currently two rabies vaccines licensed for intramuscular use in the UK. The vaccines are inactivated, do not contain live organisms and cannot cause the disease against which they protect.