RabiesRabiesRhabdovirusRhabdovirus

Dr.T.V.Rao MDDr.T.V.Rao MD

Early RabiesEarly Rabies

Rabies Rabies has been recognized in India has been recognized in India since the Vedic period (1500–500 BC) since the Vedic period (1500–500 BC) and is described in the ancient Indian and is described in the ancient Indian scripture scripture AtharvavedaAtharvaveda,,

Rabies is endemic in India, a vast Rabies is endemic in India, a vast country with a population exceeding country with a population exceeding 1.02 billion and a land area of 3.2 1.02 billion and a land area of 3.2 million km. million km.

Rabies widely spread in Asia Rabies widely spread in Asia and Africaand Africa

Rabies is widely distributed across Rabies is widely distributed across the globe. More than the globe. More than 55 000 people 55 000 people diedie of rabies each year. About 95% of rabies each year. About 95% of human deaths occur in Asia and of human deaths occur in Asia and Africa. Africa.

Most human deaths follow a bite Most human deaths follow a bite from an infected dog. Between 30% from an infected dog. Between 30% to 60% of the victims of dog bites are to 60% of the victims of dog bites are children under the age of 15. children under the age of 15.

What is RabiesWhat is Rabies

Rabies is a zoonotic disease (a disease that Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is transmitted to humans from animals) that is caused by a virus. Rabies infects is caused by a virus. Rabies infects domestic and wild animals, and is spread to domestic and wild animals, and is spread to people through close contact with infected people through close contact with infected saliva (via bites or scratches). The disease saliva (via bites or scratches). The disease is present on nearly every continent of the is present on nearly every continent of the world but most human deaths occur in Asia world but most human deaths occur in Asia and Africa (more than 95%). and Africa (more than 95%). Once Once symptoms of the disease develop, symptoms of the disease develop, rabies is fatalrabies is fatal. .

Rabies - Common factsRabies - Common facts

Mad Dog biting Humans lead to Rabies.Mad Dog biting Humans lead to Rabies. Latin Rabhas means Frenzy.Latin Rabhas means Frenzy. Hydrophobia Fear of Water, Saliva of Hydrophobia Fear of Water, Saliva of

Rabid dogsRabid dogs Pasture’s success – VaccinationPasture’s success – Vaccination

Fixed virus from Rabbit injected into Fixed virus from Rabbit injected into Joseph Meister Joseph Meister

Injected 13 injection of the cord vaccine. Injected 13 injection of the cord vaccine.

7

Rabies- A Zoonotic Rabies- A Zoonotic DiseaseDisease

Rhabdovirus family; Rhabdovirus family; genus Lyssavirusgenus Lyssavirus

Enveloped, bullet-Enveloped, bullet-shaped virionsshaped virions

Slow, progressive Slow, progressive zoonotic diseasezoonotic disease

Primary reservoirs are Primary reservoirs are wild mammals; it can wild mammals; it can be spread by both wild be spread by both wild and domestic and domestic mammals by bites, mammals by bites, scratches, and scratches, and inhalation of droplets.inhalation of droplets.

Rabies – A fatal Zoonotic Rabies – A fatal Zoonotic DiseaseDisease

Rabies in USARabies in USA

Most of the recent Most of the recent human rabies cases human rabies cases in the United States in the United States have been caused by have been caused by rabies virus from rabies virus from bats.bats. Awareness of Awareness of the facts about bats the facts about bats and rabies can help and rabies can help people protect people protect themselves, their themselves, their families, and their families, and their pets. pets.

RhabdovirusesRhabdoviruses

A Bullet shaped virus/ A Bullet shaped virus/ EnvelopedEnveloped

Contains Contains ss RNAss RNA virus virus Rhabdoviridae – Rhabdoviridae –

infects mammals.infects mammals. Important virusImportant virus

Lyssa virus- Rabies Lyssa virus- Rabies virusvirus

Lyssa means Lyssa means Rage.Rage.

Rabies virusRabies virus

Bullet shaped virusBullet shaped virus Size is 180 x 75 nmSize is 180 x 75 nm Has Lipoprotein Has Lipoprotein

envelopenvelop Knob like spikes Knob like spikes

/Glycoprotein S/Glycoprotein S Genome un Genome un

segmentedsegmented Linear negative Linear negative

sense RNAsense RNA

What is a Fixed VirusWhat is a Fixed Virus One whose virulence One whose virulence

and incubation period and incubation period have been stabilized have been stabilized by serial passage and by serial passage and remained fixed during remained fixed during further transmission.further transmission.

Rabies virus that has Rabies virus that has undergone serial undergone serial passage through passage through rabbits, thus stabilizing rabbits, thus stabilizing its virulence and its virulence and incubation period and incubation period and called as called as fixed virusfixed virus

What is a Street VirusWhat is a Street Virus Virus from a naturally Virus from a naturally

infected animal, as infected animal, as opposed to a opposed to a laboratory-adapted laboratory-adapted strain of the virus. strain of the virus.

The virulent rabies The virulent rabies virus from a rabid virus from a rabid domestic animal that domestic animal that has contracted the has contracted the disease from a bite or disease from a bite or scratch of another scratch of another animal, and called as animal, and called as street virusstreet virus. .

Any mammal can get Any mammal can get rabiesrabies..

Raccoons, Raccoons, skunks, foxes skunks, foxes and batsand bats

Dogs, cats, Dogs, cats, cattle and cattle and ferretsferrets

Humans tooHumans too

What kind of animals What kind of animals get get Rabies?Rabies?

The rabies virus can infect The rabies virus can infect all all mammalsmammals..

MammalsMammals are warm- are warm-blooded animals that have blooded animals that have hair and mammary glands to hair and mammary glands to produce milk for their produce milk for their babies.babies.

Animals like frogs, birds, and Animals like frogs, birds, and snakes do not get rabiessnakes do not get rabies..

Man’s best friendMan’s best friendbut can spread Rabies if not but can spread Rabies if not

vaccinatedvaccinated

Rabies viruses are Rabies viruses are sensitive to common sensitive to common

ChemicalsChemicals The virus is sensitive toThe virus is sensitive to

EthanolEthanol

IodineIodine

Soap / DetergentsSoap / Detergents

Ether, Chloroform, AcetoneEther, Chloroform, Acetone

Destroyed at 50Destroyed at 5000 c in 1 hour c in 1 hour

at 60at 6000 c in 5 minutes. c in 5 minutes.

Antigenic propertiesAntigenic properties

Surface spikes Surface spikes composed of composed of Glycoprotein GGlycoprotein G

Produces Produces Pathogenicity by Pathogenicity by binding to Acetyl binding to Acetyl choline receptors in choline receptors in the neural tissuethe neural tissue

Stimulate T Stimulate T lymphocytes lymphocytes Cytotoxic effect.Cytotoxic effect.

TransmissionTransmission Abrasions or scratches on skin.Abrasions or scratches on skin. Mucous membrane exposed to saliva.Mucous membrane exposed to saliva. Most frequently via deep penetrating bite Most frequently via deep penetrating bite

wounds.wounds.

Other routesOther routes.. Inhalation in bat infected caves.Inhalation in bat infected caves. Ingestion of dead /infected animal Ingestion of dead /infected animal

meatmeat Corneal transplantationCorneal transplantation

Pathogenesis of RabiesPathogenesis of Rabies

Bite by Rabid dog or other animalsBite by Rabid dog or other animals Virus are carried in saliva virus Virus are carried in saliva virus

deposited on the wound site.deposited on the wound site. If untreated 50% will Develop rabies.If untreated 50% will Develop rabies. Rabies can be produced by licks and Rabies can be produced by licks and

corneal transplantation.corneal transplantation. Virus multiply in the muscle ,connective Virus multiply in the muscle ,connective

tissue, nerves after 48 – 72 hours.tissue, nerves after 48 – 72 hours. Penetrated nerve endings.Penetrated nerve endings.

PATHOGENESISPATHOGENESISLive virusLive virus Epidermis, Mucus membrane Epidermis, Mucus membrane

Peripheral nervePeripheral nerve

CNS ( gray matter )CNS ( gray matter )

Other tissue (salivary glands,…)Other tissue (salivary glands,…)

centripetally

centrifugally

Spread of VirusSpread of Virus

From Brain virus From Brain virus spread tospread to

Salivary glands,Salivary glands,

Conjunctival cell Conjunctival cell released into tearsreleased into tears

Kidney Kidney

Lactating glands Lactating glands and Milk after and Milk after pregnancypregnancy

PathogenesisPathogenesis

Virus travels through axoplasam toward Virus travels through axoplasam toward the spinal cord, at the rate of 3 the spinal cord, at the rate of 3 mm/hour,mm/hour,

Towards the brain Towards the brain Spread from brain centrifugally to Spread from brain centrifugally to

various parts of the body.various parts of the body. Multiplies in the salivary glands and Multiplies in the salivary glands and

shed in the saliva.shed in the saliva. Cornea, facial tissues skin.Cornea, facial tissues skin.

PathogenesisPathogenesis

Incubation 1 – 3 months.Incubation 1 – 3 months. May be average from 7 days to 3 May be average from 7 days to 3

years.years. Stages of the disease.Stages of the disease.

ProdromeProdrome

Acute encephalitis.Acute encephalitis.

Coma / Death.Coma / Death.

Broad category - Broad category - PresentationsPresentations

Furious RabiesFurious Rabies

Dumb ( Rage Dumb ( Rage tranquille )tranquille )

(Landry/Guillain-(Landry/Guillain-Barre SyndromeBarre Syndrome

CategoryCategory - - WHOWHO

Category I: touching or feeding Category I: touching or feeding suspect animals, but skin is intact suspect animals, but skin is intact

Category II: minor scratches without Category II: minor scratches without bleeding from contact, or licks on bleeding from contact, or licks on broken skin broken skin

Category III: one or more bites, Category III: one or more bites, scratches, licks on broken skin, or scratches, licks on broken skin, or other contact that breaks the skin; or other contact that breaks the skin; or exposure to bats exposure to bats

Clinical FindingsClinical Findings Bizarre behavior.Bizarre behavior. AgitationAgitation Seizures.Seizures. Difficulty in drinking.Difficulty in drinking. Patients will be able to eat solidsPatients will be able to eat solids Afraid of water - Hydrophobia.Afraid of water - Hydrophobia. Even sight or sound of water disturbs the Even sight or sound of water disturbs the

patientpatient.. But suffer with intense thirst.But suffer with intense thirst. Spasms of Pharynx produces chokingSpasms of Pharynx produces choking Death in 1 -6 days.Death in 1 -6 days. Respiratory arrest / Death / Respiratory arrest / Death / Some may surviveSome may survive..

Headache, fever, sore throatHeadache, fever, sore throat Nervousness, confusionNervousness, confusion Pain or tingling at the site of the bitePain or tingling at the site of the bite HallucinationsHallucinations

– Seeing things that are not really there Seeing things that are not really there HydrophobiaHydrophobia

– ““Fear of water" due to spasms in the throatFear of water" due to spasms in the throat Paralysis Paralysis

– Unable to move parts of the body Unable to move parts of the body Coma and deathComa and death

SymptomsSymptoms

CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONS

1 – Non specific prodromeNon specific prodrome

2 – Acute neurologic encephalitis2 – Acute neurologic encephalitis Acute encephalitisAcute encephalitis Profound dysfunction of brainstemProfound dysfunction of brainstem

3 – Coma3 – Coma

4 - Death ( Rare cases 4 - Death ( Rare cases recovery ) recovery )

CLINICAL MANIFESTATIONSCLINICAL MANIFESTATIONS

Non specific prodromeNon specific prodrome 1 - 2 days 1 - 2 days 1 week 1 weekFever, headache, sore throatFever, headache, sore throatAnorexia, nausea, vomiting, Anorexia, nausea, vomiting, Agitation, depressionAgitation, depressionParenthesis or fasciculation's at Parenthesis or fasciculation's at or Around the site of inoculation of or Around the site of inoculation of virusvirus. .

Acute Neurologic Acute Neurologic EncephalitisEncephalitis

1 – 2 days to < 1 week1 – 2 days to < 1 week Excessive motor activity, Excitation, Excessive motor activity, Excitation,

AgitationAgitation Confusion, Hallucinations, Delirium, Confusion, Hallucinations, Delirium, Bizarre aberrations of thought, Bizarre aberrations of thought,

SeizuresSeizures,,

Muscle spasms, Meningismus, Muscle spasms, Meningismus, Opisthotonic posturing Opisthotonic posturing Mental aberration ( Lucid period Mental aberration ( Lucid period coma ) coma ) Hypersalivation, Aphasia, Pharyngeal spasmsHypersalivation, Aphasia, Pharyngeal spasms Incordination, HyperactivityIncordination, Hyperactivity

Acute Neurologic Acute Neurologic Encephalitis Phase - Encephalitis Phase -

PresentationsPresentations Fever T > 40.6 Fever T > 40.6 Dilated irregular pupilsDilated irregular pupils Lacrimation, Salivation & Lacrimation, Salivation &

PerspirationPerspiration Upper motor neuron paralysisUpper motor neuron paralysis Deep tendon reflexesDeep tendon reflexes Extensor plantar responses ( as a Extensor plantar responses ( as a

rule )rule ) Hydrophobia or Aerophobia (50 -70% )Hydrophobia or Aerophobia (50 -70% )

Rabies can present as Rabies can present as Grave conditionGrave condition

Majority will succumb to Majority will succumb to DiseaseDisease

Clinical presentationClinical presentation – – Leads the clues in Leads the clues in

DiagnosisDiagnosis In most cases, human rabies is In most cases, human rabies is

diagnosed primarily on the basis of diagnosed primarily on the basis of clinical symptoms and signs, and a clinical symptoms and signs, and a corroborative history of or evidence of corroborative history of or evidence of an animal bite, death of an animal, and an animal bite, death of an animal, and incomplete or no vaccination following incomplete or no vaccination following exposure. The facility for laboratory exposure. The facility for laboratory diagnosis and confirmation of rabies, be diagnosis and confirmation of rabies, be it in humans or in animals, is available it in humans or in animals, is available premortem in only a few institutions in premortem in only a few institutions in India. T India. T

Common confirmatory test - Common confirmatory test - RabiesRabies

1.1. The standard The standard premortem test is premortem test is aa fluorescent fluorescent antibodyantibody test to test to demonstrate the demonstrate the presence of viral presence of viral antigen. The standard antigen. The standard postmortem test is postmortem test is biopsy of the patient's biopsy of the patient's brain and examination brain and examination for Negri bodiesfor Negri bodies. . Autopsies are rarely performedAutopsies are rarely performed. .

DIAGNOSISDIAGNOSIS•Laboratory finding: ( CBC, CSF )Laboratory finding: ( CBC, CSF )•Exclusion of other etiologiesExclusion of other etiologies

•Pathology:Pathology: Formation of cytoplasmic inclusions: Formation of cytoplasmic inclusions: ( Negri bodies )( Negri bodies ) ( Ammon’s horn, Cerebral cortex,( Ammon’s horn, Cerebral cortex, Brainstem, Hypothalamus, Brainstem, Hypothalamus, The Purkinje cells of cerebellum, The Purkinje cells of cerebellum, Dorsal spinal ganglia )Dorsal spinal ganglia )

Laboratory DiagnosisLaboratory Diagnosis Survival possibleSurvival possible. . May need Laboratory May need Laboratory

DiagnosisDiagnosis Clinical differentiation other cases of Encephalitis.Clinical differentiation other cases of Encephalitis. Post mortem Diagnosis by Post mortem Diagnosis by By demonstration of Negri bodies.By demonstration of Negri bodies. Isolation of virus fro Mice brainIsolation of virus fro Mice brain inoculation.inoculation. tissue culture on culture linestissue culture on culture lines W 138, BHK,W 138, BHK, PCR emerging method.PCR emerging method. IF methods corneal impression method.IF methods corneal impression method.

Diagnostic methodsDiagnostic methods

Antigen detection by specific Antigen detection by specific Immuno fluorescence.Immuno fluorescence.

Ante-mortem - Conjunctival,skin Ante-mortem - Conjunctival,skin biopsy from nape of neck.biopsy from nape of neck.

Postmortem impression from surfaces Postmortem impression from surfaces of salivary glands Hippocampus,of salivary glands Hippocampus,

Histological examinationHistological examinationELISA specific antibody detection.ELISA specific antibody detection.PCRPCR

Negri bodies – A gold Negri bodies – A gold standard in Diagnosisstandard in Diagnosis

Inclusion bodies Inclusion bodies called called Negri Negri bodiesbodies are 100% are 100% diagnostic for diagnostic for rabies infection, rabies infection, but found only in but found only in 20% of cases20% of cases

Negri bodiesNegri bodiesin Brain Tissuein Brain Tissue

Negri bodiesNegri bodies  round or   round or oval inclusion bodies oval inclusion bodies seen in the cytoplasm seen in the cytoplasm and sometimes in the and sometimes in the processes of neurons of processes of neurons of rabid animals after rabid animals after death. death.

Negri bodies are Negri bodies are Eosinophilic, sharply Eosinophilic, sharply outlined, pathognomonic outlined, pathognomonic inclusion bodies (2-10 inclusion bodies (2-10 µm in diameter) found in µm in diameter) found in the cytoplasm of certain the cytoplasm of certain nerve .. nerve ..

Emerging Methods in Emerging Methods in DiagnosisDiagnosis

The reference method for diagnosing rabies The reference method for diagnosing rabies is by performing PCR or viral culture on brain is by performing PCR or viral culture on brain samples taken after death. The diagnosis samples taken after death. The diagnosis can also be reliably made from skin samples can also be reliably made from skin samples taken before death. It is also possible to taken before death. It is also possible to make the diagnosis from saliva, urine and make the diagnosis from saliva, urine and cerebrospinal fluid samples, but this is not as cerebrospinal fluid samples, but this is not as sensitive. sensitive. Inclusion bodies called Inclusion bodies called Negri Negri bodiesbodies are 100% diagnostic for rabies are 100% diagnostic for rabies infection, but found only in 20% of infection, but found only in 20% of casescases. .

DIFFERENTIAL DIAGNOSISOther viral encephalitisOther viral encephalitis

Hysteria reaction to animal bite

Landry/Guillan-barre syndrome

Poliomyelitis

Allergic encephalomyelitis ( rabies vaccine )

PREVENTIONPREVENTION

Preexposure ProphylaxisPreexposure Prophylaxis

Postexposure ProphylaxisPostexposure Prophylaxis

Ist Vaccine for RabiesIst Vaccine for Rabies Prepared by Pasteur Prepared by Pasteur

by drying various by drying various periods pieces of periods pieces of spinal cord of spinal cord of Rabbits infected Rabbits infected with fixed viruswith fixed virus

1885 1885 Joseph Joseph MeisterMeister 9 year boy 9 year boy vaccinated 13 vaccinated 13 injections were injections were given given

Patient savedPatient saved

Preexposure vaccinationPreexposure vaccination

Indicated in Indicated in

Laboratory Laboratory workers.workers.

Veterinarians Veterinarians and technical staff.and technical staff.

Bat handlers.Bat handlers.

Supporting care in Supporting care in Animal/Dog BitesAnimal/Dog Bites

Basic care in Animal Basic care in Animal bitesbites

Before exposure to infectionBefore exposure to infection In Veterinary surgeons animal handlers.In Veterinary surgeons animal handlers. Specific Prophylaxis Specific Prophylaxis After exposure to Dog bite.After exposure to Dog bite.Local treatmentLocal treatment Cauterization Cauterization Scrub with Soap and clean.Scrub with Soap and clean.Use cetavalon, tincture of IodineUse cetavalon, tincture of IodineAntirabic serum Antirabic serum don't suturedon't suture

Tell an health care Tell an health care worker worker immediatelyimmediately

Wash the wound Wash the wound out with soap and out with soap and waterwater

Inform the doctor Inform the doctor right awayright away

If you are bitten or If you are bitten or scratchedscratched

POSTEXPOSURE PROPHYLAXISPOSTEXPOSURE PROPHYLAXIS

1 – Wound cleaning & treatmentWound cleaning & treatment

Post exposure Post exposure vaccinationvaccination

Anti Rabis vaccines are given when Anti Rabis vaccines are given when person is person is

1 Bitten1 Bitten

2 Scratched2 Scratched

3 Licked 3 Licked

By Rabid animalBy Rabid animal

animal to be kept for 10 days ?animal to be kept for 10 days ?

VaccinesVaccines Semple vaccineSemple vaccine Contain 5 % suspension. Of infected Contain 5 % suspension. Of infected

Sheep brain, ( Infected with fixed virus ) Sheep brain, ( Infected with fixed virus ) Inactivated with Phenol at 37Inactivated with Phenol at 3700cc Vaccines available after inactivation with Vaccines available after inactivation with

Beta propiolactone Used in IndiaBeta propiolactone Used in India Vaccine contains Nucleic capsid antigen,Vaccine contains Nucleic capsid antigen, Small quantities of Glycoprotein GSmall quantities of Glycoprotein G Used in Developed countries Neural Used in Developed countries Neural

complications.complications.

Neural VaccinesNeural Vaccines**

Class I slight riskClass I slight risk Class II Moderate riskClass II Moderate risk Class III Great riskClass III Great risk Nerual vaccines may cause Nerual vaccines may cause

Neuroparlytic complications, Neuroparlytic complications, Laundry’s type ascending paralysisLaundry’s type ascending paralysis

• Dose is regulated according to grade/class of bitesDose is regulated according to grade/class of bites• Many countries do not use in view of neurological complicationsMany countries do not use in view of neurological complications

HUMAN RABIES Cell culture VaccinesHUMAN RABIES Cell culture Vaccines

Vaccine:Vaccine: Human diploid cell vaccine (HDCV)Human diploid cell vaccine (HDCV) Developed by Koprowsky,Wiktor,and PlotkinDeveloped by Koprowsky,Wiktor,and Plotkin

Purified chick embryo cell vaccine (PCEC)Purified chick embryo cell vaccine (PCEC) Purified Vero cell vaccine (PVRV)Purified Vero cell vaccine (PVRV) Purified duck embryo vaccine (PDEV)Purified duck embryo vaccine (PDEV)

Post exposure Post exposure ProphylaxisProphylaxis

The vaccination is The vaccination is given ongiven on

0, 3, 7, 14, 30, 0, 3, 7, 14, 30, and 90and 90thth day day

Immunity lasts for Immunity lasts for 5 years5 years

Injected on deltoid Injected on deltoid region IM/SCregion IM/SC

Not to be given in Not to be given in the gluteal regionthe gluteal region

POSTEXPOSURE PROPHYLAXISPOSTEXPOSURE PROPHYLAXIS 3 –3 – Active immunizationActive immunization

Cell culture Vaccines in – Cell culture Vaccines in – commonly prescribedcommonly prescribed

1 1 Human diploid Human diploid cell vaccinecell vaccine..

2 2 Purified chick Purified chick embryo cell embryo cell vaccinevaccine

3.Purified Vero cell 3.Purified Vero cell vaccinevaccine

Human Diploid CellHuman Diploid CellVaccineVaccine

Koprowsky, Viktor, Koprowsky, Viktor, Plokin discovered Plokin discovered

Inactivated in Inactivated in Betaproprionate.Betaproprionate.

No serious side No serious side effects.effects.

Human Diploid cell Human Diploid cell vaccines purified .vaccines purified .

Sub Unit vaccines in Sub Unit vaccines in progress/developed.progress/developed.

Human Diploid Cell Human Diploid Cell VaccinesVaccines

DosageDosage Preexposure prophylaxis Preexposure prophylaxis 0 – 7 – 21 – or 28 – 56 days0 – 7 – 21 – or 28 – 56 days A booster after 1 year,A booster after 1 year, Repeat once in 5 days,Repeat once in 5 days,Post exposure ProphylaxisPost exposure Prophylaxis Sex dosesSex doses 0 -3 -7-14 – 30 - 90 days0 -3 -7-14 – 30 - 90 days Given IM or SC in the Deltoid region Given IM or SC in the Deltoid region Don't inject inGluteal region.Don't inject inGluteal region.

Preexposure prophylasixis Preexposure prophylasixis dosesdoses

Given on the Given on the following daysfollowing days

0, 7, 21,or 28 0, 7, 21,or 28 and 56and 56thth day day

Generally given to Generally given to Vet nary Vet nary personalpersonal

Passive ImmunizationPassive Immunization

Human Rabies Human Rabies Immunoglobulin HRIGImmunoglobulin HRIG

High Risk bitten on High Risk bitten on face and neckface and neck

Given a dose of 20 IU Given a dose of 20 IU /Kg wt/Kg wt

Half at the site of bite Half at the site of bite and rest IM route.and rest IM route.

Active immunization Active immunization should be initiatedshould be initiated with with passive immunization.passive immunization.

Future of Rabies Future of Rabies VaccinesVaccines

A number of experimental vaccines are A number of experimental vaccines are under development that may provide under development that may provide alternative safe and potent but less alternative safe and potent but less expensive vaccine options. These expensive vaccine options. These include include DNA vaccinesDNA vaccines, recombinant , recombinant viral vaccines, and recombinant protein viral vaccines, and recombinant protein vaccines. Further testing is needed to vaccines. Further testing is needed to determine if and which one of these determine if and which one of these novel vaccines will make their way into novel vaccines will make their way into mass production and application in the mass production and application in the future. future.

Subunit or Genetically Subunit or Genetically Engineered vaccines for RabiesEngineered vaccines for Rabies A viral immunizing A viral immunizing

agent that has been agent that has been treated to remove treated to remove traces of viral nucleic traces of viral nucleic acid so that only acid so that only protein subunits protein subunits remain. The subunits remain. The subunits have less risk of have less risk of causing adverse causing adverse reactions.reactions.

Several trails in Several trails in progressprogress

EpidemiologyEpidemiology

No Danger of Nursing Rabies No Danger of Nursing Rabies patients but do take precautionspatients but do take precautions

Any animal bite can cause Rabies Any animal bite can cause Rabies except Miceexcept Mice

BATS in caves in spread he disease BATS in caves in spread he disease by respiratory disease.by respiratory disease.

India around 30,000 die with Rabies.India around 30,000 die with Rabies. Vaccination of the Dogs and Vaccination of the Dogs and

Licensing of the DogsLicensing of the Dogs

In spite of Health Education several die In spite of Health Education several die due to Rabies infection in Developing due to Rabies infection in Developing

worldworld

World's Rabies Day (on September World's Rabies Day (on September 28)28)

World Rabies Day World Rabies Day is a cooperative is a cooperative global event global event planned to reduce planned to reduce the suffering from the suffering from rabies. This day rabies. This day celebrates Dr. celebrates Dr. Louis Pasteur’s Louis Pasteur’s vision of a vision of a rabies rabies free worldfree world. .

Created by Created by Dr.T.V.Rao MD Dr.T.V.Rao MD for ‘e’ for ‘e’ learning Programme in learning Programme in

developing worlddeveloping world

EmailEmail

doctortvrao@gmail.comdoctortvrao@gmail.com