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DescriptionCNS infectious disease of mammals caused by the rabies virus:
- Highest case fatality rate of any known infectious disease
- 30,000–70,000 people die/yr worldwide
- Especially common in Southeast Asia, Philippines, Africa, South America, and Indian subcontinent
- US has 2–3 human cases per year.
- Most clinical cases in US from foreign travel and bat exposures
- Raccoons, skunks, foxes, bats, dogs, woodchucks, groundhogs are reservoirs.
- In US bats are the most common reservoir while abroad dogs are more common.
- Squirrels, rats, mice, hamsters, guinea pigs, gerbils, chipmunks, and rabbits can also be infected but there has never been a reported case of human transmission.
- Negative-stranded RNA genome, family Rhabdoviridae, genus Lyssavirus
- Mode of transmission:
- Contact with infected saliva of host
- Bite: Most common
- Nonbite: Saliva or bat aerosol exposure to an open wound or mucous membrane
- Transplant procedures are the only well-documented person-to-person transmission
- Not considered a transmission risk: Petting rabid animal or contact with the blood, urine, or feces of a rabid animal
- Progression after infection:
- Virus multiplies in local tissue and is taken up into muscle through n-acetylcholine receptors.
- Virus enters peripheral nerves and is transported to CNS via retrograde axoplasmic flow at ∼1–4 inches per day
- Once in CNS, rapid replication and dissemination cause encephalitis.
- Centrifugal spread of virus to peripheral nerves, including salivary glands