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Rabies

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Rabies – A zoonotic disease Rabies is a zoonotic disease, meaning it is transmitted to humans from animals. The rabies virus is a member of the Rhabdovirus family and it is caused by the virus Neurotropic Lyssavirus (Woodroffe, Ginsberg & Macdonald, 1997). It leads to an acute, central nervous system infection, which is characterized by CNS irritation, followed by paralysis and death (Woodroffe, Ginsberg & Macdonald, 1997). It occurs in more than 150 countries and territories and dogs are the source of 99% of human rabies deaths. The natural reservoir for the rabies virus is in the wild animal that bites a human. Animal reservoirs include semi-wild dogs, skunks, raccoons, fox, bats and mongoose (Woodroffe, Ginsberg & Macdonald, 1997). Essentially, the frequency of contacts between susceptible and infectious individuals is the rate-determining step in the spread of the disease but it is extremely difficult to measure in the wild (White, Harris and Smith, 1995). There is an increase in rabies in late summer and early fall in red foxes. This increase in rabies corresponds to time of dispersal and reproductive maturation in juvenile males (Johnston and Beauregard, 1969). A limited natural human immune response to rabies does exist. A reason for a failure to protect in humans is the poor immunological response that the virus provokes. The natural killer (NK) cell activity was assessed in patients with rabies. There was no significant difference in number of killer cells between rabies patients and normal controls. Results showed that NK cells of rabies patients were not fully stimulated and that might contribute to the virulence of rabies (Panpanich, Hemachuda, Piyasirishilp, Manatsathit, Wilde, and Phanuphak, 1992).

The behavioural symptoms of rabies are classic, however, a diagnosis that is only based on the symptoms is difficult because the symptoms are similar to other diseases, conditions and complications. The only way to be confirmed if an animal is rabid is to perform a direct fluorescent antibody test (dIFA) on the brain tissue (Smith, 1996). The dIFA test is rapid, sensitive, specific, easy to perform and relatively inexpensive. Epidemiological studies have studied precise identification of a rabies virus variant through this method of diagnosis (Smith, 1996). The duration of a relapse potential of rabies is zero (Smith, 1996). Since rabies is not curable, it can only be prevented, which implies that the disease is always present once attained. There is no treatment for rabies, however there are methods of prevention before and after exposure to virus. There is a rabies vaccine regimen that provides protection against rabies. The vaccine works in two ways: Essential components of rabies postexposure prophylaxis are immediate thorough cleansing of all wounds with soap and water and administration of anti-rabies immune globulin and vaccine (Dean, Baear and Thompson, 1963). Globulin from hyperimmunized human plasma donors is given. Preexposure immunization is given to high-risk groups such as those who work in rabies labs (Dean, Baear and Thompson, 1963). The only means of eliminating the vector is by eliminating rabies in dogs through vaccination. Vaccination of animals, most importantly, dogs, has reduced the number of human rabies in many countries (MacInnes, Smith, Tinline, Ayers, Bachmann, Ball, Calder, Crosgrey, Fielding, Hauschildt, Honig, Johnston, Lawson, Nunan, Pedde, Pond, Stewart, and Voigt, 2001).

Rabies vaccine and immunoglobulin is very expensive. A typical vaccination series with the rabies immunoglobulin can cost from $2000 to $7000 + per person (Baer, Abelseth, and Debbie, 1971). According to one study, elimination of canine rabies is epidemiologically and practically feasible through mass vaccination of domestic dogs; domestic dog vaccination provides a cost-effective approach to the prevention and elimination of human rabies deaths (Lembo, Hampson, Kaare, Ernest, Knobel, Kazwala, Haydon, Cleaveland, 2010). There has also been elimination of fox rabies from Belgium using a recombinant vaccinia-rabies vaccine (Brochier, Costy, Pastoret, 1995). As mentioned above, rabies has non-human reservoir, some naturally induced immunity, effective intervention that prevents the disease and documented elimination in various areas. The disease also shows a lot of burden, as there is no cure for it, which makes it a life-threatening disease that will ultimately lead to death. Hence, these factors support the idea that rabies can be eradicated.

Works Cited Dean, J.D., Baear, M.G., and Thompson, R.W. (1963). Studies on the local treatment of rabies-infected wounds. Bull World Health Organization, 28(4), 477-486. MacInnes, D.C., Smith, M.S., Tinline, R.R., Ayers, N.R., Bachmann, P., Ball, G.D., Calder, A.L., Crosgrey, J., Fielding, C., Hauschildt, P., Honig, M.J., Johnston, H.D., Lawson, F.K., Nunan, P.C., Pedde, A.M., Pond, B., Stewart, B.R., and Voigt, R.D. (2001). Elimination of rabies from red foxes in eastern Ontario. Journal of Wildlife Diseases, 37(1), 119-132. Baer, M.G., Abelseth, K.M., and Debbie, G.J. (1971). Oral Vaccination of Foxes Against Rabies. American Journal of Epideiology, 93(6), 487-490. Lembo, T., Hampson, K., Kaare, T.M., Ernest, E., Knobel, D., Kazwala, R.R., Haydon, T.D., Cleaveland, S. (2010). The Feasibility of Canine Rabies Elimination in Africa: Dispelling Doubts with Data. PLoS Neglected Tropical Diseases, 4(2), 1-9. Brochier, B., Costy, F., Pastoret, P. (1995). Elimination of fox rabies from Belgium using a recombinant vaccinia-rabies vaccine: an update. Veterinary Microbiology, 46(1-3), 269279.

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