Rabies: The Oldest Disease, Yet Without Cure

by Mladen

Rabies is deadly disease caused by Rabies virus from Rhabdoviridae family. It is the oldest known disease, but science didn't find adequate therapy yet.

Nostradamus was writing about terrible disease coming upon the mankind in the form of deadly bullet. When discovered, Rabies virus was seen as bullet-form virus. Read about Rabies and learn about it. Maybe you will need that knowledge in the future.

Short History of Rabies

Prevention is the key. There is no cure for rabbies, only prevention.

Rabies or Lyssa is deadly encephalomyelitis caused by Rabies virus. Three main signs of the disease are: agitation, hydrophobia and progressive myoparalysis. There is no cure for this illness, and thus, prevention is of great importance. Of course, not everyone with rabies infection will die. Patient is lost when the infection reaches CNS (central nervous system). 

With Homer we got the name of the disease. Kardanus made an assumption it was transmitted by saliva of infected dog. Demokrit and Hippocrates were first to explain the symptoms. Zink, in the year 1804, finally proved infected dog's saliva was the way of transmission. Kugelstein (1826) defined Rabies as infection of CNS. 

Louis Pasteur made it possible to prevent infection of CNS after the initial colonization of the skin (after the bite of infected animal).

Rabies Infection: Epidemiology

Source of infection is infected animal or man.

Wolves, bats, foxes, raccoons, cats and dogs are most common rabid animals. This illness is mostly seen in Southern Europe, Asia and Africa. Places with greatest number of infected animals are: area of Balkans, Iran, Southern Asia and tropical Africa. 

One bite or scratch by the rabid animal is enough to trigger the infection. Colonization of the skin, and  sometimes of the deeper structures, can remain localized, or it can spread. It has been proven that Rabies virus can be transmitted by aerosol too. Two men were infected that way during cave expedition. Later is has been found that cave was home for hundreds of contaminated bats. No bite wounds were ever detected on these men. Corneal transplantation is, also, one of the possible ways for transmission. 

Some statistics say that over 400 000 vaccines are used for treating possible Rabies infection every year. Only in USA they use 40 000 vaccines in the same period of time. It is believed that these vaccines prevent clinical manifestations in around 390 000 men and women per year. Four hundred infected people die from Rabies every year. 

"Peste si grande viendra a la grand gousse,
Proche secours, et bien loing les remedes."

 

Very great plague will come with the great shell,
Relief near, and the remedies very far.

Nostradamus

What Does Rabies Virus Do to Human Body?

Rabies virus is extremely aggressive. It was created by evolution to be the winner and never to loose. 

Once patient is infected by it, RV starts replicating and starts moving toward the brain. Skin is the start and brain the finish of his race. It is also our race. It is important to know that once RV enters CNS, there is no way back. While still in the skin and deeper structures, the infection can be localized by vaccine and immune serum (read about it in Rabies Prevention).

Incubation varies from two weeks to sixteen years (two to nine weeks in average). During incubation virus is replicating itself in skin cells. RV finds his way to the brain following nerves. It is unique way of traveling trough the body characteristic for this specific microbe. It enters human cells, multiplies there and destroys it. In 24 hours, 40 million of viral particles are produced.

Clinical symptoms and signs:

It is well known that every contact with animal will cause local infection, but not every contact will lead to Lyssa. As said, Lyssa is referred to encephalitis, and Rabies infection is just term for colonization of non-neurological tissues.

Prodroma (general signs and symptoms of illness): pain around the wound, fever, vomiting, feeling of weakness. All those symptoms are found in all other diseases including influenza. 

Acute neurological disease:
There are two basic forms of Rabies: furious and paralytic. Furious form occurs in 80% of patients. While paralytic form of Lyssa goes with little positive symptoms (nothing but progressive myoparalysis), furious form goes with strong, painful and unpleasant symptoms specific for this disease.
-Hydrophobia is pathological fear of water. Even mentioning of water causes pharyngeal spasm and agitation. Patients are extremely dehydrated, but every contact with water leads to fear, pharyngeal spasm and aggressiveness.
-Aerophobia is fear of wind. 
-Drooling is one of the symptoms in later stages. RV affects salivary nerves too. It follows is in centripetal and centrifugal path, affecting salivary glandules. This is reason for excessive production of saliva in patients. 
-Hallucinations.
-Extremely strong agitation. 

Coma
Coma is the final stage of disease before death. Patient enters this stage on 6th day of Lyssa (average prediction).

Rabies Prevention

To the right you can read about how Britain was fighting against Rabies in 1970s. Strict measures they had since 19th century helped Britain to become rabies-free country. To keep it that way British decided to keep every animal brought to the country by travelers in quarantine for 6 months.

Last death in Britain from this disease occurred  in 1959. Women got infected in India, and died after returning to homeland. 

In case of being wounded by wild animal, what should you do?

Every bite or scratch by wild animal is treated as if the animal was rabid. Wound must be well washed up, treated with alcohol and antiseptic solutions. Good disinfection right after being bitten, should stop viral particles from moving on. 

After this, you must visit your doctor to receive anti-rabies vaccine and  HRIG (human rabies immunoglobulin). Patient must receive HRIG and vaccine within six hours from the bite. 

It is good to know that head injuries are more likely to lead to Lyssa than injuries of extremities.

Modern science is still without cure for rabies. So, prevention of simple infection with this virus going into Rabies (encephalitis) is the only thing we can do. 

"Rabies is a killer.
One selfish act of animal smuggling could bring rabies permanently into this country.
There is no cure for rabies.
The symptoms are very painful and distressing.
The disease affects both animals and people.
Rabies is now widespread in Europe and is getting closer to our shores.
Please help to keep rabies out of Britain."
POSTER. CENTRAL OFFICE OF INFORMATION.
MINISTRY OF AGRICULTURE, FISHERIES AND FOOD.
LONDON, 1976.

Lyssa: Diagnosis of Infection And Disease

There is no test to diagnose the affection by Rabies virus. The best way to do so is by performing biopsy of the brain of the animal that has bitten the patient. This is impossible most of the times. For this very reason, every patient bitten by wild animal should be treated as infected. 

We can be sure it is Lyssa only when it is too late. Hydrophobia is the only sign medical expert can use as proof of infection. 

Milwaukee Protocol: Possible Cure for Rabies

Milwaukee protocol uses treatment by induced coma. Coma is medicaly induced in patients. It is believed that if you give enough time to organism, it would fight off the virus. Inducing coma in patients, we actually are buying time. Virus itself is not causing physical damage to the brain. 

Medical researches have shown most deaths are caused by temporary brain dysfunction with little to no damage occurring to the brain itself.

This procedure is still controversal. Read more about Milwaukee Protocol in treatment of Rabies in my other article.

Updated: 08/31/2012, Mladen
 
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C.T. Driver on 02/25/2014

An excellent write up on this terrible illness. At age 12 yrs, my brother, age 4 yrs. were dog sitting for a neighbor who left for a few days to show her horses. The medium sized cute and friendly dog licked our hands and faces when we fed and played with him. The dog became ill and died several days later, the autopsy found rabies. Both my brother and I were injected daily for 21 days. This was 1952, in a middle class neighborhood of So. Cal. I am now 74 yrs. and still enjoying animals.

health on 03/25/2013

Rabies was our biggest fear when I lived in South America. As a young teenager me and the friends used to go hiking, and all the peasants would have loose dogs that chased you. None of us got bit though but we were always nervous about the semi-wild dogs.

Mladen on 04/03/2012

@ Guarded_Secrets: Yes, hikers should be extremely careful when interacting with wild animals. Especially with raccoons.
I am glad you have found this article useful.
Cheers!

Guest on 04/03/2012

Wow! I never realized rabies can't be cured. I found your artcile very interesting and it's definitely important for people to understand. Especially how to possibly detect a rabid animal. I hike a lot and it is useful for hikers to know this stuff. Next time I see a raccoon acting out of the ordinary, I'll know to be extra cautious.

Mladen on 03/24/2012

Yes, Janices7, you are right. Not many people even know this disease exists. Those who know about rabies, many of them don't know it is on the rise. Thank you for your comment!

janices7 on 03/21/2012

Interesting read. I think many people don't realize that even a tiny, discreet scratch from a rabid animal or bat can kill you so it is best to be cautious.

Mladen on 03/11/2012

David, I am glad you'va found this article interesting. You are right, Pasteur did make first anti-rabies vaccine. That was the most important step in fight against this virus.
Because of him, 400 000 people in the world, that got bitten every year, have chance to live.
I must repeate: vaccine only works after or before bite, when the virus is still far from central nervous system. It only prevents it reaching the brain. Once the neurological symptoms start, there is no cure. Well, Milwaukee protocol gives little chance, bur read more about it in other article (follow the link).
Thank you for you comment, David!

DavidPaulWagner on 03/11/2012

Interesting article! I seem to remember that the 19th century French chemist and microbiologist, Louis Pasteur, created the first (or early) vaccines for rabies. What do you think of the work that he did?

Mladen on 03/05/2012

Katie, I am glad you have found it useful! Fighting against rabid animals is very important. I already stated Britain is rabid-free country, and they don't have to be scared of going into nature. But, sadly, in most other countries in the world, situation is whole different. I was writing about that huge number of 400 000 people that get bitten every year by suspected rabid animal.
You made the point: "... if you feel there's a animal acting out of norm call animal control".

katiem2 on 03/05/2012

Good to know, so if you feel there's a animal acting out of norm call animal control. I saw a really big raccoon walking around on my kids swing set one after noon and thought hmmm they don't come out during the day, called animal control and they safely removed the animal, it was rabid... I learned some helpful information here, thanks for this guide on rabies the oldest disease and with no cure. All the more reason to take precautions.


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