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RABIES IS A VIRUS THAT ATTACKS THE BRAIN
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OKAY BACK FROM THE INFECTIOUS DISEASE WARD 🏨
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A MAN BITTEN ON THE TOE BY A DOG 🐕
A 49 Year Old Man Presented To The Infectious Disease Ward
The Authors Suspected Human Rabies Because Of His Hydrophobia
A Dog Had Bitten Him On The Big Toe
The Bite Came 2 Months Before His Hospitalization
He Would Have Received Local Wound Care Right After The Bite
Only One Dose Of Rabies Postexposure Vaccine Was Given
It Was Given One Week After The Exposure
The Physical Examination Found Him Conscious
He Was Breathing Rapidly
His Pulse Was 105 Per Minute
He Complained Of Intense Thirst
Any Attempt To Drink Water Caused A Hydrophobic Spasm
The Spasm Was Described As A Blockage In The Throat
It Also Worsened His Difficulty Breathing
He Systematically Repelled The Glass Of Water
The Man Died The Day Of His Admission
Rabies Was Confirmed By A Direct Fluorescent Antibody Test
The Test Used Postmortem Brain Samples
He Did Not Receive The Four Doses Of Rabies Postexposure Vaccine
Those Four Doses Are Recommended By The World Health Organization
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HOW RABIES TRAVELS ALONG NERVES 🧠
The Rabies Virus Is A Lyssavirus That Infects Mammals
It Is Transmitted Through Saliva
Most Commonly That Means The Bite Or Scratch Of An Infected Animal
In The United States Several Variants Of The Virus Circulate
They Circulate In Animals Including Raccoons Skunks Foxes And Bats
From The Point Of Entry The Virus Is Neurotropic
It Moves Quickly Along The Neural Pathways
Its Destination Is The Central Nervous System
After The Brain Is Infected The Virus Moves Outward
Next Come The Peripheral And Autonomic Nervous Systems
Eventually The Virus Migrates To The Glands And Organs
A 2019 CDC Report Describes How Deadly The Infection Is
It Says Infection Is Fatal In Over 99 Percent Of Cases
That Applies Regardless Of The Variant Or Animal Reservoir
The CDC Calls It One Of The World's Most Deadly Diseases
This Report Says The Disease Is Fatal In Humans And Animals
Death Comes Within 1 To 2 Weeks Of Symptom Onset
The Bitten Man's Case Report Also Lists The Classic Signs
It Calls Hydrophobia Characteristic Of Furious Rabies
Other Classical Features Are Fluctuating Consciousness
A Modified Mental State Is Another Classical Feature
The List Also Has Aerophobia And Phobic Or Inspiratory Spasms
It Ends With Autonomous Stimulation Signals
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HOW MANY PEOPLE DIE OF RABIES 🌍
The CDC Estimates 59,000 Rabies Deaths Worldwide Each Year
98 Percent Of Those Cases Are Caused By The Canine Rabies Variant
That Estimate Includes About Two Deaths In The United States
The United States Eliminated The Canine Rabies Virus Variant In 2004
From 1947 Animal Vaccination And Leash Laws Improved Rabies Control
Canine Rabies And Related Human Cases Fell Sharply
By The Late 1960s Fewer Than 500 Rabid Dogs Were Reported Annually
At That Time Three Human Rabies Cases Were Reported Each Year
From 1960 To 2018 The CDC Counted 125 Human Cases In The US
Of Them 36 Were Attributed To Dog Bites During International Travel
Among Them 89 Were Acquired In The United States
Bat Rabies Virus Variants Caused 62 Of Those 89
Bites And Scratches From Bats Are Often Small And Can Be Overlooked
In 2018 About 55,000 People In The US Sought Postexposure Prophylaxis
They Had Contact With A Potentially Rabid Animal
The Prophylaxis Is Rabies Vaccine And Immune Globulin
Its Cost Averages $3,800 Not Counting Hospital Or Wound Care
The CDC Calls US Human Rabies Rare But Of Extremely High Consequence
