2,992
回編集
差分
ナビゲーションに移動
検索に移動
編集の要約なし
{{TM menu}}
==epidemiology==
*endemic >150 countries
***target of vaccine
**human receptor: nAChR, NCAM, p75NTR - all developed only in nerve cells
==responsible animals==
*''Lyssavirus'' circulates within a same animal species
**sometimes transmitted to other species - "spillover" phenomenon
*can infect all warm-blooded animals
==pathophysiology==
*retrograde fast axonal transport CNS 15-100mm/day
*spread from CNS to peripheral nerve
*incubation 4-13 weeks, occasionally up to 6 years
*despite catastrophic clinical outcome, histopathological changes in CNS are quite mild
**macroscopically unremarkable
**microscopically minimal changes characterized by perivascular cuffing of mild degeneration of neuron, microglial activation
==transmission route to human==
*99.99% animal bites
*aerosol inhalation
**in cave where infected bats live
*organ transplantation
*unrecognized exposure
**ingestion of infected dog meat
**butchering of infected dog
==symptoms==
#prodromal symptoms 2-10 days
##itchy, tinglings, numbness around bitten site
#acute neurological period 2-10 days
##furious rabies - 80%
###hydrophobia, aerophobia, hypersalivation, hallucination, high grade fever
##paralytic rabies - 20%
###urinary retention →incontinence, constipation
###hydrophobia uncommon - difficult to diagnose
##coma to death of 100%
*[https://www.youtube.com/watch?v=GI5lW1wp6UU LANCET Rabies 1/3]
*[https://www.youtube.com/watch?v=GbTfdVRxhXs LANCET Rabies 2/3]
*[https://www.youtube.com/watch?v=9A8-CkrvZlQ LANCET Rabies 3/3]
==diganosis==
*most of cases are diagnosed postmortem
*history of animal bite
*histology of autopsy-obtained brain specimen
**microscopic observation of Negri body
*immunofluorescnet
*RT-PCR of N gene
==prevention==
*PEP
*PreP
==control==
*exclusion of straydogs
*establishment of dog registration
*mass vaccination for dogs
==JAPOHR Project==
*collaboration with STAREPS Project
*one health approach
