Rabies
rabies is one since thousands of years well-known virus infection, which causes an acute life-threatening Encephalitis (brain inflammation ) with animals and humans. Synonymous ones are the terms Lyssa, Rabies and rise up. In former times one used also the synonym Hydrophobie (water fear).
The virus knows most kinds more warm-bloodilyAnimals concern, are however rare under non--carnivores. The stereotypische picture of a stuck on (“rabid”) animal is “moved dog “with foam before the mouth, in addition, cats, Frettchen, foxes, Dachse, Waschbären, cheek crescents, stinking animals and the Fledertiere - the Vampire bat [The mode rotundus and/or. The mode spec.]; with insect-corrosive Fledertieren usually bats (Microchiroptera) and fruit-corrosive Fledertieren usually flight dogs (Megachiroptera very rarely) - and/or transfer classical rabies or another form can become rabid. Main carrier is the fox. Squirrel, other rodents and Rabbits are stuck on very rarely. Birds get rabies very rarely, since their Körpertemperatur lies more highly than it is necessary for an optimal Vermehrung of the virus. Rabies can show up also in a “paralytischen “form in such a way specified, with which itself the stuck on animal unnaturallycalmly and withdrawn holds back.
Between 40,000 and 70,000 humans annually most die in Eastern Europe, Asia at rabies, (80% as per. Physician newspaper of 30. April 2003) and Africa, where rabies is endemic. Half of the deaths world-wide concerns children and young people under 15Years (source: Physician newspaper of 30. April 2003). Approximately 10 million humans annually treated according to a suspicion rabies to have exposed itself.[1]
Table of contents |
exciters
the differently minted rabies becomes by cylindrical formed, behüllte single (-) - strand RNA - viruses, (ss (-) RNA), the kind Lyssaviren from the family of the Rhabdoviridae causes. With all these exciters altogether seven Genotypen are differentiated at present:
- Genotyp 1: Rabiesvirus (RABV) = rabies virus of this virus is the classical rabies virus.
- Genotyp 2: Lagos bat virus = Lagos asked virus (LBV)
- Genotyp 3: Mokola virus (MOKV)
- Genotyp 4: Duvenhage virus (DUVV)
- Genotypen 5 and 6: European bat Lyssavirus = European asked lyssavirus (EBLV 1, 2)
- Genotyp 7: Australian bat Lyssavirus = Australian asked lyssavirus (ABLV)
these viruses has usually either a spiralenförmige or cubic symmetry. HaveLyssaviren a spiralenförmige symmetry, D. h. their sticking on particles have approximately cylindrical shape. This is actually typical for viruses, which strike plants. Humans striking viruses wear generally rather Kubiksymmetrie and to take to shapes, which come regular polyhedrons close.
Genotyp 2 are excludedall other Genotypen of cases of rabies with humans, enumerated above, described.
All well-known rabies viruses are very fast inactivated by drynesses, sunlight and certain disinfectants.
transmission
the virus is present in the saliva of a rabid animal and the infection way nearly always leads across a bite. Butalso smallest injuries of the skin and mucous membranes can the penetration of the virus by lubrication infection and/or. Contact infection make possible. In vitro a transmission occurred by mucous membranes. Possibly a transmission in this form happened with humans, who investigated populated caves from bats. Except with the Organtransplantation (3Cases in the USA at the beginning of the yearly 2004 and 3 cases in Germany at the beginning of of 2005), the transmission from a person was so far not observed to the other one.
disease process and symptoms
after the infection of humans by the bite of an animalspreads the virus over the inside of the nerve fibers into the peripheral nerves in back Mark and finally arrives at the central nervous system. If the virus should arrive by the bite directly into the bloodstream, it can reach the central nervous system also very fast. Only during thatmore or less early phase, thus in the first hours, is enough is still another inoculation possible. As soon as the virus reached the brain, an inoculation is no longer effective.
The period between the infection and the first flu-like symptoms (incubation period), can up to twoYears last, normally are it however 3 to 12 weeks. However also incubation periods were convincingly stated by up to 10 years.
The virus causes a Encephalitis (brain inflammation), on which then the typical symptoms appear. It can also strike back Marks, which itself in Myelitis (back Mark inflammation)expresses. During the transmission by a bite in arm or leg frequently first pain at the bitten extremity expresses itself. Sensitivity loss according to the skin dermatome was regularly observed. Therefore many, above all atypical disease processes are wrongly estimated, first as Guillain Barré syndrome. Soon after it increasethe centralnervous symptoms, like paralyses, fear, confusion, excitement, further progressively to the Delirium, to abnormal behavior, hallucinations, and sleeplessness. The paralysis of the rear cranial nerves (Nervus glossopharyngeus, Nervus vagus) leads to a throat paralysis, connected with oneTo swallow inability to speak (with dogs “hoarse barking”) or - this is typical during later phases of the illness. The sip disturbance is called falsely also “Hydrophobie “. Also the produced saliva cannot be abgeschluckt no more and forms the foam before mouth orMuzzle.
The illness can run also in the “mute” form, with which a part of the symptoms mentioned is missing. However a clarification in the region of the Hippocampus and at the Nucleus Caudatus is independent of the process form during the picture giving with the Kernspintomographen. Nearly always2 to 10 days after the first symptoms death occurs. The few people, from which it admits is that they survived the illness, had heaviest brain damage carried off.
symptoms with the animal
at rabies got sick animal, above all dogs, which are normally peaceful,can thereby particularly aggressive and biting become and they get foam before the muzzle. In addition a large unrest and moving desire come. The symptoms mentioned carry in addition with the virus in a large periphery to spread. Also assumed that the well-known symptom of the water shyness was strengthenedleads to shake off the foam the muzzle which serves also a spreading of the virus.Evolution biologists assume an external control of the organism is the basis for this behavior by the virus on biochemical level, which developed in an evolutionary adjustment process.
therapy
itno well-known cure gives against rabies. After an infection and an excess of the period for a Nachimpfung lately a treatment with antiviral medicines, Virustatika, and contemporaneous artificial coma for metabolic reduction was tried. These therapy attempts were however so far not successfully, there only some fewPatients such a treatment with heaviest brain damage survived.
Vorbeugung
the illness can be prevented however by punctual inoculation. Rabies originally condemned everyone, which got sick with it, to death, until Louis Pasteur 1885 developed and used the first rabies inoculation, around the life of To save Joseph master, who had been bitten by a rabid dog. Today's vaccines are relatively painless and into the arm, similarly as a flu or an Wundstarrkrampf inoculation are given. They consist of inactivated viruses, which are angezüchtet in human (human ) diploiden cell lines or chickens fibroblasts.
An inoculation can be still successful also hours after a bite. For a subsequent inoculation remains more time, if the wound is relatively far distant from the head and were hurt by the bite no venous blood vessels. The institute for Robert cook gives the following guideline for the post office-expositionalInoculation forwards:
| Degree of the exposition | kind of the exposition | immune prophylaxis | |
|---|---|---|---|
| by a rabies-suspicious or rabid wild or domestic animal | by a rabies vaccine seal | ||
| I | affecting/feeding animals, Belecken of the intact skin | affecting vaccine seals with intact skin | no inoculation |
| II | nibbling at the uncovered skin, superficial,not bleeding scratches by an animal, Belecken not of the intact skin | contact with the inoculation liquid of a damaged vaccine seal with not intact skin | inoculation |
| III | any bite injury or scratching wounds, contamination of mucous membranes with saliva (z. B. by leakages, splashes) | contamination of mucous membranes and blow skin injuries alsothe inoculation liquid of a damaged vaccine seal | inoculation and uniquely simultaneously with the first inoculation passive Immunisierung with rabies Immunglobulin (20 IE/kg body weight) |
should be tried to catch and not isolate the rabies-suspicious animal (do not kill!), since it observes in quarantine spent under veterinary controlwill can. Footstep after 10 to 14 days rabies up, was not not sticking on the animal (kontagiös).If the animal gets sick, a virus diagnostics can be accomplished. With the infected person only a diagnosis can be placed after outbreak of the illness.
During the preventing inoculationagainst rabies it concerns a dead vaccine, which consists usually of inactivated rabies viruses, which cannot release the illness any longer. This active inoculation is injected in several doses in the distance from some days to weeks into the upper arm. The exact inoculation plan is preparation dependent. ThatBody forms anti-bodies after the injection against the viruses. The inoculation must one year after the first inoculation cycle once be repeated and afterwards every 5 years be refurbished.
With an injury by a rabies-suspicious animal first a passive Immunisierung with finished anti-bodies is squirted. Becomes simultaneousbegun with the active inoculation. In addition the Tetanus must - protection to be controlled. Helpful is also thorough washing of the wound with water and soap, in order to remove as much infectious material as possible.
myth and history
in earlier times was rabiesby myths, superstition and mistakes and stirred up, since the illness led nearly inevitably to death, the fears and the fantasies of humans surround. Also that rabies became to transfer allegedly by wolves, contributed to the legend formation , the origin of the who wolf faith z. B. is rooted inthe rabies illness of humans. Already in the antique one concerned Aristoteles and Euripides with the illness, in the Greek God world were kind bad , Hekate, Aktaion and Lykaon Verkünder, widen or victims of rabies. Sirius, main star in the constellation of the large dog, owes itsName of the legend to be Wegbereiter of the epidemic in the high summer - at the dog steam turbine and gas turbine systems (at those Sirius in sun proximity stands; one accepted in former times, sun and Sirius in this time would cooperate) - became dogs, which one with the spreading of rabies inConnection brought, malträtiert and sacrificed. In the Middle Ages , on the basis of Augustinus, the origin of rabies was looked for with the devil, the holy Hubertus is considered since this time as a protection patron against rabies.
spreading and fight
the rabies virus survive in spacious, varied, rural animal world reservoirs.The mandatory inoculation of animals is less effective in rural areas. Particularly in developing countries it is possible that animals are not in private property; their killing can be unakzeptabel. Sip vaccines can be distributed in seals surely, and exactly this has rabies in rural areas of France, Ontarios,Texas, Florida and elsewhere successfully together-shrink leave. Vaccination campaigns can be however expensive, and a cost benefit analysis can the responsible persons to it bring, itself for regulations to the bare containment, instead of deciding to the complete removal the illness.
In order to fight the spreading of the illness, exists for the transnationalPassenger traffic with small house and home animals (dogs, cats, Frettchen) already for a long time a general compulsory vaccination against rabies. The additional regulations very different from country to country become for the placing of animals within the European union with the introduction of the European Union home animal document of identificationstarting from that 4. October 2004 standardizes.
Rabies is endemic in many parts of the world, and one of the reasons for quarantine periods in the international livestock transport was the attempt to keep the illness away from unverseuchten areas. In the meantime however many industrial nations, all permit in front Sweden, domestic animals unencumbered travel betweenthe territories, if the animals can to have been shown by an appropriate defence reaction, inoculated against rabies.
Germany
in Germany shows the fight of rabies large successes. While still in the year 1980 altogether 6800 cases were announced,in the year 1991 still 3500, in the year 1995 only 855, in the year 2001 still 50 and 2004 of still 12 announced cases was. With 5 cases 2004 stricken by rabies the fox is strongest.
The fight of rabies become in the latterYears inoculation seals as mentioned either thrown off hunt-practice-entitled yielded or, as in individual Lands of the Federal Republic, wide from airplanes.
2004 was announced in Germany cases of rabies to animals from the Lands of the Federal Republic Baden-Wuerttemberg , Berlin , Hamburg , Hessen , Lower Saxony , Rhineland-Palatinate and Schleswig-Holstein.
To 4. December 2005in Berlin with by children the found, ill and late deceased broad wing bat (Eptesicus serotinus) was determined by veterinary surgeons of the institute for food, medicaments and animal epidemics (ILAT) in Berlin rabies. With the rabies exciters occurring with bats it concerns independentVirus types. It called European asked Lyssavirus (EBL) with the variants 1 and 2 or European bat rabies virus. Bat rabies is its own illness, which is to be distinguished from fox rabies. By the media an urgent request of all possible contact people was made itself as a precaution,Inoculate to leave.
Austria
the Austrian Land of the Federal Republic Tirol is considered as rabies-free (June 2005).
Switzerland
Switzerland applies since 1999 as rabies-free. The disease liberty was reached by a purposeful fox vaccination campaign.
Great Britain
of Great Britain, strict adjustmentswith the import of animals it has, was accepted that it is completely free from rabies, until 1996 an individual water bat were discovered, which was infected with a rabies-like virus, that usually only with bats occur - the European bat Lyssavirus 2 (EBL2). There were nonefurther well-known cases until September 2002, than in Lancashire a further water bat positively up EBL2 was tested. A bat Schützer, of the stuck on Bat bitten was, received a post office exposition treatment, whereupon it did not get sick with rabies.
In November 2002 David McRae became, a bat Schützer outGuthrie, Angus, Scotland, which, as one believed, by a bat had been bitten, the first person, who separated in Great Britain since 1902 at rabies. It died at that Illness to 24. November 2002. To 2. July 2004 announced German Press Agency that in the USArabies transferred by an organ donor to the receivers was. Three patients, who had transplantiert gotten contaminated organs, had died at the illness. The organ donor had been infected by a bat with the deadly virus, as the US epidemic supervising authority CDC in Atlanta had reported.
In Great Britain dog licenses, killing from road dogs, muzzle obligation and other measures carried to the extermination of rabies at the beginning 20. Century. Lately also the large-scale inoculation of cats, dogs and Frettchen was successful in some industrialized countries with the fight against rabies.
the USA
since the development of effective vaccines for humans and Immunglobulin - treatments is the number of the victims of rabies in the USA of 100 or more per year at the beginning 20. Century, on 1-2 per year fallen, which are due to a large extent to bat bites.
Australia
Australia is one of few parts of the world, where rabies was never brought in. However comes the Australian bat Lyssavirus natural-proves both with insect-corrosive and with fruit-corrosive bats (flight foxes) of most mainland states forwards. Scientists believe that the virus in populations of bat everywhere inthe row of flight foxes of Australia is present.
India
India is one of the countries, in those many cases of rabies (India: ca.30 000/Jahr) with humans admits is. The dark number might lie far over it. The transmission takes place there predominantly via bites of unsolicited dogs (also on thatCountry!). Since a Immunglobulin - treatment is not available, almost exclusively with the post office exposition method one treats, which promises possibly not as good healing chances as the combined method. With a longer stay should be thought thus of a previous active inoculation (travel medicine).
messageof 22. February according to
2005 messages in Germany 2005 three receivers of organ donations infected themselves beginning with rabies. The Organspenderin had probably infected itself at one India vacation and the virus on over the organs had passed. It is questionable whether the Spenderin already signs of a rabies infection shownhad, which had been misinterpreted as consequence of your cocaine consumption.
Six humans received organs of the Spenderin. The Empfängerin of the lung succumbed to the infection in the morning 20. February 2005, the 70-jährige kidney receiver to 21. February 2005. Also the kidney Pankreas receiver succumbed to the illness despite a new therapyto 7. April 2005. One assumes that the illness could spread by the Immunsuppression necessary for a successful Transplatation very fast.
The other three receivers show up to now no symptoms. They are active and passively inoculated, their prognosis are good. Two the organ receivera cornea/callosity transplant received, so that the necessary Immunsuppression and the operation stress are relatively small, which prevented an early breaking out of the illness. The receiver of the liver was inoculated forwards zirca 15 years against rabies, so that could not break the illnesses off (conditions: 22.February 2005, see also: Wikinews article over the case).
Web on the left of
| Wiktionary: Rabies - word origin, synonyms and translations |
- http://www.m-ww.de/krankheiten/infektionskrankheiten/tollwut.html
- http://www.gesundheit.de/roche/ro22500/r23391.html
- institute for Robert cook: Rabies instruction card for physicians (February 2005)
- side over rabies on English detailed information that of center for Disease control and Prevention
- http://oesterreich.orf.at/oesterreich.orf?read=detail&channel=8&id=345536current case of rabies in Austria (September 2004)
- you consider disease history of the world-wide only survivors rabies female patient without
| previous inoculation please the reference to health topics! |
