Take Caution When Bats Are Near | Features | CDC Take Caution When Bats Are Near Bats play an important role in our ecosystem. However, they are also associated with diseases deadly to humans. Learn how you can stay safe when bats are near. Diseases Spread by Bats Several highly fatal diseases have been linked to bats. Rabies is perhaps the most well known disease associated with bats. Along with animals such as dogs, foxes, raccoons, and skunks, bats are one of the primary animals that transmit rabies. An exposure to rabies most commonly occurs when a person is bitten by a rabid animal. It can also be transmitted when the saliva from a rabid animal comes in contact with a person's mouth, eyes, nose, or a fresh wound. When a person is exposed to rabies, timely administration of a vaccine known as post-exposure prophylaxis (PEP) can prevent infection. Once a person becomes infected and symptoms begin to occur, rabies is almost always fatal. Each year in the United States, up to 30,000 persons receive PEP due to potential exposure to a rabid animal, including bats. Histoplasmosis is another disease associated with bats.

Its symptoms vary greatly, but the disease primarily affects the lungs. Occasionally, other organs are affected. When this happens it can be fatal if untreated. In addition, Histoplasmosis is caused by a fungus that grows in soil and material contaminated with droppings from animals, including bats. Droppings, also known as bat guano, can contaminate the soil and cause infectious spores to be released when the soil is disturbed. Even though it can be found throughout the world, it is widespread in certain areas of the U.S. and can be found in places that harbor large populations of bats, including caves. While most infected persons have no apparent ill effects, antifungal medications are used to treat many forms of the disease. Bats and Diseases around the World Even though rabies and histoplasmosis can be found all over the world, some diseases associated with bats are found exclusively in certain regions of the world. Notably, research suggests that bats might be the source of several hemorrhagic fevers, which affect multiple organ systems in the body and often lead to life-threatening diseases. One of these diseases is Marburg hemorrhagic fever, which is found exclusively in Africa.

Past outbreaks have shown that Marburg Hemorrhagic Fever kills up to 90% of those infected. While the natural host had for years been unknown, new research suggests that fruit bats are a natural source of this virus, and the virus has been isolated repetitively from fruit bats in Uganda. The same may be true for Ebola hemorraghic fever. The virus that causes this disease is often referred to as the "cousin" of Marburg virus, since they are the only distinct viruses that belong to a group of viruses known as filoviruses. Like Marburg, Ebola is highly fatal and is found mostly in Africa. Recent studies indicate that, as with Marburg, bats are likely to be a natural source of this virus, although no Ebola virus has been isolated from bats. Two other viruses - Nipah (which causes Nipah virus encephalitis) and Hendra (which causes Hendra virus disease) - are also associated with bats. Research suggests that Hendra virus is associated with fruit bats (commonly called flying foxes) in Australia.

Nipah and related viruses are also associated with the same group of bats in Southeast Asia and parts of Africa, although outbreaks of disease in humans have so far been limited to Malaysia, Singapore, India, and Bangladesh. Both viruses can cause severe respiratory and neurologic disease in humans. Another group of viruses known as coronaviruses have been detected in multiple species of bats. Coronavirus infection can sometimes cause mild respiratory illness in humans, but these viruses were also implicated in the outbreak of Severe Acute Respiratory Syndrome (SARS) in Southeast Asia. While bats do not carry or transmit SARS, research has linked coronaviruses to bats in countries all over the world. In addition, Lyssaviruses have been discovered on every inhabited continent. This group of viruses causes rabies, in addition to other diseases that can be fatal to humans. While current rabies vaccines are effective against many of the viruses in this group, several Lyssaviruses identified in Africa and Asia primarily associated with bats cannot be prevented with current rabies vaccines. Further studies may shed light on the role of bats as the source of these viruses and their ability to transmit diseases caused by these viruses to humans.

Stay Alert in Areas where Bats are Found Many bats rely on cave roosts and are often found in groupings that can number in the millions. Cave explorers, spelunkers, divers, and others whose activities take them into or around caves should exercise caution when in these environments. Make sure be on the lookout for bats, which often roost or hibernate at high points within caves. It is also important to avoid being near or coming into contact with bat droppings. When possible, avoid entering caves that are known to contain populations of bats. In addition, it might be a good idea to bring a flashlight into the cave to help better identify the presence of bats or other animals. If bats are present in the immediate area, consider leaving the cave or moving to an area of the cave where there are no bats. Some bats also roost in tree cavities or foliage, and might be spotted in areas where outdoor activities take place, such as hiking or camping. While there have been instances of humans exposed to rabid bats , most bats in a natural setting are not rabid and, in many outdoor situations, the presence or sighting of bats is common and normal.

However, precautions can be taken at outdoor locales to help minimize the risk of exposure to bats and their excretions: When possible, prevent bats from entering outdoor living quarters and other occupied spaces. Consider " bat-proofing " your living space. Screens or mosquito netting can provide a useful barrier against direct bat contact. Teach children to never to handle live or dead bats, as well as any unfamiliar wild or domestic animals (even if they appear friendly). Tell them to report any contact or unusual animal behavior to an adult right away. In some settings, materials contaminated with bat droppings may have to be disposed of or decontaminated. In these situations, local and state authorities can provide more information on the requirements for the removal, transportation, and disposal of contaminated material. Clean-up of areas contaminated with bat droppings should not be attempted by non-trained personnel, and proper personal protective equipment (PPE), including respirator, mask, gown, and gloves, should be worn by anyone handling the potentially infectious material. Take Steps to Keep Bats Out of Your Home Some bats live in buildings, and may continue to do so with little risk to inhabitants if they are unable to access living areas and the potential for contact with people is low.

However, bats should always be prevented from entering rooms of your home. As noted above, "bat proofing" your home or living quarters can prevent bats from using a home for a roosting site. For best results, contact an animal control or wildlife conservation agency and ask for assistance. If you choose to do the "bat-proofing" yourself, here are some suggestions: Carefully examine your home for holes that might allow bats entry into your living quarters. Any openings larger than a quarter-inch by a half-inch should be caulked. Use window screens, chimney caps, and draft-guards beneath doors to attics. Fill electrical and plumbing holes with stainless steel wool or caulking. Ensure that all doors to the outside close tightly. Most bats leave in the fall or winter to hibernate, so these are the best times to "bat-proof" your home. During summer, many young bats are unable to fly. If you exclude adult bats during this time, the young may be trapped inside. Safely Capture Bats and Dispose of Dead Bats If a bat is present in your home, contact an animal-control or public health agency for assistance.

It may be important to capture the bat for rabies testing, especially if a potential bite or exposure has occurred. Sometimes, professional help may be unavailable. In such cases, use precautions to capture the bat safely, as described below. To begin, you will need: leather work gloves (put them on) small box or coffee can piece of cardboard tape The steps you should take to capture the bat are: When the bat lands, approach it slowly, while wearing the gloves, and place the box or coffee can over it. Slide the cardboard under the container to trap the bat inside. Tape the cardboard to the container securely, and punch small holes in the cardboard, allowing the bat to breathe. When no potential exposure has occurred, the bat can be safely released outside. If a bite or exposure to saliva (e.g., into a person's mouth, eyes, or a fresh wound) has occurred, your health department or animal-control authority should be contacted to make arrangements for rabies testing. If you come across a dead bat, call animal control services to see if they can safely remove the animal. In some instances, such services might not be immediately available. Under these circumstances, follow the below steps to safely discard the dead bat.

Get a cardboard box or Tupperware container Place it over the bat Slide a cardboard or plastic lid under the box/container so that the bat is confined within. Remove it from the area until animal control services can arrive to safely dispose of the bat. Treatment After a Potential Exposure While bites are a common way for diseases to be spread from bats to humans, exposure to saliva and other secretions can also lead to infection. If you are bitten or saliva from a bat gets into your eyes, nose, mouth, or wounds, wash the affected area thoroughly and get medical attention immediately. Bats have small teeth that may leave marks not easily seen (see picture). Although many people know if they have been bitten by a bat, there are certain circumstances when a person might not be aware or able to tell if a bite has occurred. For example: If a person awakes to find a bat in the room If you find a bat in a room with an unattended child If you see a bat near a person with a disability If the above occurs, get immediate medical attention. In all circumstances, contact local or state health departments for assistance with medical advice and testing bats for rabies.

When it cannot be ruled out that the bat is free from rabies and an exposure has occurred, (PEP) may need to be considered. When bat droppings, saliva, or other secretions are believed to be nearby, closely monitor your health, especially any fever, chills, headache, or muscle pain. If these symptoms appear after being in an area when bats might have been nearby, seek medical attention and be sure to note your presence in these areas. Be sure to also note any travel that has recently taken place, especially to African countries. This is especially important if it has been less than a month since a potential exposure to bats. Living Safely With Bats Even though bats sometimes spread diseases to people, they are able to peacefully co-exist with humans and provide us with many benefits. Worldwide, bats are a major predator of night-flying insects, including pests that cost farmers billions of dollars annually. Throughout the tropics, seed dispersal and pollination activities by bats are vital to rain forest survival. In addition, studies of bats have contributed to medical advances including the development of navigational aids for the blind. Unfortunately, many local populations of bats have been destroyed and many species are now endangered.

The best protection we can offer these unique animals is to learn more about their habits and recognize the value of living safely with them. More Information Hydrophobia - RightDiagnosis.com Hydrophobia Hydrophobia (medical condition): An infectious disease that can affect any mammal including... more » See also: Hydrophobia: a symptom of rabies in humans consisting of an aversion to swallowing liquids.

Source: WordNet 2.1 These medical condition or symptom topics may be relevant to medical information for Hydrophobia: SYN » Treatments for Rabies Hydrophobia: Related Diseases Hydrophobia: Hydrophobia is listed as a type of (or associated with) the following medical conditions in our database: Raccoon bite - 44% of USA rabies cases Skunk bite - 28.5% of USA rabies cases Bat bite - 12.5% of USA rabies cases Fox bite (type of Animal bite ) - 5.5% of USA rabies cases See full list of 10 causes of Hydrophobia (Rabies) Symptoms of Hydrophobia (Rabies) See full list of 65 symptoms of Hydrophobia (Rabies) Treatments for Hydrophobia (Rabies) Treatments for Hydrophobia (Rabies) include: Human rabies immunoglobulin (HRIG) shots - a form of rapid passive immunization; used before starting rabies shots. Rabies vaccine shots - active immunization; typically a series of 5 shots; there are various types of rabies shots.

See full list of 11 treatments for Hydrophobia Treatment of Hydrophobia: For more treatment information about Hydrophobia, see treatment of Rabies (Hydrophobia) Hydrophobia: Article Excerpts about Rabies Rabies, NIAID Fact Sheet: NIAID (Excerpt) Rabies is an acute and deadly viral infection of the central nervous system. It is one... (Source: excerpt from Rabies, NIAID Fact Sheet: NIAID ) What is rabies?: DVRD (Excerpt) Rabies is a disease that affects wild animals, domestic animals (like pets and livestock), and humans. It is caused by a ... (Source: excerpt from What is rabies?: DVRD ) Hydrophobia as a Symptom Hydrophobia (symptom): rabies also known as "hydrophobia" is a viral zoonotic neuroinvasive... more » Hydrophobia (symptom): See Hydrophobia (symptom information). More information on symptom: Hydrophobia : Disease Outbreak Control Division | Rabies (hydrophobia) Disease Outbreak Control Division Rabies (hydrophobia) What is rabies?

Rabies is a very serious disease caused by a virus that affects wild animals, but humans can also become infected. Unless rabies infection is treated promptly, serious brain damage and death can result. Most deaths from rabies occur in developing countries where prompt medical attention and preventive vaccinations are not readily available. Hawaii is the only state in the United States that is free of rabies. How do you get it? Rabies is usually spread to humans through the bites of rabid (rabies-diseased) animals. You can also get rabies when a scratch or fresh break in the skin is directly exposed the saliva from a rabid animal. All warm-blooded mammals, including man, can get rabies. On the US mainland, wild animals that are most often associated with rabies include skunks, foxes, raccoons, and bats. What are the symptoms of rabies? The early symptoms of rabies include malaise, alternating periods of irritability and anxiety, headache, fever, and sometimes, itching or pain at the site of the bite. Rabies can lead to numbness or paralysis, spasms of the throat muscles, seizures, mental confusion, coma, and death. When do symptoms start?

The symptoms usually start 2 to 8 weeks after exposure to a rabid animal. Rarely, it can take as few as 5 days or more than a year for symptoms to appear. What is the treatment for rabies? There is no treatment for rabies after symptoms start, and the disease is almost always fatal. However, doctors can prescribe medicines (called postexposure prophylaxis, or PEP) to be given after exposure and before symptoms begin that can prevent the disease from progressing. After an animal bite, immediately and carefully cleanse the entire site of the bite or wound with lots of soap and water. See a doctor immediately to determine whether PEP is indicated. What happens if you are exposed to rabies and don’t get treated? If left untreated, rabies is almost always fatal. However, exposure to a rabid animal does not always result in the disease. When rabies is suspected, getting immediate PEP can be effective in preventing disease. How can you keep from getting rabies? Cleanse animal bites or wounds immediately with lots of soap and water.

If rabies is suspected, especially in an area where rabies is a problem, promptly seek the advice of a doctor, the Department of Health, or the local health authority. Avoid all wild animals, especially those acting strangely. In areas where rabies is found, vaccinate pets to protect them from getting rabies. For more information, see the CDC’s website. About Us Rabies: Vaccine, Symptoms & Treatment for the Virus Medical Author: Jerry R. Balentine, DO, FACEP Jerry R. Balentine, DO, FACEP Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident. Medical Editor: Melissa Conrad Stöppler, MD Melissa Conrad Stöppler, MD Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr.

Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology. In the U.S., one or two people die from rabies each year. Animal vaccinations and postexposure prophylaxis protocols have nearly eradicated rabies in the U.S. What is rabies? Rabies is a viral illness spread via the saliva of an infected animal. This occurs usually through biting a human or another animal. Transmission can also occur through saliva touching an open wound or touching mucous membranes. What causes rabies? Rabies is caused by the rabies virus. The virus infects the brain and ultimately leads to death. After being bitten by a rabid animal, the virus is deposited in the muscle and subcutaneous tissue. For most of the incubation period (which is usually one to three months), the virus stays close to the exposure site. The virus then travels via peripheral nerves to the brain and from there, again via peripheral nerves, to nearly all parts of the body. Any mammal can spread rabies.

In the United States, rabies is most often transmitted via the saliva of bats, coyotes, foxes, raccoons, and skunks. In the developing world, stray dogs are the most likely animal to transmit rabies. The virus has also been found in cows, cats, ferrets, and horses. The local health department will usually have information on which animals in the area have been found to carry the rabies virus. What are risk factors for rabies? Any activity that brings someone in contact with possible rabid animals, such as traveling in an area where rabies is more common (Africa and Southeast Asia) as well as outdoor activities near bats and other possible rabid animals, all increase one's risk of getting infected with rabies. Medically Reviewed by a Doctor on 3/18/2016 hydrophobia - Dictionary Definition : Vocabulary.com Random Word hydrophobia Foaming at the mouth? Terrified of drinking water? You're displaying all the signs of hydrophobia, a common symptom of rabies. Unfortunately by this point you're probably beyond curing. Or reading online definitions.

Take hydro (meaning "water") and phobia (meaning "fear") and you have hydrophobia — a fear of water. This could be a purely psychological issue that started in the lake at summer camp, or it could be physically motivated by disease — such as rabies. CDC - The Rabies Virus - Rabies ShareCompartir The Rabies Virus Rabies virus belongs to the order Mononegavirales, viruses with a nonsegmented, negative-stranded RNA genomes. Within this group, viruses with a distinct "bullet" shape are classified in the Rhabdoviridae family, which includes at least three genera of animal viruses, Lyssavirus, Ephemerovirus, and Vesiculovirus. The genus Lyssavirus includes rabies virus, Lagos bat, Mokola virus, Duvenhage virus, European bat virus 1 & 2 and Australian bat virus. Structure Rabies virions are bullet-shaped with 10-nm spike-like glycoprotein peplomers covering the surface. The ribonucleoprotein is composed of RNA encased in nucleoprotein -(), phosphorylated or phosphoprotein -Illistration of virus, and polymerase -virus.

Rhabdoviruses are approximately 180 nm long and 75 nm wide. The rabies genome encodes five proteins: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G) and polymerase (L). All rhabdoviruses have two major structural components: a helical ribonucleoprotein core (RNP) and a surrounding envelope. In the RNP, genomic RNA is tightly encased by the nucleoprotein. Two other viral proteins, the phospoprotein and the large protein (L-protein or polymerase) are associated with the RNP. The glycoprotein forms approximately 400 trimeric spikes which are tightly arranged on the surface of the virus. The M protein is associated both with the envelope and the RNP and may be the central protein of rhabdovirus assembly. The basic structure and composition of rabies virus is depicted in the longitudinal diagram below. The cross-sectional diagram demonstrates the concentric layers: envelope membrane bilayer, M protein, and tightly coiled encased genomic RNA. Rabies is an RNA virus.

The genome encodes 5 proteins designated as N, P, M, G, and L. The order and relative size of the genes in the genome are shown in the figure below. The arrangement of these proteins and the RNA genome determine the structure of the rabies virus. Replication The rabies virus genome is single-stranded, antisense, nonsegmented, RNA of approximately 12 kb. There is a leader-sequence (LDR) of approximately 50 nucleotides, followed by N, P, M, G, and L genes. The fusion of the rabies virus envelope to the host cell membrane (adsorption) initiates the infection process. The interaction of the G protein and specific cell surface receptors may be involved. After adsorption, the virus penetrates the host cell and enters the cytoplasm by pinocytosis (via clathrin-coated pits). The virions aggregate in the large endosomes (cytoplasmic vesicles). The viral membranes fuse to the endosomal membranes, causing the release of viral RNP into the cytoplasm (uncoating).

Because lyssaviruses have a linear single-negative-stranded ribonucleic acid (RNA) genome, messenger RNAs (mRNAs) must be transcribed to permit virus replication. 1: Adsorption (receptors and virion interation). 2: Penetration (virus entry). 3: Uncoating (envelope removal). 4. Transcription (synthesis of mRNAs). 5. Translation (Synthesis of structural proteins). 6. Processing (G-protein gycosylation). 7. Replication (production of genomic RNA from intermediate strand. 8. Assembly. 9: Budding (complete virions). A viral-encoded polymerase (L gene) transcribes the genomic strand of rabies RNA into leader RNA and five capped and polyadenylated mRNAs, which are translated into proteins. Translation, which involves the synthesis of the N, P, M, G and L proteins, occurs on free ribosomes in the cytoplasm. Although G protein synthesis is initiated on free ribosomes, completion of synthesis and glycosylation (processing of the glycoprotein), occurs in the endoplamsic reticulum (ER) and Golgi apparatus.

The intracellular ratio of leader RNA to N protein regulates the switch from transcription to replication. When this switch is activated, replication of the viral genome begins. The first step in viral replication is synthesis of full-length copies (postive strands) of the viral genome. When the switch to replication occurs, RNA transcription becomes "non-stop" and stop codons are ignored. The viral polymerase enters a single site on the 3’ end of the genome, and proceeds to synthesize full-length copies of the genome. These positive strands of rabies RNA serve as templates for synthesis of full-length negative strands of the viral genome. During the assembly process, the N-P-L complex encapsulates negative-stranded genomic RNA to form the RNP core, and the M protein forms a capsule, or matrix, around the RNP. The RNP-M complex migrates to an area of the plasma membrane containing glycoprotein inserts, and the M-protein initiates coiling. The M-RNP complex binds with the glycoprotein, and the completed virus buds from the plasma membrane. Within the central nervous system (CNS), there is preferential viral budding from plasma membranes.

Conversely, virus in the salivary glands buds primarily from the cell membrane into the acinar lumen. Viral budding into the salivary gland and virus-induced aggressive biting-behavior in the host animal maximize chances of viral infection of a new host. Hydrophobia – Symptoms and Causes of Hydrophobia – Treatment Share your stories and support others... Hydrophobia Tweet Water is one of the few things that are necessary to all forms of life on the planet. As a human, water is important to us for hundreds of different reasons and is crucial in our way of life. We need to ingest it to survive, we need it bathe in it, and our bodies are made up of over 55 percent water. As a result, the fear of water seems almost impossible but it does exist and it can be incredibly dangerous to live with. Hydrophobia is an intense, irrational fear of water that can be commonly diagnosed at childhood and should be treated as soon as possible. Certain types of hydrophobia may also appear in later stages of contracting rabies, which would require treatment on an immediate basis.

Symptoms of Hydrophobia Since Earth is made up of about 70 percent of water, it is easy to see why this fear can be a very difficult one to live with. If you notice common symptoms associated with hydrophobia, consider visiting a health professional to discuss the treatment options available to you. Here are several situations in which a hydrophobic person may be uncomfortable with: Fear of drowning or being submerged, even by irrational amounts of water. Avoiding any and all situations in which a body of water may be present. Avoidance of most liquids, not just water. Keeping a distance from liquid sources such as sinks and showers Causes of Hydrophobia Hydrophobia can be a very dangerous, crippling disease that can lead to severe mental problems and create social obstacles, such as the inability to bathe. Hydrophobia can also be caused by rabies and noticed in the later stages of infection. In the latter case, it is imperative you visit a health professional immediately. Treatment of Hydrophobia Although only a few of the adults suffering from hydrophobia bother to seek treatment, several methods have been proven effective in dealing with the fear of water . If this fear is left untreated, it may develop and become even more intense over time.

While some may start off by simply being afraid of entering the ocean or other body of water, the fear may begin to find other ways to present itself. These same sufferers may soon be afraid to bathe or consume any type of liquid, which would certainly begin to negatively impact their personal lives on both a social and mental level. Treating hydrophobia at a younger age can help combat these aspects of the fear and prevent the fear from developing and haunting them into their adult lives. If you have an ongoing fear of water and are interested in exploring different treatment options, there are many top rated health professionals available near you. View Resources Rabies RABIES ETIOLOGICAL AGENT: Rabies virus (a rhabdovirus) THE DISEASE: This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. A deep-seated fear of rabies is almost instinctual despite the actual rarity of the infection in man, perhaps reflecting a primordial knowledge of the virtual certainty of death once disease is overt.

PATHOLOGY: The rabies virus is usually transmitted to man by a bite that implants saliva containing an infective dose of virus in muscle and near nerve tissue. The virus may undergo a limited amount of reproduction in the muscle cells at the site of inoculation. The virus travels along the nerves from the point of inoculation to the CNS. The dense concentration of sensory nerve endings in the head, face, neck and fingers accounts for the higher fatality rate observed when these areas are exposed. Similarly, the more extensive or severe the bite wounds, the higher the mortality, because more nerve tissue is exposed to an infective dose of rabies virus. After entering the CNS, the virus replicates in the neurons of the gray matter before traveling centrifugally along nerves from the CNS to invade a variety of organs and tissues. Humans and animals dying of rabies commonly exhibit characteristic cytoplasmic inclusion bodies in neurons of the brain; these are called Negri bodies. The presence of Negri bodies is pathognomonic of rabies infection, but their absence does not preclude the disease. In humans who have died from rabies, Negri bodies are prominent in ganglion cells, particularly in the hippocampus and cerebellum.

Other changes also present in the CNS include edema, hemorrhage, congestion, and perivascular cuffing in all parts, but most severe in the pons and medulla. In the cranial, spinal, and sympathetic ganglia, there are actual foci of necrosis with neuronophagia and infiltration with lymphocytes. The severity of the histopathologic changes in the spinal cord often corresponds to the site of bite - for example, the lumbar cord is most extensively affected when the bite is on the foot. Gross changes are inconspicuous. DIAGNOSIS: Where there is a history of bite by a known rabid animal and the bitten person shows typical symptoms, the clinical diagnosis of rabies is usually evident. In many instances, a history of exposure is lacking, and the diagnosis of rabies may be missed unless revealed by postmortem laboratory tests. The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. The length of this incubation period is a function of: 1. The number of sensory nerves ending in the bitten area 2. The dose of virus 3.

The severity of the bite wounds 4. The distance from the bite wound to the CNS There are three clinical phases of the disease: 1. Prodromal phase - the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling. 2. Excitation phase - the excitation phase begins gradually and may persist to death. It may be punctuated at any time by depression and paralysis.

There usually are increasing anxiety, apprehension and a sense of impending doom. Although the tone of the somatic musculature is increased, there may be weakness of the muscle groups around the location of the bite. Cranial nerve malfunctions result in ocular palsies with: a. Strabismus - failure of the eyes to follow one another in any movement. This is due to incoordination of the extra-ocular muscles. b. Dilation or constriction of the pupils that may be asymmetric and associated with: (1) Hippus (abnormal exaggeration of the rhythmic contraction and dilation of the pupil, independent of changes in illumination or in fixation of the eyes). (2) Nystagmus (continuous rolling of eyeball) (3) Diplopia c. Absence of corneal reflexes d. Weakness of facial muscles e. Hoarseness f. Babinski and Chaddock signs g. Papilledema There may be tachycardia or bradycardia (slow heart beat), cyclic respiration, urinary retention and constipation. Hydrophobia, the classical diagnostic manifestation of rabies, is an affliction of the excitatory phase of the disease.

When the patient attempts to swallow liquids, forceful, painful expulsion occurs as a consequence of spasmodic contraction of the muscles of swallowing and respiration. Once experienced, the sight, sound or smell of liquids may provoke the syndrome. The ensuing choking may cause severe apnea (temporary cessation of breathing) and cyanosis. Death frequently occurs during the course of such a convulsive attack. Dehydration is a common consequence. 3. Paralytic phase - hydrophobia, if present, disappears and swallowing becomes possible, although difficult, as the paralytic phase sets in. A progressive, general, flaccid paralysis develops. Apathy shades into stupor, progressing to coma. There is urinary incontinence. Peripheral vascular collapse ensues and death follows. Definitive diagnosis of rabies depends on laboratory procedures: 1. Isolation of the virus from saliva, CSF, urine, nerve tissue 2. Fluorescent rabies antibody (FRA) test on brain tissue 3. Presence of Negri bodies PROGNOSIS: Only 6 people have ever recovered from rabies. CNS sequelae are common. TREATMENT: The most important immediate treatment includes: 1.

Washing the wound with copious amounts of soap and water. 2. Apply 1% quaternary ammonium compounds after all traces of soap have been removed. 3. Apply antirabies serum by careful instillation into the wound and by infiltration around the wound. Administer serum systemically. 4. Postpone suturing the wound. 5. Institute antitetanus procedures 6. Start administration of vaccine pending autopsy of animal involved in the bite. Stop treatment if animal is normal. 7. If rabies symptoms ensue give extensive supportive care (treat symptoms as they appear): a. Tracheostomy to prevent hypoxia b. Careful tracheal suctioning c. Use of supplemental oxygen d. Relieve intracranial pressure by insertion of a CSF reservoir connected to the lateral ventricle (cavity in the forebrain, one in each cerebral hemisphere) e. Control focal seizures with anticonvulsant therapy VACCINES AVAILABLE: a. Semple - type of nerve tissue vaccine - no longer commercially available in U.S. Causes severe immune reactions against the neural tissue. b. Duck embryo vaccine - hypersensitivity to eggs may result in a reaction to this vaccine.

This may include: (4) Transient urticaria (skin reaction) (5) Anaphylactoid reactions Generally, however, the reactions are only local erythema and induration. Dose (minimum) - 1 ml/day subcutaneous for 14 days; (maximum) - 23 doses (requires 7-10 days for response). c. Attenuated virus vaccine grown in human diploid cells. Injected IM in any part of the body. 1 ml dose. 5 injections at 3,7,14 and 28 days after first injection. d. Recombinant vaccine - vaccinia virus with rabies glycoprotein gene. (1 vaccination) 2. Antirabies antiserum a. Heterologous (equine origin) - given IM around the wound and in the buttocks. Serum sickness may result from the use of this product. b. Homologous (human origin) - fewer side effects but much more expensive. virus - Why does rabies cause hydrophobia? - Biology Stack Exchange Why does rabies cause hydrophobia?

up vote 4 down vote accepted Rabies causes hydrophobia in the encephalitic stage which means when it affects the brain and causes swelling and inflammation of multiple areas of the brain. Hence, it affects the complex swallowing areas in the brain. Initially into the course of the disease, the patient has involuntary contractions of neck muscles when he drinks water. At later stages of disease, the patient starts contracting his muscles even at the thought of water. Rabies virus is a neurotropic virus which means that it travels through nerves because of its preference to attach to acetylcholine receptors in the neurons. That is how the virus spreads from the bite site to the brain(via the nerves). 3 Why hydrophobia specifically and consistently? Most diseases causing encephalitis or other pathology to the brain has very varied clinical spectra. – AndroidPenguin Apr 22 '14 at 21:34 Yes why specifically – rhill45 Apr 23 '14 at 16:42 This is a good answer above but would like to let this question sit a little longer. What are the swallowing areas of the brain etc...

– rhill45 Apr 23 '14 at 16:44 The swallowing areas of the brain are located in temporal cortex, pons and medulla oblongata – Pranay Aryal Apr 23 '14 at 17:57 1 It starts off with difficulty swallowing water, progressing on to fear of water just on mentioning it. I guess it affects the center of the brain subserving fear. Why fear to water specifically, I do not know the answer. As a clinician, it doesn't bother me much because it has no therapeutic implications. It only serves to me as a marker to suspect rabies. There are many things in medicine which haven't or cannot be explained by reasoning but have shown to be significantly(statistically) associated. But I appreciate your inquisitiveness. – Pranay Aryal Apr 30 '14 at 0:32

Question: What disease is associated with hydrophobia?
Answer: Rabies