A zoonotic lethal disease RABIES DISEASE

AGENT: RHABDOVIRIDAE, LYSSAVIRUS ARN simple chain with a lypidic envelope. All mammal species can be affected. It is pressent in saliva and nervous sistem of infected individuals. It is labil on the environment, it needed a direct transmission from an infected reservoir. Fundamental burden of disease is present in domestical animals ( dogs: 95% of transmitted cases to humans and cats) and in wild mammals mostly bats, foxes, wolfs, etc.

TRANSMISSION Bites or direct contact of saliva from infected animal with a cutted or scratched skin or mucousses. Extremely rare case by corneal transplant from an infected undiagnosticated donant Infected animals starting virus excretion by saliva from around five days before clinical manifestation of disease.

SINTOMATHOLOGY 1sth Fase: INCUBATION PERIOD: 1-3 month without sinthoms 2nd Fase: PRODROMIC PERIOD: 2- 10 days with undefined sinthoms 3rd Fase: NEUROLOGIC PERIOD: 2-7 days encephalic affected. Signs: anxiety, hyperactivity, violence reactions, depression, paralisis, facial espasmus, convulsions. 4th Fase: COMA: 1-10 days ended with death

PATOLOGY Animals infected have extremely extrange attitudes, can attact without provocation. Bats are flight during day, falling on the floor and crashing with objects and other animals. In humans: after infection by wound or bite iniciate a first replication of the virus in perilessional muscular tissue, then go through the neuronal axons to the ganglia and between neurons to the cerebrum, finally it is localised all around the body within nervous system and salivar glands. It is lethal in 99.9% of cases without treatment before the second period.

EPIDEMIOLOGY World distribution, except Antarctic continent. Domestic and wild presentation. Principal vectors: dogs( 95%) and bats Only seven survivors registered after syntomatology detected. More than 150 countries affected, mostly in Africa and Asia( 55.000 human death/year). Asia with 31.000 deaths/year has the 60% of deceses of the whole world by this disease.

40% of victims of bites from animals possibly with rabies disease have less than 15 years. Every year more than 15 millions of persons have been vaccinated after an animal attac, fortunally this prevent hundreds of thouthands of deaths. It is a neglected disease in poor and vulnerable countries where rarely deadi is notifyed and where can’t have access to vaccines and inmunoglobulins. Mostly the victims are between 5 to 14 years old.

SOLUTION On dicember 2015 The World Health Organization with the Organization for Animal Health, the Food and Africulture Organization of United Nations and the Global Alliance for Rabies Control according a global compromise to rise for 2030 no human death by this disease. This iniciative marks the first time when Human health and animal health organizations worked together looking for a common estragegy against one disease.

What must be done: Massiff vacciation of dogs, if it is possible vaccinate cats too. Dog populations control: sterilization, stray animals control. Improving access to PEP ( vaccines and antibodies) for people bited Increase surveillance, dog population, bats and other possible reservoirs. And public awareness raising.