History, pathology, clinical symptom and prophylaxis of rabies

Ronald Panmei *

Rabies apprehension at Churachandpur on  January 15 2015
Rabies apprehension at Churachandpur on January 15 2015 :: Pix - TSE

Rabies, also called Hydrophobia (Lyssa, Rage or Mad dog) is a deadly virus spread to people or another animal from bites of rabies infected animal. It is an acute viral encephalitis(inflammation of brain) which affects man and other warm blooded animals.The symptoms are characterized by signs of abnormal behavior, nervous disturbances, impairment of consciousness, ascending paralysis and death. Animals like dog, fox, wolf, jackal, skunk, mongoose, cat, rat, squirrels, vampire bat are extremely susceptible in tropical areas of the world.

Cattle, goat and sheep are moderately susceptible but Reptiles and birds don't get rabies. Rabies in animals exist in 2 epidemiological types Urban type i.e.transmission takes place through dogs (stray) and another type is Sylvatic type i.e through wildlife (e.g. fox, jackal, wolf, skunk, mongoose, vampire bat, hyena, etc.


Virus was 1st documented in Egypt before 2300 B.C. and in ancient Greece, where it was described by Aristotle but in India report of rabies was in 5000 years ago in Vedic period and The method of transmission of rabies was not recognized until 1804. India is a rabies endemic area estimated population of 5000 die every year. A scientific or experimental approach to rabies was delayed until 1793, when John Hunter published his very important paper, "Observations and heads of enquiry on canine madness".

Hunter suggested that the transmission of rabies should be studied by inoculating saliva from rabid animals and humans into dogs and that attempts should be made to inactivate the "poison" in the saliva. These ideas may have inspired the experiments by Zinke (1804) and Magendie and Breschet (1813). Zinke used a paintbrush to introduce saliva from rabid dogs into incisions made in the skin of dogs, cats, rabbits, and chickens, which duly developed signs of rabies.

In the same year Magendie and Breschet infected dogs with saliva from human patients with hydrophobia. Galtier (1879) was responsible for an important technical advance. He found that rabbits could be infected with rabies and were far more convenient experimental animals than dogs. Pasteur adopted the use of rabbits in his studies of rabies begin in 1880.He was the first to recognize that the major site of infection was the CNS.

Attenuation of the fixed virus was achieved by desiccation of rabbit spinal cord for up to 14 days. Pasteur was able to protect dogs from challenge by immunizing them with the desiccated material, and in 1885 he used his vaccine for the first time in Joseph Meister, a boy severely bitten by a rabid dog and was successful.Improvements in Pasteur's vaccine were achieved by Semple and Fermi, who killed the virus rather than attenuated it, and by Fuenzalida and Palacios developed a suckling mouse brain vaccine which carried a lower risk of neuroparalytic complications.

The use of passive immunization with equine hyperimmune serum has been vindicated by the famous natural experiment following an attack by a rabid wolf on 29 people in Iran in 1954. Usually rabies is transmitted in the saliva, when an infected animal bites another (virus in saliva 2 days before onset of signs). Less often, spread by any contact between infectious saliva or neurological tissues, & mucous membranes or breaks in skin.

Virus is not transmitted through intact skin. Rarely Aerosol transmission has been documented in laboratories and bat caves with a high density of aerosolized virus particles.It has also have documented that it has been transmitted by ingestion of laboratory animals.

The pathology condition is that virus enter via animal bite,then virus replicate in muscle at the sie of bite then virus infect the nerve in peripheral nervous system moves by retrograde transport then virus replicate in spinal cord to brain,brain got infected,virus travels from brain via nerve to other tissue such as eye kidney salivary gland.

Clinical sign in man : After several days, anxiety, confusion & agitation may appear, and progress to insomnia, abnormal behavior, hypersensitivity to light and sound, delirium, hallucinations, slight or partial paralysis, hypersalivation,difficulty swallowing, pharyngeal spasms upon exposure to liquids, and convulsions. Either an encephalitic (furious) form with hyperexcitability, autonomic dysfunction and hydrophobia, or a paralytic form characterized by generalized paralysis, may predominate.

Death usually occurs within 2 to 10 days; survival is extremely rare. Animals can display aggressive behavior, ataxia, irritability, anorexia, lethargy or excessive salivation. Cats are more likely to be aggressive than dogs.

Hydrophobia : Patient can't swallow because of violent jerky contraction of diaphragm and accessory muscles of inspiration when patient attempts to swallow liquid. Patients will be terrified during this reaction and may even experience this at the sight of water or if water touches their face. Aerophobia:an extreme fear of air in motion can be elicited from some patients. This can also cause violent muscle spasms in the neck and pharynx, hallucinations, seizures, ataxia, focal weakness and arrhythmias can occur.Other form is "dumb" or paralytic rabies. Management of rabies are of No effective treatment exists yet but Postexposure Prophylaxis/PEP are of 3 steps :

1. Wound care : immediate thorough washing with soap and water and a virucidal agent such as povidine-iodine or 1-2% benzalkonium chloride. Shown to be protective if performed within 3 hours of exposure. If puncture, swab deeply in wound and around edges.

2. Passive Immunization : Human rabies immunoglobulin (HRIG) 20 IU/kg ASAP, but not longer than 7 days after vaccine is given. Infiltrate entire dose around wound, any remaining IG inject IM at a site distant from the vaccine.

3. Human diploid cell vaccine (HDCV): 1 ml (deltoid) on days 0,3,7,14,28. Vaccine : Do not give in gluteal. If injected into fat, no antibodies formed. HRIG and HDCV: Give in different anatomical sites and never in the same syringe. Reactions : Itching, erythema, pain, swelling

Systemic : HA, myalgia, nausea.

* Ronald Panmei wrote this article for The Sangai Express
This article was posted on February 15, 2017.

* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.

  • Chingarel Biodiversity Park #1 :: Gallery
  • Junior Girls District Football #2 :: Gallery
  • Aesthetics & Culture (Performing Arts)
  • A Song of Hopes :: Poem
  • ..roads in NE may drive small tribes away..
  • 'NPF is natural ally of BJP'
  • Sadar Hills District Demand: News Timeline
  • AMAND Education Aid
  • Challenges before MST bus service
  • Public transport system in Manipur
  • Great June Uprising #3 :: Gallery
  • Kang Chingba @Singjamei :: Gallery
  • Nengvah, Krehe, Achoubi :: eMing
  • On Probable Origin of Letter Atiya
  • 181, Cyber Crime ; How about Zero FIR?
  • Shree Shree Govindajee Temple :: 360 °
  • Manipur U-19 Teams victorious at 'Oorja'
  • Remove Army Camp from MU Campus
  • The Killing Fields :: News Timeline
  • MU VC neglecting academics : MUSU
  • 100 days of BJP led Govt
  • AFSPA - a push to arms?
  • Id-ul-Fitr @Imphal #1 :: Gallery
  • 15th Mega Miss North East :: Gallery
  • Cyclist have Rights on the roads
  • International Day Against Drug Abuse
  • Mary Khyriem is Mega Miss North East
  • Felicitation of Thangjam Guneshwar
  • Corruption of lairik-laisu
  • Approaches towards NE development
  • Jobs at Thangjam Agro (Likla)
  • Militarising a place of learning : AR in MU
  • ..Liangmais to withdraw from Zeliangrong
  • Scientist Thangjam felicitated
  • Idd-ul-Fitre celebrated in NE
  • Konung Kang Chingba #1 :: Gallery
  • Suman Ningthoujam is Mega Mister NE
  • Kang Chingba (Rath-yatra)
  • Baptism of pugilist Sarita Devi..
  • President of India from Manipur, when?
  • Conditions leading to birth of Marxism
  • Meeting on oil Exploration at Tupul
  • Condoles death of Palal Haokip
  • Diabetes Detection - Medical Camp
  • Dzukuo: SAYO refutes Mao CSO allegation
  • Cong to Delhi: Lift lid on Naga pact
  • Manipur man to contest presidential poll
  • Three Mothers Art Gallery :: Gallery
  • U 14 Subroto Football :: Gallery
  • Environment Day: Loktak Ema Laments
  • Khangchiu/Liuchiu: Liangmai institution #2
  • Value based education in schools
  • Yoga and dress
  • Bengal Govt repressing Gorkha people
  • Media appeals management to obey..
  • Recreation- a Serious Business
  • Reintroducing MST bus service
  • Subhadra chhuri huranba :: Funga Wari
  • Kanglei Haraoba Festival #3 :: Gallery
  • Angkor Wat - Cambodia #6 :: Gallery
  • Traffic Jam gigs on home ground
  • Cheiraoba Ching Kaba #6 :: 360 ° View
  • Preserving Macha Ebemma Khudithibi area
  • Life in some hill villages
  • Paramedical Courses Admissions
  • NPF responds to Congress diatribe
  • Surrogate teachers
  • Great June Uprising #2 :: Gallery
  • Road Condition @Senapati :: Gallery
  • School on Phum: Innovative Learning Place
  • Sketches of the Countryside :: Poem
  • Why MBA in Business Analytics ?
  • Grand finale of Mega Miss North East
  • Rehabilitation of Villagers affected by Mora
  • Making NFSA meaningful: Life into MSFC
  • Expecting some appreciable act
  • Earth crack at Kangpokpi #2 :: Gallery
  • Yoga Day @Khuman Lampak :: Gallery
  • Finance Capitalism & the Naga Question
  • Alumni 1998 Batch Ki Ningai
  • Manipur Univ's CMS awarded 4.5 out of 5
  • Legal Training for Justice Workers
  • Career Counselling for Bishnupur students
  • International Yoga Day
  • Indo-Naga Talks 2017 :: News Timeline
  • Noting the SOS from the DC of Kpi
  • For that little bit more
  • Lai Khong Chingba @Thangjing #4
  • Landscape of Kangpokpi :: Gallery
  • Yeningthagi Wari Kumhei :: Gallery
  • Beyond beef eating
  • World Father's Day :: Poem
  • Bereavement of Khaplang & can of worms
  • Union HRD Prakash Javadekar at Imphal
  • Jobs at basicP, Singjamei
  • Job at Escent Diagnostics, Imphal
  • Treating patients with a human touch
  • Deliberate mistakes
  • Yu Thongba by Loi of Awang Sekmai #2
  • Dialysis Programme @JNIMS :: Gallery
  • Pukhri Macha at Kangla :: 360 ° View
  • Khangchiu/Liuchiu: Liangmai institution #1
  • Mass awareness on congress grass
  • Shut down in hills, Unity Day in valley
  • Sever pol ties: Where does this leave NPF ?
  • June in Manipur
  • June 18 effect
  • Great June Uprising #1 :: Gallery
  • The Great June Uprising 2001 :: Photos
  • Stalls @Barak (spring) Fest #2 :: Gallery
  • Farmers: Occupation or a Game?
  • Food, nay tobacco, for thought
  • Paris climate agreement & India's role
  • The day to pay tribute to our own father
  • Annual Iftar Gathering at Konthagram Masjid
  • Compositeness of settlers of Manipur #3
  • The Great June 18 Uprising :: Tribute
  • Flooding at Kangpokpi :: Gallery
  • Robert Naorem collections at Milan Walk
  • Peace in post-Khaplang North-East
  • My Manipur: A tryst with ground reality
  • Ignoring the parallel Government
  • Call to IM leadership to wake up
  • Talk offer from Naga outfit: Delhi should..
  • Regulating private schools
  • Arbind Soibam (Singer) :: Erang Photos
  • Tha, Tha Thabungton: Reviewing a Lullaby
  • No More WW2 Bridge at Heingang
  • Women in Khasi & Jaintia society
  • My Song :: Poem
  • Mind boggling job interviews
  • Researchers from Kerala & Maharashtra..
  • Ripe opportunity for awareness & action
  • Flood in Imphal- June 14 :: Gallery
  • Dr. Asha Sougaijam, short stories winner
  • 6th Thang-Ta Federation Cup at Agra
  • Yu Thongba by Loi of Awang Sekmai #1
  • Yaipan, wild flower @Ukhrul :: Gallery
  • NEROCA Vs Southern Samity #5:: Gallery
  • Buddhism in Manipur
  • PDS : Proven Deceitful System
  • Love thy neighbour as thyself
  • B.Tech admission in NIT Manipur by JoSAA
  • Resolution adopted by Naga People Front
  • Iftar with locals at Lilong
  • Doubtful sincerity
  • Film Personalities #3 :: eRang Classic
  • U17 District Subroto Football :: Gallery
  • India's troubled region evades scribe-killing
  • Agenda of the BJP led Government #7
  • Sendra Park & Resort #3 :: 360 ° View
  • Career options in Education #2
  • Feverous Earth :: Poem
  • Create the right ambience for the kids
  • Reposing the trust
  • Compositeness of settlers of Manipur #2
  • Moirangthem Arup at Marathon, Africa
  • For the love of football
  • .... Moirang Sendra is for Moirang
  • Counselling for DU admission
  • Congratulate candidates from Thadou
  • North East - Delhi Consultancy
  • Jobs at PR Enterprises, Keisampat
  • Discussion on Oil Exploration at Chandel
  • Crucial period for parents/guardians
  • Manipur Sangai Festival 2016 #5 : Ooba
  • RKFD Sangai Trophy Veteran #2 :: Gallery
  • Achingliu Kamei at Half Marathon, St Albans
  • Sleepless night :: Poem
  • Arambam Boby Singh felicitated at Guwahati
  • Vice-free campus beckons Manipur student
  • Meeting on Stop Oil Exploration at Maklang
  • Shillong Lajong Signs Players For U-15
  • Need for a strong Congress ..Opposition
  • Lai Khong Chingba @Thangjing #3
  • 2nd Hill People's Day by CM :: Gallery
  • Barak Festival at Senapati #2 :: Gallery
  • Phynyx coming up with new original songs
  • Goods & Service Tax & its role in Manipur
  • Oil Exploration Consultation at Khangabok
  • Condolence for Khaplang :: Nagaland CM
  • To each his own
  • Earth crack @ Kangpokpi #1 :: Gallery
  • Eyek Tamba :: Learn Manipuri script
  • Major David Manlun :: Gallery
  • Pottery by Thongjao, Kakching :: Gallery
  • Gurumayum Robert (Archer) :: Profile
  • Lai Khong Chingba @Thangjing #2
  • Nampanliu Riamei : Ningtingale Award
  • Flood in Imphal [May 31] #2 :: Gallery
  • HSLC 2017 : Result
  • HSLC 2017 : Stats/Subject Toppers
  • HSLC 2017 : Result (External)
  • HSLC 2017 : Top 25
  • Shirui Lily Festival, Ukhrul #4 :: Gallery
  • Art exhibition at Ukhrul :: Gallery
  • President presents Award to Prof Subadani
  • Camping @ Phangrei, Ukhrul #1 :: Gallery
  • Kanchan Soibam :: eRang Photos
  • HSE 2017 : Toppers in Science :: Gallery
  • Class XII result announced :: Gallery
  • Nungbi Chaphu - Ukhrul Pottery :: Gallery
  • Ksh Bhaktakumar- Mr India 2017:: Gallery
  • Featured Photo for 2017 #2 :: Gallery
  • Landscape of Manipur #6: Wallpaper
  • 'Nura Pakhang'(Video) @Portugal:: Gallery
  • Purul, Senapati :: 360 View Panorama