Rhabdoviruses

Rabies virus stands apart as the most uniformly fatal of all viruses and remains one of the most common viral causes of mortality in the developing world. Much of the basic virology of the rhabdoviruses has been elucidated by studies of vesiculoviruses. The epidemiology of human rabies primarily reflects that of animal rabies in the community. Cases of animal rabies throughout the world can be separated into two groups. In the developing world, rabies is predominantly a problem of domestic animals, with a smaller contribution from wild animals. In the more developed nations, animal control procedures have largely eliminated rabies from domestic animals, and wild animals are the major groups affected. The human immune response to natural rabies virus infection is insufficient to prevent disease. Human rabies virus infections are typically divided into two forms: furious and paralytic (or dumb). Furious rabies patients who receive maximal intensive care support and survive for a longer-than expected period appear to pass in the paralytic phase prior to death. Any levels in cerebrospinal fluid (CSF) are diagnostically valuable this is true even for patients who have received postexposure prophylaxis. The currently employed human vaccines in the United States include human diploid cell vaccine (HDCV) and purified chicken embryo vaccine (PCEC). These vaccines are remarkably safe and immunogenic.