Rabies virus

Entry into break in skin (bites, abrasions, mucosa)

Incubation period (4 days 2 years)

Imminent thoracolumbar involvement (PNS): Pupillary dilation, lacrimation, increased thick saliva production / foaming of mouth, excessive perspiration Anxiety & fear Hydrophobia Pronounced muscular stimulation & general tremor Mania & hallucinations with lucid intervals Convulsions

INV A SION PHA SE

Pain Fever Headache Malaise Sore throat Anorexia Increased sensitivity

EX CITEM ENT PHA SE

PA RA LYTIC PHA SE
( DEPR ESSION PHASE)

coma

Gradual weakness of muscle groups: muscle spasms cease, ocular palsy, vertigo, facial & masseter palsy, weakness of muscles of phonation, loss of tendon reflexes, neck stiffness (+)Babinski [lesions at pyramidal tract], (-) Kernigs, (-) Brudzinskis HR shifting from tachycardia (100-120) to bradycardia (40-60) Cheyne-Stokes respiration Local sensation diminshed (pain, heat, cold) Incoordination General arousal Bladder & intestinal retention (damage to the innervation of the musculature of intestine & bladder) Hydrophobia disappear but with slight difficulty swallowing in some cases, patient shows period of recovery, this apparent remission is followed by rapid progressive paralysis Ascending paralysis,flaccid paralysis of extremities until it reaches the respiratory muscle Apathy, stupor

Death