Rabia: una zoonosis que persiste en el siglo XXI

Abstract

Rabies has been described since 2300 BC and is currently the cause of death of approximately 60,000 people in the world each year, mainly in Asia and Africa. It is an RNA virus, neurotrope, which belongs to the Lyssavirus family. It is considered a zoonotic disease, where dogs and bats are the main ones involved. As a virus with neurological tropism, once it enters the body, it travels retrograde until it reaches the central nervous system. The clinical manifestations are presented depending on the nerves which it is later spread. In this way, if it affects the salivary glands, it allows it to transmit itself to other organisms and perpetuate its cycle.

Its incubation period is variable, ranging from two weeks to seven years. Reason why the clinical history becomes essential for its diagnosis. An incubation, prodromal, and acute neurological phase has been described. It presents a broad neurological clinical spectrum. One of its characteristics, is the encephalitis, also the hydrophobia and aerophobia. In addition, it may present paralytic episodes that lead to patient’s death.

Moreover, the diagnosis is confirmed by laboratory tests. In many cases, the diagnosis of certainty is even established post mortem with samples of brain tissue.

Nowadays, no medication has been described that reverses all the symptoms once they are present. However, important actions have been described to consider. Methods such as pre-exposure prophylaxis and post-exposure prophylaxis have been documented. Associated with this, the Milwaukee protocol was implemented almost two decades ago; guidelines with which the initial patient survived, but with significant neurological sequelae.

It should be noted that rabies is a disease that seeks to eradicate through vaccination, so it is essential to raise awareness about its benefits.