Diagnosis
The diagnosis of rabies is generally made clinically.
Fluorescent antibody has been used to detect rabies antigen in tissue e.g. - nuchal skin biopsy - viral antigens or RNA detected at the base of hair follicles containing peripheral nerves, in salivary secretions, in brain tissue (post mortem)
Negri bodies are detected in about 90% of patients with rabies at post-mortem.
Clinical cases can be confirmed by the presence of one or more of the following laboratory criteria: (2)
- presence of viral antigens
- isolation of virus in cell culture or in laboratory animals
- presence of viral specific antibodies in the cerebrospinal fluid or in the serum of an unvaccinated person
- presence of viral nucleic acids detected by molecular methods in samples (for example, brain biopsy sample, skin, saliva, concentrated urine) collected post mortem or when the patient is alive.
Reference:
- Crowcroft NS, Thampi N.The prevention and management of rabies. BMJ. 2015;350:g7827.
- World Health Organization. WHO expert consultation on rabies: WHO TRS N°1012 (third report). April 2018 [internet publication].
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