Talk:Rabies

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Tragedy in Germany: six transplants have rabies

Terrible tragedy looms in Germany: more recent news say all six transplants have rabies now. Added to the article. See: http://news.bbc.co.uk/1/hi/world/europe/4271453.stm

Mentioned in FoxTrot

This article was mentioned in a FoxTrot comic strip (the image) about Wikipedia today (May 7 2005), though it obviously didn't get the same attention that Warthog did as a result [1]. Just thought I'd mention it. --Phoenix-forgotten 17:52, 2005 May 7 (UTC)

Detection & Questions about Incident

Is there a way to tell if a cat has rabies, so that I can not be afraid of approaching that animal? In other words, are there cases where a cat would not show the typical signs of having rabies (agression, drooling, rabid), but still have it? Perhaps in the very early stage of it getting the virus (or maybe even during vaccination)? Also, if a cat is vaccinated, thus showing no signs of having rabies; if you are scratched/bitten by the cat, would you still get rabies? I was recently playing with this neighbourhood cat, (it had a collar and seemed to be either currently domesticated, or WAS domesticated but escaped and is now feral); however, that doesn't really matter, since the cat could STILL have rabies. The cat showed no signs of having rabies (typical signs); I am unaware of other symptoms, so I'm unsure... The cat had accidentally scratched me very slightly; and it was only later that I noticed the skin had a trace amount of blood; as tiny as a paper cut. I'm thinking a scratch of that small magnitude can still deliver rabies? Also, the cat has a habit of taking hold of your hand, and giving it a gentle "gnaw" or bite; sort of in a playful manner. I don't believe any blood was drawn, but some skin was scratched; similar to when a person scratches his own hand with his nails; not enough to draw blood, but still a scratch... Again it was until later had I noticed this, so IF blood was drawn, it may have already healed/been washed off. Based on what I've seen; and the little I know about this particular cat or rabies-symptoms in general, I'm thinking the cat may STILL have rabies (albeit there are no symptoms), and am afraid that his playful bite/gnawing or accidental scratch may have transfered rabies to me. I am also worried about other diseases like cat scratch fever, etc.—Preceding unsigned comment added by 24.23.6.222 (talk)

Ecological effect

Missing in this article is description of any ecological impact of rabies. An unreliable source just told me that a recent racoon rabies epizootic in northeast Pennsylvania has decimated the racoon population resulting in marked increase in wild turkeys (whose eggs are eaten by racoons). Was there actually an upsurge in racoon infection and did this significantly affect the population in a manner at all comparable to the impact of canine distemper? Myron 10:37, 23 October 2006 (UTC)

I am wondering whether there should be a section outlining methods of rabies control. India and the subcontinent is currently fighting a battle against canine rabies and human death. Various methods of control are being tested perhaps a summary might be indicated. benjicharlton (talk) 22:42, 25 August 2008 (UTC)

Rabies in cats

Recent attack made by a cat on a human resulted in the cat being strangled to death. Just a point of interest: http://www.smh.com.au/news/world/i-was-bleeding-all-over/2007/06/21/1182019235640.html

Can the Virginia Opossum transmit rabies?

The Virginia Opossum is a Marsupial, but still it is a Mammal, so can it become infected? —Preceding unsigned comment added by 129.252.89.201 (talk) 18:51, August 30, 2007 (UTC)

3 or 6 survivors?

There seems to be disagreement, and contradiction on the reference page cited very first. The directly cited article says that there were only three survivors of symptomatic rabies, and then the later case study linked to from that page says explicitly that there were five before Jeanne, and that would make six survivors. Do we have another reference to resolve this contradiction?

History?

There seems to be little material on the history of prevention and treatment of rabies. Given the effect on human history, it seems to be worth a section.

Prevalence

Why does the section on rabies in the United States take up the bulk of the section when they have only a handful of new infections each year and places such as India have tens of thousands?

Also there seem to be inconsistencies in the "rabies-free zone" descriptions, I have read that Australia is considered rabies-free in spite of ABLV, while it states that the UK is not rabies free because of another lyssavirus. cyclosarin (talk) 08:33, 27 May 2008 (UTC)

We could add the definition of Rabies Free as per OIE

Rabies free country

A country may be considered free from rabies when: the disease is notifiable; an effective system of disease surveillance is in operation; all regulatory measures for the prevention and control of rabies have been implemented including effective importation procedures; no case of indigenously acquired rabies infection has been confirmed in man or any animal species during the past 2 years; however, this status would not be affected by the isolation of a European Bat Lyssavirus (EBL1 or EBL2); no imported case in carnivores has been confirmed outside a quarantine station for the past 6 months.

Link: http://www.oie.int/eng/normes/mcode/en_chapitre_2.2.5.htm#rubrique_rage Under this definition the UK is considered Rabies Free as is Australia. While Rabies is a member of the Lyssavirus's EBLV adn ABLV are not the same as rabies. The severity of spread is nothing like rabies. benjicharlton (talk) 23:37, 25 August 2008 (UTC)

The Australian Government considers the following areas Rabies free (ie Category 1,2 or 3)

Rabies Free Countries and Territories

Category 1	Category 2	Category 3a&b	Other Rabies Free
New Zealand	Bahrain Barbados Cyprus Falkland Islands Fiji French Polynesia (includes Tahiti, Society Islands, Marquesas Islands, Austral Islands, Tuamotu Islands, Gambier Islands) Guam Hawaii Iceland the Republic of Ireland Japan Malta Mauritius New Caledonia Norway Singapore Sweden Taiwan the United Kingdom Vanuatu	American Samoa Federated States of Micronesia Kiribati Papua New Guinea Solomon Islands Wallis and Futuna Western Samoa Christmas Island Cook Islands Nauru Niue Palau Kingdom of Tonga Tuvalu	Cocos (Keeling) Islands Norfolk Island

Given the Australian Governments extremely tight policies regarding quarantine - I believe this might be a reliable source of Rabies Free Countries. benjicharlton (talk) 23:37, 25 August 2008 (UTC)

Currently, the map of Rabies-free countries and its caption do not seem to match: Finland and Hawaii are mentioned in the caption but are not highlighted on the map, and Germany and Austria (and Cyprus, I think) are highlighted on the map but are not mentioned in the caption. Neither seems to match the Australian government's list above (for example New Zealand is not on the map and many are not in the caption). Does anybody know what the map and caption are based on? Maybe somebody who knows how could change the map to match the list above? 81.98.32.49 (talk) 11:03, 6 November 2008 (UTC)

Some comments

1) In the clinical manifestations part there is no mention about the classic furious (80%) and paralytic (20%) rabies categories. Every major ID textbook (mandell, gorbach, cohen etc) approaches the disease by using this method

2) Miss Giese isn't the sole survivor without severe neurologic sequelae- in fact 2 years later she still had dysarthria and ataxia (source: http://content.nejm.org/cgi/reprint/357/9/945.pdf). The unique survivor without long term disability is described in this article: Hattwick MA, Weis TT, Stechschulte CJ, Baer GM, Gregg MB. Recovery from rabies. A case report. Ann Intern Med 1972;76: 931--42. The unique fact about her case is the lack of vaccination.

3) It should be clearly stated that in the Milwaukee protocol case, the virus was never isolated from her body, the diagnosis was made by the patient's history and antibodies in CSF. This is unique among the 6 survivors, as in all other 5 the virus was identified via biopsies. This fact tones down the "miracle treatment" aura of this article (maybe it was a weaker strain, or her immune system was surprisingly effective)

4) Parts of this article are copy/pasted from other sources, word for word (like harrison, the cdc article about the Giese case, even the Wisconsin medical college page about this particular case, as it's one of the first to come up after googling for "milwaukee protocol"... poor research in my opinion)

these were my 2 cents 85.73.221.233 (talk) 00:08, 15 July 2008 (UTC)

Possible Misinformation about Post-Exposure Prophylaxis

I have been doing some research about rabies on the internet, from official and non-official sites. There seems to be some contradicting information, which may lead to people being misinformed about this disease. Most sites say that incubation time lasts about 1 to 3 months before symtpoms start appearing, that once the virus enters the CNS and symptoms being to appear it is too late to begin treatment. A few sites mention specifically, that it is too late to being treatment once the virus infects a neuron, which would be found in the PNS, and long before the virus makes its way to the CNS. I don't know if this is true, and I would like an expert to confirm or refute this. Is the body's immune system capable of accessing and destroying the rabies virus if has incubated for a significant amount of time (ie. 2 weeks) and infected a neuron located in the PNS, but before it has made its way to the CNS via axonal transport?

Some sites claim that since incubation time lasts so long, that people have time (such as 1 month) to receive PEP treatment. If it is true that the immune system does not have access to the virus once in the PNS (still technically in its incubation stage without symptoms appearing for another couple of weeks) the misinformation on the internet would lead people too seek out treatment much to late for it to be effective.

Again, I would appreciate an expert responding to this. Thank you in advance, Perwisky (talk) 21:18, 5 August 2008 (UTC)

As you indicated, once the virus enters the peripheral nerve, it is thought to be relatively resistant to immune-mediated deactivation. The precise time at which this happens in an individual patient is difficult or impossible to know, and the extent of delay that renders postexposure prophylaxis ineffective is not known. So post-exposure prophylaxis should be instituted whenever exposure is suspected, regardless of the interval between exposure and treatment. Loupe (talk) 17:07, 20 August 2008 (UTC)

I noticed that there is a mistake in the first sentence -- it says "consists of over 28 days." Consists of what over 28 days? 206.194.127.112 (talk) 19:25, 2 September 2008 (UTC)

The spatial and temporal distribution of opossum rabies

The title and content of this section is confusing. How does an outbreak of rabies among opossums in Virginia, which resulted from previous outbreaks across the united states, relate to the parent section or to the rest of the article which discusses rabies as a whole?

Furthermore how does it warrant the name "The spatial and temporal distribution of opossum rabies"? Usually the words "spatial" (nature of space) and "temporal" (nature of time) are used within the context of theoretical physics, not epidemiology (the closest topic this section relates to).

I believe this sub-section should either: be merged into the parent section, cut out into its own section discussing the epidemiology of rabies, or omitted. ChyranandChloe (talk) 01:08, 6 October 2008 (UTC)

"Spatial distribution" and "temporal distribution" are commonly used terms -- try Google-searching for them (as phrases). In fact, "spatial and temporal distribution", as a phrase, gets 342,000 Google hits. However, you're right that the opossum section is poorly written -- I think you should go ahead and rewrite it if you feel like it. Looie496 (talk) 01:17, 6 October 2008 (UTC)

320,000 is not a good number of hits and in the context of the "space and time" it is actually extremely small (the exact phrase received 5.5 million hits). It is not a "commonly used term", and in the context of the article it would a stretch to imagine that the distribution of cases of rabies among opossums would have an effect on the nature of space and time. I think it would be best to merge it into the parent section, and in a copy-edit sweep after a strong outline is established we could figure out how to use it. ChyranandChloe (talk) 01:39, 6 October 2008 (UTC)

Regardless of the number of ghits, "spatial distribution" and "temporal distribution" are not limited to the field of physics: they are both common concepts in epidemiology. For example, a quick search for "spatial AND temporal AND distribution AND rabies" on PubMed turns up 11 articles - most of them since 2003 - including this one: Guerra MA, Curns AT, Rupprecht CE, Hanlon CA, Krebs JW, Childs JE (2003). "Skunk and raccoon rabies in the eastern United States: temporal and spatial analysis". Emerging infectious diseases. 9 (9): 1143–50. PMID 14519253. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) -- MarcoTolo (talk) 01:47, 6 October 2008 (UTC)

I still find it unusual for the title of the section to be so lengthy and filled with jargon, and yet to begin by stating the cases of infected opossums are spillover cases. Ultimately I'd like to here what you think should happen to this section. ChyranandChloe (talk) 01:58, 6 October 2008 (UTC)

I agree that, as a section title, it is both too long and uninformative. I've been bold and re-sectioned the various vectors under a single heading. While all the subsections still need significant work, I think it flows a bit better that way. Thoughts? -- MarcoTolo (talk) 04:06, 6 October 2008 (UTC)

Article restructuring

I approve, though classifying the animals as vectors does not seem entirely accurate. Perhaps a more fitting title would be "Rabies and animals", however I think we need to establish a criteria for what these sections are to be about before we proceed. The subsection "Bats" primarily discusses the history of rabies and bats, the subsection "Skunks" back-tracts to prevention and treatment before discussing a campaign for the approval of a vaccine, in "Opossums" it discusses epidemiology, in "Dogs" it discusses epidemiology and then symptoms, and finally in "Wolves" it discusses some history and then some behavioral information. Ultimately what I am saying is that this article has little cohesion, the sections and subsections don't make sense when read together. My thoughts are to cut section "Rabies vectors" into its own article and breifly discuss it in a summary section (possibly "Rabies in animals" or shorter "Animals") which could be under epidemiology. As a draft I'm proposing to establish an outline, possibly:

• Virology
  • Structure
  • (Genome)
  • (Life cycle)
  • (Viral reservoirs)
• Prevention
  • Pre-exposure prophylaxis
  • Post-exposure prophylaxis
• Symptoms
• Treatment
  • Induced coma
• Epidemiology
  • Vectors (previously Transmission)
  • Prevalence
  • Rabies and animals
  • Recent cases
• Cultural impact
• Standard appendices...

I can begin the migration, though I'd like to see what you guys think. As a side note, under WP:LAYOUT Further reading isn't a subsection of References, References are generally reserved for external sources that verify the article and not recommended reading. ChyranandChloe (talk) 03:05, 7 October 2008 (UTC)

I've been bold and took the first step towards restructuring the article. There is still work to be done, and I'll get to it as time permits. Currently two articles have been splintered: Rabies and animals and Prevalence of rabies, both require work to create summaries, relevant, and concise material — which will the next phase. No content has been lost in this transition, however many sections have migrated (to the two splintered articles), renamed to provide accessibility, or rearranged. Nevertheless, there is some inconsistencies that need to be assessed such as standardizing and condensing the prose, explaining jargon, and eliminating padding.

One of the results of this transition is to increase emphasis on the epidemiology and virology. "Pet passports", "Dogs", "Bats", and so forth contain significant amounts of information discussing the political aspects, historical references, and current events. Rabies is a virus, and to ensure that its contents remain relevant, these sections have been summarized and moved. ChyranandChloe (talk) 03:37, 10 October 2008 (UTC)

Short footnotes

I'm switching the referencing style to short footnotes because this makes citing a lengthy work easier. The primary difference is simply giving the option to place the full citation at the bottom in the "Bibliography" section and being able to cite the exact page number or a quotation in the inline while keeping it concise. No conversion is necessary, it only opens the option to allow our references to be easier to verify. In addition, I'm also going by Looie496's innovation of adding a link to the inline to the full citations thus further simplifying verification. ChyranandChloe (talk) 04:24, 11 October 2008 (UTC)

Cultural impact

Rabies have been the source to cultural references for its violent symptoms. Because of this, it should receive some acknowledgment for the traditions, beliefs, and impact on society it has fostered. However in a previous consensus: Talk:Rabies/Archive 1#"In popular culture" "Popular culture" was removed on the grounds of WP:TRIVIA, however I believe we can reintroduce it on basis that for it to be "notable" it: (1) must have an article of its own, (2) is the main or significant theme of the the work, and (3) if the list exceeds 15 entries, the section will be splintered into its own article where it may expand further following the previous guidelines. I've copied and paste the cultural references MarcoTolo cited as the main theme from Talk:Rabies/Archive 1#"Rabies in popular culture" section, part 2 to start off the sub-section. ChyranandChloe (talk) 04:06, 11 October 2008 (UTC)

Epidemic vs. endemic

Since this has caused some confusion in the article, I'll address it here.

• An epidemic is a disease (usually infectious) which appears in a given human population at an elevated rate, i.e. at a higher rate that historically seen. "Epidemic" is a noun, though it can be used as an adjective (an attributive noun). (NB: A pandemic is a widespread epidemic.)
• Endemic (an adjective) means "native to a given area": endemic infections are those which are continuously present at low levels in an area.

-- MarcoTolo (talk) 21:33, 4 November 2008 (UTC)

Thank you for clarifying that (didn't catch the last part). However, I don't think Epidemic fits the situation either. The definition I used (Pinceton's WordWeb) "A widespread outbreak of an infectious disease; many people are infected at the same time". The infection is not widespread, and to avoid any misconception and WP:SYNTH we can just leaved it as "involving". ChyranandChloe (talk) 04:07, 5 November 2008 (UTC)