Rabies Ag Test User Guidelines

20161011

Animal that attacked pet should be subjected to Rapid Rabies Ag test with the brain

PositiveNegative

Can’t Test due to owners

Pet should be euthanized

Pet can’t be euthanized due to owners

Unvaccinated animal should be observed for 6 months in quarantine and vaccinated

http://www.cliniciansbrief.com/article/rabies-clinic

Animal should be observed for 10 days and submitted for Rapid Rabies Ag test with Saliva

Apply first aid to bite wounds Viral shedding

during observationClinical signs during observation

Should be euthanized and brain need be submitted for Rapid Rabies Test & laboratory tests

Vaccinated animal should be revaccinated immediately and be observed for 45 days in quarantine

Can be applied to every animal in the area where Rabies is endemic

Etiologic Agent

• RNA virus• Rhabdoviridae• Lyssavirus ; highly neurotropic

• Prevalent in Latin America, Asia, and Africa• In India, every year 25,000 cases human rabies infection occur per year

https://www.health.gov.au/internet/main/publishing.nsf/Content/ED62D139B56F7B80CA257BF0001B7422/$File/ABLV-rabies-song-gl-June2014.pdf

http://bio113portfolioleighhobson2.weebly.com/rabies.html

http://www.merckvetmanual.com/mvm/nervous_system/rabies/overview_of_rabies.html

Viral shedding & Transmission

• Viral shedding• shed in saliva several days prior to the onset of the clinical signs

(virus might be shed intermittently in saliva)

• Transmission• Saliva, Bite of infected animal• Contact with saliva or nervous tissue, fluids of rabid animal• Blood, vomitus, feces, urine and fomites are not the sources for

rabies transmission

http://www.cliniciansbrief.com/article/rabies-clinic

Could Rabies be transmitted during incubation period?• Regardless of long incubation period, if animal is shedding the virus thereby is capable of transmitting the disease, it can be suspected that the disease will show clinical signs within 10 days of observation.

• If dog does not show clinical signs within 10 days after the bite, it can be suspected that dog didn’t transmit the virus when the dog had bitten the other animal. Therefore the bit victim is free of concern for the virus infection.

http://www.cliniciansbrief.com/article/handling-potential-rabies-exposure

Incubation Time

• The incubation time depends on the site of virus infection

• The farther from the CNS, the longer the incubation time (bite on the head or neck has short incubation periods)

• Average incubation period in dogs: 3~8 weeks (from several days to up to 6 months)

• Most rabies cases in dogs develop within 21~80 days after exposure• Average incubation period in cats: 4~6 weeks

http://www.cliniciansbrief.com/article/rabies-clinic

http://www.merckvetmanual.com/mvm/nervous_system/rabies/overview_of_rabies.html

Infection stage of DogsStage Duration Clinical Signs

Prodromal stage 1~3 days Lick infection siteAnxious/docile/irritableFever, lethargy, snapping

Furious stage 1~7 days Restlessness, irritability, enhanced response to stimuliDrooling, ataxia, seizure, comaBiting, barking

Paralytic stage 1~10 days Paralysis (Jaw stay open)Difficult swallowingSaliva drippingParalysis, coma, ataxiaRespiratory failure

http://www.cliniciansbrief.com/article/rabies-clinic

Infection stage of Human

1. Early symptoms ; flu-like symptoms, pain, paresthesias at bite site

2. anxiety, confusion and agitation

3. Encephalitic & paralytic forms

4. Hydrophobia: Rabies disease may lead to painful spasm ofbreathing muscles with attempts to drink, leading to conditioning

Pathogenesis

1. At the infection site, virus bind to the cells via nicotinic acetylcholine receptors

2. Virus remain at infection site for several months

3. Virus multiplies in the muscle cells at the site of the bite (incubation phase)

4. Virus moves by the axons to arrive to the CNS

5. When virus arrive at dorsal root ganglia and spinal cord, virus can be spread to CNS (prodromal phase)

6. Brain cells are infected

7. Infection induce Encephalitis, neural degeneration

8. Virus moves to saliva glands by the time the virus can be detected with saliva, virus can also be detected with the brain

http://bio113portfolioleighhobson2.weebly.com/rabies.html

Clinical Findings

• Clinical signs are similar among the infected species

• Acute behavioral changesanorexia, apprehension, nervousness, irritability, hyperexcitabilityseek for solitude, ataxia,

• Unexplained progressive paralysisUncharacteristic aggressiveness, suddenly become vicious, lose fear against people

http://www.merckvetmanual.com/mvm/nervous_system/rabies/overview_of_rabies.html

Diagnosis

• Laboratory designated by government can perform experiments according to the standardized protocols for rabies testing.

• Immunofluorescence microscopy with fresh brain tissue (medulla oblongata, cerebellum which is preserved by refrigeration )

• Virus isolation by the mouse inoculation, tissue culture – uncommon

• Rapid Tests for emergency situation and local animal hospitals

http://www.merckvetmanual.com/mvm/nervous_system/rabies/overview_of_rabies.html

Treatment Protocol

• Actually, unvaccinated animals should be euthanized immediately

• However, if the owner is against it, the animal can be isolated for 6 months in quarantine to observe clinical signs and vaccinate on one month before the end of isolation

• Vaccination is not 100% protective Any one bitten by the animal is on the risk of infection

http://www.merckvetmanual.com/mvm/nervous_system/rabies/overview_of_rabies.html

Rapid Rabies Ag Test

• Description : Detection of Rabies virus antigen

• Specimen : 10% canine brain homogenate

• Cat.No : RG1801DD

Test Procedure

Advantages of Rapid Rabies Ag

• When the rabid animal can’t be observed for a period of time• When the situation is urgent (emergency)• When specimen quality is not good

http://eo2.commpartners.com/users/APHL/downloads/100-932-12-Presentation.pdf

Evaluation Data

• South Africa, University of Pretoria (2009)

• Specificity: 100%

Evaluation Data

• France OIE Reference Lab (2012) • RDIT vs FAT• Sensitivity: 88.3%• Specificity: 94.7%

• RDIT vs RICIT• Sensitivity: 87.8%• Specificity: 99%

Evaluation Data

• Germany OIE Reference Lab (2008)

• Sensitivity: 85%

Indirect FAT

+ -

BioNoteRapid

Rabies Ag

+ 35 0 36

- 6 0 6

41 0

Evaluation Data

• Australian Animal Health Laboratories Diagnostic Services Response Group

• Sensitivity: 100%• Specificity: 100%

Evaluation Data

• US Military veterinary unit

• Sensitivity: 96.9%• Specificity: 100%

Evaluation Data

• India, Guru Angad Dev Veterinary Univ.

• Sensitivity: 91.6 %• Specificity: 100 %

Evaluation Data

• Korea Government, Animal, Plant and Fishries Quarantine and Inspection Agency

• Sensitivity: 95 %• Specificity: 98.9 %