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Rage

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Rage
Diagnosis

Rage — an acute infectious disease of animals and the person caused by a virus. It is shown by the increased nervous irritability, hydrophobia, an aerophobia, paralyzes, comes to an end with a lethal outcome.

Etiology. The activator — a neurotropic virus which is a little steady in external environment. At boiling he perishes in 2 min., is quickly inactivated by solutions of lysol, chloroamine, carbolic and hydrochloric acids. In corpses of animals remains till 4 months.

Epidemiology. Rage belongs to group of zoonoz. All hematothermal animals are ill. The main source and the reservoir of a virus are wild carnivorous (foxes and wolves) and house (dogs, cats) animals. Infection of animals and the person occurs at hit of saliva on the injured skin or mucous membranes and at stings mad animals. The causative agent of rage collects and allocated through sialadens not only during an illness, but also in an incubation interval for 24 — 72 h, and sometimes in 7 — 8 days prior to emergence of the first symptoms of a disease.

Pathogeny. Entrance infection atriums are the injured skin and mucous membranes. From a wound the virus on nerve fibrils gets into the central nervous system and concentrates in certain departments of a head and spinal cord, causing their damage. Selectively neurons of a hippocampus, myelencephalon, cranial nerves, lumbar part of a spinal cord and sympathetic a ganglion are surprised. From the central nervous system the virus extends on nervous trunks on all organism including in sialadens.

Reproduction of a virus is resulted by inflammatory, dystrophic and necrotic changes of a nervous system. At pathomorphologic research of a brain of the dead from rage hemorrhages, fabric hypostasis, a necrosis of nervous cells are found. In cells of a hippocampus Babesh's little bodies, specific to rage — Negri, the representing virus colonies surrounded with the changed cytoplasm are defined.

Clinic. The incubation interval lasts from 8 to 90 days, up to 1 year more rare, 20 — 30 days are more often. The short incubation is noted at a sting of the head, person and hands, longer — at a sting of the lower extremities.
The disease begins with harbingers. At first there is a concern, oppression, aspiration to retire, the patient seizes melancholy. Body temperature sometimes increases to subfebrile. In the field of a sting unpleasant feelings, pain appear. The hem of the healed wound sometimes inflames, becomes painful. There is an increased reflex irritability, fear, alarm, quite often hallucinations. In 1 — 3 day the period of the expressed excitement begins, the concern, spasms of respiratory and deglutitory muscles with signs of disorder of function increases. Attempt to take a sip causes a spasm of muscles, the patient with fear removes a glass. Later hydrophobia at a look and splash of water develops. There are convulsive attacks from the air movement (aerophobia), the loud speech, bright light. The attack begins concern and fear, motive excitement and a spasm of muscles of a throat, disorder of breath. Painful spasms distort a face. It becomes cyanotic. Convulsive states are combined with psychomotor excitement and aggression, auditory and visual hallucinations. The attack proceeds several seconds then the consciousness is recovered. However muscular spasms repeat again, follow one by one from the slightest irritation. In an excitement stage temperature increases to 40 — 41 °C. The voice becomes hoarse, the plentiful sialosis, perspiration appear. In process of a course of a disease there come paralyzes. Psychomotor excitement and spasms weaken, the patient calms down. He can eat food and drink water. Weakness develops, there are paralyzes of extremities, function of pelvic bodies is broken, temperature increases to 42 °C, the death occurs from a cardioplegia or a respiratory center. In blood the neutrophylic leukocytosis, an aneosinophilia, in urine — protein, sugar, acetone is defined.

Atypical forms of rage are sometimes observed: bulbar, paralytic, cerebral, cerebellar. At atypical forms of a disease excitement and hydrophobia are poorly expressed or are absent. The death occurs on 6 — the 8th day of an illness, and sometimes within 1 days.



 
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