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Recommendations of a national working group on prevention and control of rabies in the United States. Article II: Laboratory diagnosis of rabies. The National Working Group on Rabies Prevention and Control
  • Published Date:
    November 15, 1999
  • Status:
    current
  • Source:
    Journal of the American Veterinary Medical Association. 1999; 215(10):1444-6.
Filetype[PDF-164.98 KB]


Details:
  • Pubmed ID:
    10579039
  • Description:
    Rapid, readily available, and accurate diagnosis of rabies is the keystone of prevention. All surveillance activity and description of the complex epizootiologic characteristics of rabies in the United States is based on laboratory diagnosis. Veterinarians are the first line of defense against rabies when responding to clinically ill animals. Rabies is an important consideration when an animal has compatible clinical signs because of the diverse potential sources provided by wildlife reservoirs, such as raccoons, skunks, foxes, and bats. Historically, the most imminent threat of rabies exposure to veterinarians and clients originated from domestic dogs. However, rabies in canids has been nearly eliminated throughout most of the United States via vaccination and control of stray dogs. At present, the greatest threat of rabies is among domestic cats, cows, horses, and captive wild animals. Infection with rabies among these animals poses unique risks for exposure of multiple persons, often because rabies is considered late in the clinical course or during postmortem examination.2-5 The standard diagnostic test consists of direct fluorescent antibody (FA) testing of impressions made from fresh brain samples (ie, cerebellum, hippocampus, and brain stem). Fresh brain tissue may not be routinely collected, and this prevents diagnosis with the FA test. If necropsy has been performed, formalin-fixed tissues may be the only available samples. Experimental diagnostic techniques may need to be applied, such as the direct FA test on formalin-fixed material, immunohistochemistry, or polymerase chain reaction assay on paraffin-embedded tissue.6 Accurate diagnostic capacity and appropriate management of biting animals are essential to the proper handling of potentially exposed animals. In conjunction with local or state health authorities, practicing veterinarians are often directly involved in the 10-day confinement and observation of biting animals or the euthanasia and submission of brain material for testing. They are also routinely consulted in the management of exposed animals; this consists of a 6-month quarantine or the euthanasia of native animals and the booster of previously vaccinated animals. A reasonable index of suspicion of rabies among animals with neurologic signs of disease, the preservation of appropriate fresh brain tissue, and demonstrably proficient diagnostic laboratories are essential to the appropriate treatment of potentially exposed humans, as well as identification of at-risk animals for consideration of increased vaccination coverage.

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