2.2.1 What are the components of human rabies surveillance?

Rabies is characterized by a strict viral neurotropism, meaning that the virus has a special affinity for nervous tissue. After peripheral inoculation, depending on the site of infection, viral transport occurs from the periphery to the central nervous system (brain) when severe illness, coma and death follow, after a variable incubation period.
As with any other pathogenic neurotropic microorganism, the clinical picture is relatively non-specific early on, with varying neurological symptoms that can be more or less pronounced depending on the stage of the clinical course (for details see here).
Therefore, human rabies surveillance should be an integral part of the differential diagnosis of any human showing neurological symptoms and pathology compatible with an acute encephalitis (with or without a history of animal bite). Information gained by a physician by asking specific questions of a patient or relatives is critical for substantiating suspicion of rabies or for ruling it out. Rabies diagnosis in humans based solely on clinical grounds is unreliable. Whenever possible, laboratory diagnostic confirmation of suspected and probable human cases should be sought.

next page: 2.2.2 Why is laboratory confirmation needed to make rabies surveillance in humans reliable?


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[en]Version 1 Last updated December 2014[fr]Première version, dernière mise à jour Juin 2015