1Bhargava Degree College, University of Jammu, Jammu & Kashmir.
2Veterinary, Presidential L Camels and Camel racing Affairs Center, UAE Biotech Research Center, Abu Dhabi.
3Shri Mata Vashino Devi University Katra, Jammu & Kashmir.
Despite being one of the worst viral infections, rabies is one of the oldest known. Rabies continues to be a serious hazard to human health, particularly in underdeveloped nations, despite tremendous progress in our understanding of viruses. The rabies virus causes the disease, which mostly affects the central nervous system and, if symptoms start to show, can result in deadly encephalitis. Over 59,000 people die from rabies each year, especially in areas with poor access to healthcare, despite the disease's well-established existence and the availability of efficient pre-exposure and post-exposure vaccinations. Dogs are the principal animal carriers of the disease, and the sickness is mostly spread via animal bites. Although rabies can be avoided with early post-exposure prophylaxis (PEP) intervention, the disease is nearly always lethal once clinical signs appear. The lack of efficient remedies once the virus enters the brain emphasises how urgent it is to increase prevention through widespread animal immunisation campaigns, public awareness campaigns, and easier access to healthcare. Although there are still obstacles to overcome, ongoing research holds out promise for novel therapeutic approaches, such as antiviral medications and more effective vaccinations. The pathophysiology of rabies, treatment challenges, the disease's worldwide impact, and present and upcoming initiatives to prevent, investigate, and develop novel therapies are all covered in this article.
The rabies virus, which belongs to the Lyssavirus genus in the Rhabdoviridae family, is the cause of rabies. The central nervous system (CNS) of animals, including humans, is the main organ affected by the virus. It is usually spread by an infected animal's saliva, usually through bites or scratches. The virus travels along nerves in the neurological system and finally reaches the brain, where it causes inflammation and ultimately death. India has the highest rate of rabies, and the country's roughly 1.7 million dogs are a contributing factor, with a roughly 1:36 dog to human ratio. Dogs may be divided into four main groups: domestic dogs (wholly reliant, somewhat restricted), communal dogs (unrestricted, partially dependent), feral dogs (unrestricted, independent), and pets (supervised, restricted). In India, the majority of dogs are believed to fit into the latter three groups. This feature is a major hurdle in rabies prevention and control. An increase in homeless dogs, a lack of post-exposure treatment and vaccination, a lack of diagnostic infrastructure, a weak monitoring system, a lack of public knowledge, a lack of concern, and a lack of government financing are the key obstacles to rabies prevention and control.
|
Feature |
Details |
|
Family |
Rhabdoviridae |
|
Genus |
Lyssavirus |
|
Transmission |
Saliva of infected animals (bites, scratches) |
|
Primary Target |
Central Nervous System (CNS |
|
Replication Site |
Muscle cells near the entry point |
|
Incubation Period |
Weeks to months (varies with location and severity of bite) |
|
Fatality Rate |
Nearly 100% after symptom onset |
|
Prevention |
Post-Exposure Prophylaxis (PEP) before symptoms appear |
Fig 1.1 Key Facts about Rabies Virus
Rabies differs from many other viral illnesses in that, once symptoms appear, it is nearly always lethal. Once within the body, the virus multiplies in muscle cells close to the infection site. After then, it enters the neurological system and starts its destructive path there. A limited window for intervention is provided by the incubation period, which can vary from weeks to months and is the interval between exposure and the onset of symptoms.
Fig.1.2 Progression of Rabies Virus in the Body
2. Signs and Development
Early on, the symptoms of rabies, such fever, headache, and exhaustion, often mimic those of less dangerous conditions. However, the symptoms worsen significantly as the infection spreads. Patients frequently suffer from anxiety, disorientation, agitation, hallucinations, and hydrophobia (a fear of water) when the infection advances to the brain. Usually 2–10 days after symptoms start, paralysis develops in when the virus attacks the motor neurones, resulting in respiratory failure and death. Unfortunately, because the virus damages the brain and spinal cord irreversibly, the condition is nearly always deadly by the time these serious symptoms manifest. This trend highlights the significance of early intervention and makes treating rabies very difficult.
3. The Difficulties in Rabies Treatment
Although rabies may be prevented with a safe and effective vaccination, there is currently no proven antiviral therapy for when symptoms appear. Once the rabies virus has entered the brain, it may be very difficult to eradicate. The main reason there is no treatment for rabies symptoms is that the virus may swiftly infiltrate the brain and inflict permanent harm. However, early treatment can stop the infection from getting to the central nervous system. A course of post-exposure prophylaxis (PEP) vaccinations can successfully stop the disease from developing in a human bitten by a possibly rabid animal. PEP consists of injections of the rabies vaccine, sometimes combined with rabies immune globulin (RIG), which aids the body in battling the virus until it is able to establish an immune response of its own. Even with these precautions, the prognosis is dire once the illness spreads to the brain. There is a limited window for effective therapy, and survival is uncommon once symptoms appear. This emphasises the necessity of improved early detection methods, increased access to preventative treatment, and public health education.
Fig.3.1 What Happens Step-by-Step (A Simple Flow)
The prevalence of rabies varies globally. The World Health Organisation (WHO) reports that most rabies deaths take place in Asia and Africa, and that the illness is a serious public health issue in nations with poor access to medical treatment. Dog bites are responsible for more than 95% of human rabies infections, and the illness mostly strikes rural regions where residents have frequent contact with dogs and other animals. Immunoglobulin and rabies immunisations are frequently unavailable in these areas, and treatment can be quite expensive. Because of this, rabies is an avoidable tragedy that may be eradicated with more access to vaccinations and information. Furthermore, rabies persists in regions with unchecked stray dog populations and insufficient animal immunisation programs. Addressing rabies in these areas requires a multipronged strategy that includes expanding access to post-exposure prophylaxis, educating people about the dangers of rabies, and launching widespread canine vaccination campaigns.
Even while rabies is still a major worldwide health concern, research into the virus and its therapies has advanced significantly. Potential therapeutic targets that might be used for antiviral medications have been identified by recent studies into the processes of rabies virus infection. While some research has concentrated on finding tiny chemicals that can prevent the virus from spreading throughout the neurological system, other studies are investigating how genome editing technologies like CRISPR might be able to stop viral replication. The creation of a more potent rabies vaccine is among the most exciting developments in rabies research. Although the current vaccinations are quite effective, they may be expensive and sometimes require many doses. In order to lessen the strain on healthcare systems, particularly in environments with limited resources, researchers are developing new, affordable vaccinations that might be given in fewer doses.
The creation of therapies that can aid in the management of rabies symptoms once the illness has progressed past its early stages is also gaining attention. Antiviral medications and therapeutic chilling (induced hypothermia) are two experimental therapies that have been tried to reduce the disease's progression. These therapies are still in the experimental stage, though, and further study is required before they can be widely used.
Prevention is the most effective way to fight rabies. It is crucial to concentrate on stopping the disease's transmission by immunising animals against rabies in addition to expanding access to vaccinations and post-exposure prophylaxis. It has been shown that mass dog vaccination campaigns and initiatives to manage stray animal populations can effectively lower the number of human rabies incidents. Furthermore, it's critical to educate both urban and rural communities about rabies. Many deaths can be avoided by teaching humans how to avoid coming into contact with rabid animals, how to see the symptoms of rabies in animals, and when to get medical attention after possible exposure.
CONCLUSION
Rabies is still considered one of the most deadly viral illnesses in the world, and once symptoms start to show, almost every person dies. Although post-exposure prophylaxis (PEP) and effective vaccinations can prevent the illness if given early, the dearth of available treatments after the virus enters the brain emphasises how important early intervention and prevention are. Rabies disproportionately strikes communities with poor access to medical treatment, especially in rural areas with unchecked stray dog populations. Coordinated actions are needed to combat rabies worldwide, including widespread canine vaccination programs, more public education, and easier access to prompt medical care. . There's possibility of more effective treatment and maybe even the eventual elimination of the illness on account of ongoing research into novel medicines and vaccinations. To lessen the burden of rabies and stop unnecessary fatalities, there must be ongoing world cooperation and investment in research, prevention, and awareness.
REFERENCES
Raksha Lalotra*, Arun Singh, Charu Lata, Studying Rabies Virus: A Worldwide Danger and the Quest for a Cure, Int. J. of Pharm. Sci., 2025, Vol 3, Issue 4, 2342-2347 https://doi.org/10.5281/zenodo.15244714
10.5281/zenodo.15244714
