<unk>  is a viral zoonotic disease that causes acute encephalitis (inflammation of the brain) in mammals. In non-vaccinated humans,<unk>  is almost invariably fatal after neurological symptoms have developed, but prompt post-exposure vaccination may prevent the virus from progressing. The<unk>  virus is categorized as a Lyssavirus. The molecular biology of<unk>  consists of bullet shaped virus with helical symmetry that has a length of approximately 180 nm.<unk>  typically has its greatest effect on the brain.<unk>  is typically defined by encephalitis and myelitis. Various carnivorous animal species have been identified as the source of<unk>  virus (RV). In Africa and Asia, domestic dogs are the main reservoirs of<unk>  virus infection. Whereas, in the United States, racoons, foxes, skunks, coyotes, possums and bats are understood to be responsible for the spread of<unk>  virus. RV infects neurons and leads to the degeneration of the neuronal processes by disrupting cytoskeletal integrity. The differential diagnosis for<unk>  deals with eliminating diseases with similar symptoms from the diagnosis. There are many viruses that can appear similar to<unk>  such as encephalitis and the herpes simplex virus. According to the World Health Organization (WHO), human<unk>  is present in 150 countries and territories and on all continents, except for Antarctica. India has been known to have the highest incidence of<unk> . A bite from an infected animal is the biggest risk factor.<unk>  is a clinical diagnosis that includes a thorough medical history and a high degree of suspicion. Patients are asymptomatic during the incubation period. Prodromal symptoms may include low-grade fever, chills, malaise, myalgias, weakness, fatigue, anorexia, sore throat, nausea, vomiting and headache. Clinical<unk>  can present as encephalitic ("furious")<unk>  or paralytic ("dumb")<unk> .<unk>  eventually results in progressive encephalopathy, respiratory arrest, coma and death within 10 days of the onset of symptoms. Common physical examination findings of<unk>  include hyperpyrexia alternating with hypothermia, tachycardia, respiratory collapse, hypersalivation, lacrimation, sweating, dilatation of the pupils and bradycardia. Skin findings may include percussion myoedema, bite marks and bruises. Lumbar puncture may show lymphocytic pleocytosis, CSF protein-elevation and normal glucose concentration. Patients with suspected exposure to<unk>  or asymptomatic patients can benefit from thorough wound cleaning followed by a combined<unk>  vaccination and immune globulin administration, these patients have a good prognosis. Human diploid cell<unk>  vaccines are made using the attenuated Pitman-Moore L503 strain of the virus. Human diploid cell<unk>  vaccines have been given to more than 1.5 million humans as of 2006. Treatment after exposure, known as post-exposure prophylaxis or "P.E.P.", is highly successful in preventing the disease if administered promptly, within fourteen days after infection. The first step is immediately washing the wound with soap and water, which is very effective at reducing the number of viral particles. In the United States, patients receive one dose of immunoglobulin and five doses of<unk>  vaccine over a twenty-eight day period. One-half the dose of immunoglobulin is injected in the region of the bite, if possible, with the remainder injected intramuscularly away from the bite.
Rabies
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Lábrea fever
Rat-bite fever
Cotton fever
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