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Rabies, Human
2011 Case Definition

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

CSTE Position Statement(s)

  • 10-ID-16

Clinical Description

Rabies is an acute encephalomyelitis that almost always progresses to coma or death within 10 days after the first symptom.

Laboratory Criteria for Diagnosis

  • Detection of Lyssavirus antigens in a clinical specimen (preferably the brain or the nerves surrounding hair follicles in the nape of the neck) by direct fluorescent antibody test, OR
  • Isolation (in cell culture or in a laboratory animal) of a Lyssavirus from saliva or central nervous system tissue, OR
  • Identification of Lyssavirus specific antibody (i.e. by indirect fluorescent antibody (IFA) test or complete rabies virus neutralization at 1:5 dilution) in the cerebrospinal fluid (CSF), OR
  • Identification of Lyssavirus specific antibody (i.e. by indirect fluorescent antibody (IFA) test or complete rabies virus neutralization at 1:5 dilution) in the serum of an unvaccinated person, OR
  • Detection of Lyssavirus viral RNA (using reverse transcriptase-polymerase chain reaction [RT-PCR]) in saliva, CSF, or tissue.

Case Classification

Confirmed

A clinically compatible case that is laboratory confirmed by testing at a state or federal public health laboratory.

Comments

Laboratory confirmation by all of the above methods is strongly recommended.



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