Rabies

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Nationally notifiable since 1927

1.0 National Notification

Only confirmed cases of disease should be notified.

2.0 Type of Surveillance

Routine case-by-case notification to the federal level

3.0 Case Classification

3.1 Confirmed case

Clinical evidence of illness with laboratory confirmation of infection:

• detection of viral antigen in an appropriate clinical specimen, preferably the brain or the nerves surrounding hair follicles in the nape of the neck, by immunofluorescence
  OR
• isolation of rabies virus from saliva, cerebrospinal fluid (CSF), or central nervous system tissue using cell culture or laboratory animal
  OR
• detection of rabies virus RNA in an appropriate clinical specimen

3.2 Probable case

Clinical evidence of illness with laboratory evidence:

• demonstration of rabies-neutralizing antibody titre ≥ 5 (complete neutralization) in the serum or CSF or an unvaccinated person

4.0 Laboratory Comments

Negative results do not rule out rabies infection because viral material may not be detectable (e.g. early in infection). CSF frequently remains negative.

The presence of rabies-neutralizing antibodies can indicate an exposure to rabies virus antigen or passive immunization.

Negative serologic results do not rule out a rabies infection because antibody levels may not surpass the detection threshold (0.5 IU) and seroconversion is usually very late.

5.0 Clinical Evidence

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

6.0 ICD Code(s)

6.1 ICD-10 Code(s)

A82

Rabies

A82.0

Sylvatic rabies

A82.1

Urban rabies

A82.9

Rabies, unspecified

6.2 ICD-9 Code(s)

7.0 Type of International Reporting

8.0 Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

9.0 References

Date of Last Revision/Review:

May 2008