tailieunhanh - Tropical Neurology - part 4

Nhiễm bệnh dại ở người là một trong những nguyên nhân phổ biến nhất của viêm não ở các nước đang phát triển. Nó vẫn còn một vấn đề sức khỏe quan trọng ở nhiều quốc gia và hầu như chắc chắn kết quả trong cái chết. Bệnh dại ảnh hưởng đến động vật có vú trên cạn và không khí | Chapter 9 Human Rabies Pathogenesis Clinical Aspects and Current Recommendations for Prophylaxis Terapong Tantawichien and Visith Sitprija Rabies infection in man is one of the most common causes of encephalitis in developing countries. It is still an important health problem in many countries and almost inevitably results in death. Rabies affects terrestrial and airborne mammals including the following families of animals Canidae dogs wolves foxes and coyotes Procyonidae raccoons Viverridae mongooses Mustelidae skunks weasels and martens and Chiroptera bats as reservoirs. All mammalian species are however believed to be susceptible. Rabies spreads amongst mammals by bites contamination of intact and abraded mucosal membranes with virus-laden saliva inhalation of aerosol ingestion of infected prey and transplacentally. In man rabies is nearly always secondary to bites although exposure through the inhalation of the virus or through the transplant of an infected cornea also occurs. Rabies is essentially a zoonosis. The major reservoirs for human rabies are domestic dogs stray dogs and cats. Rabies is a major public health problem in most parts of Asia South and Central America Africa and some Pacific Islands where unvaccinated dogs roam freely. Wild animals are less important vectors in rabies endemic areas but they continue to pose a hazard in North America and in Western Europe. In these areas most human rabies is due to bites by rabid wild animals including bats. The World Health Organization WHO reports at least 40 000 human deaths annually from rabies worldwide. Almost all of these deaths have resulted from dog bites. Contrary to the public perception of the disease almost all fatal cases of rabies in developing countries did not receive post-exposure rabies treatment. These potentially preventable deaths occur primarily in Asia Africa and Latin America where animal control vaccination programs and effective human post-exposure prophylaxis are not widely .