Manual of Clinical Microbiology


Rabies Lyssavirus

Last Updated:2019

There are numerous etiologic agents in the genus Lyssavirus that result in an acute, fatal viral encephalomyelitis known as rabies in both humans and animals. These agents are single-stranded, bullet-shaped…

Description of the Agent

Lyssavirus virions are bullet-shaped, measure approximately 180 by 75 nm, and consist of five structural proteins: the glycoprotein (G), matrix protein (M), nucleoprotein (N), phosphoprotein (P), and large polymerase protein…

Epidemiology and Transmission

Rabies is a zoonotic disease (primarily an animal disease that may be transmitted to humans). All mammals are susceptible. Although RABV is endemic on five of seven continents, the geographic…

Clinical Significance

The initial clinical presentation of rabies in humans and animals may be rather unremarkable and nonspecific. The majority of incubation periods range from several weeks to several months after exposure.…

Collection, Transport, and Storage of Specimens

A summary of tests, required samples, and shipping and storage conditions is presented in Table 1. Rabies specimen submission guidelines and forms may be found at the Centers…

Isolation Procedures

Isolation methods are useful in detecting infectious virus in samples and are sometimes used as confirmatory test alternatives to the standard DFA test. The classical methods include in vivo isolation…


As previously described in detail, identification of a Lyssavirus infection is made typically by direct examination of brain impressions and demonstration of specific viral inclusions (antigen) by DFA testing. Isolates…

Typing Systems

Rabies viruses may be easily identified by antigenic and molecular methods as being associated with the broad groups of carnivore and bat variants. Through antigenic analysis, at least five major…

Serologic Tests

The serologic tests for RABV antibody include rabies virus neutralization assays and antibody-binding assay methods. Each varies in sensitivity, specificity, type of antibody detected, and the viral antigen (protein) recognized.…

Antimicrobial Susceptibilities

As previously described, no specific rabies antiviral biologics are currently licensed, and the prognosis remains inexorably grim. Once clinical signs are present, rabies remains fatal in more than 99% of…

Evaluation, Interpretation, and Reporting of Results

Written protocols, which include quality assurance and quality control measures, are essential for all diagnostic tests. All reagents for antigen detection should be optimized before use with known positive samples…

Section Editor: Angela M. Caliendo

Volume Editor: Marie Louise Landry

Editors in Chief: Karen C. Carroll and Michael A. Pfaller

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