CSTE Position Statement(s)
Clinical DescriptionRabies 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.
ConfirmedA clinically compatible case that is laboratory confirmed by testing at a state or federal public health laboratory.
CommentsLaboratory confirmation by all of the above methods is strongly recommended.
1. CDC. (1990). Case Definitions for Public Health Surveillance. MMWR, 39(RR-13), 1-43. https://www.cdc.gov/mmwr/preview/mmwrhtml/00025629.htm