Polymerase chain reaction and other laboratory techniques in the diagnosis of long incubation rabies in Australia
1993
McColl, K.A. | Gould, A.R. | Selleck, P.W. | Hooper, P.T. | Westbury, H.A. (Commonwealth Scientific and Industrial Research Organisation, Geelong (Australia). Australian Animal Health Lab.) | Smith, J.S. (Centers for Disease Control, Atlanta (USA). Rabies Lab.)
Blood and post-mortem tissues from a 10-years-old girl were submitted to the Australian Animal Health Laboratory. Clinical signs and histopathological lesions had suggested a diagnosis of rabies, but, an unusually long incubation period of at least 5 years did not encourage such a diagnosis. Serological examinations by the rapid fluorescent focus inhibition test revealed a dramatic increase in rabies virus-neutralising antibody during the 10-day period of hospitalisation. The results of a fluorescent antibody test on brain smears, and an immunoperoxidase test on formalin-fixed sections of brain were also consistent with a diagnosis of rabies. Attempts to isolate virus were unsuccessful. Polymerase chain reactions (PCRs) were conducted on a brain sample, and subsequent sequencing of gene fragments, and comparison with equivalent regions of known rabies viruses, confirmed that the fragments originated from a virus belonging to the rabies virus serotype. This case demonstrated the advantage of using a range of laboratory techniques to obtain a definitive diagnosis, in particular, a PCR-based test, and demonstrated that an unusually long incubation period should not discourage a tentative clinical diagnosis of rabies
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