6 results
192 - Rabies
- from Part XXIII - Specific organisms: viruses
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- By Gloria von Geldern, Neuroimmunology and Neurological Infections, Anita Mahadevan, National Institute of Mental Health & Neurosciences, Susarla K. Shankar, National Institute of Mental Health & Neurosciences, Avindra Nath, National Institute of Mental Health & Neurosciences
- Edited by David Schlossberg, Temple University, Philadelphia
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- Book:
- Clinical Infectious Disease
- Published online:
- 05 April 2015
- Print publication:
- 23 April 2015, pp 1220-1225
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Summary
History
The first clear reference to rabies was from writings by Aristotle in circa 380 BC in which he described the symptoms and transmission of rabies in dogs. Despite centuries of observations on the transmission, symptoms, and a myriad of unsuccessful remedies, the disease remained invariably fatal until approximately 1885, when Louis Pasteur developed the first rabies vaccine in Paris. Unable to identify the organism – indeed unaware of even the difference between bacteria and viruses – he cultured it in the spinal cords of rabbits and, ultimately, injected it into Joseph Meister, a young boy attacked by a rabid dog on his way home from school. Given the severity of his wounds on his face, hands, and legs he undoubtedly would have died; however, he received a series of 13 injections, survived, and subsequently spent his life working as a guard at the Pasteur Institute.
Epidemiology
In 2010, the Centers for Disease Control and Prevention (CDC) reported that there were 6153 cases of rabies in animals and 2 human cases in the United States. Hawaii has been the only state free of rabies infection in humans and animals. Ninety-two percent of cases were in wild animals. In Europe, the World Health Organization (WHO) reported 6065 cases of animal rabies and 9 human cases in 2012. Most of these occurred in Eastern Europe. In Latin America, there were 111 cases of human rabies reported between 2010 and 2012. The highest prevalence of rabies worldwide is still in developing countries, with India being in the lead followed by China, Nepal, and Myanmar. A rising incidence has also been seen in some African countries such as Malawi. In the United States the largest reservoirs remain in raccoons followed by skunks, bats, foxes, and coyotes. Raccoon and fox reservoirs are mainly from the eastern states; bat and skunk cases were also found in parts of the south, Pacific Northwest, and California. Domestic animals only accounted for about 6.8% of rabies. Interestingly, cats are found to be infected with rabies almost double the infections of dogs. The cases of rabid cats continue to rise, whereas the cases in other animals are declining yearly. This paradox may be due to administration of vaccines in certain animals, especially dogs. In Europe, the rabies reservoir is mainly the fox, whereas the bat is the main reservoir in Australia, Mexico, and parts of South America. Worldwide, death from rabies is usually from a rabid dog.
Chapter 7 - Movement disorders in HIV- and AIDS-related central nervous system infections
- from Section II - Movement disorders in systemic disease
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- By Sarah M. Kranick, Section of Infections of the Nervous System, National Institute of Neurological Diseases & Stroke, National Institutes of Health, Bethesda, MD, USA, Avindra Nath, Section of Infections of the Nervous System, National Institute of Neurological Diseases & Stroke, National Institutes of Health, Bethesda, MD, USA
- Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
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- Book:
- Movement Disorders in Neurologic and Systemic Disease
- Published online:
- 05 April 2014
- Print publication:
- 20 February 2014, pp 89-98
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Summary
Introduction
There are a number of important infectious etiologies that must be considered in patients presenting with movement disorders. Abnormal movements have been recognized as the presenting sign of HIV infection since the 1980s (Nath et al. 1987). While the incidence in the developed world of certain classic movement disorders due to infections, such as Sydenham’s disease, has waned with greater antimicrobial availability, physicians continue to see a wide spectrum of infectious etiologies due to patients travelling long distances, as well as increased use of immunomodulatory agents and iatrogenic immune suppression. The recognition of infectious agents in the differential diagnosis of movement disorders can be of great clinical significance when treatment for the infection is available, such as in Whipple’s disease, which has been reported in association with AIDS (Jankovic 1986); in other cases, such as prion disease, in which treatment is not available, identification of the infectious etiology is important for diagnosis, prognosis, and epidemiological control to prevent potential spread of the infection. Recognition of infectious agents as the etiology of movement disorders may also assist with localization of the lesion (see Figure 7.1). In the case of HIV infection, which is to some extent treatable as a chronic infection, neurologists must recognize abnormal movements that may be a manifestation of the infection with HIV itself, as well as those movements attributable to opportunistic infections, and those that occur as complications of combined antiretroviral therapy (cART) or symptomatic treatment. With HIV-infected patients achieving much greater length of survival, there will likely be more cases of neurodegenerative disorders such as idiopathic Parkinson’s disease (PD), and thus issues related to management of PD in patients with HIV infection will also become increasingly salient.
Contributors
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- By Douglas L. Arnold, Laura J. Balcer, Amit Bar-Or, Sergio E. Baranzini, Frederik Barkhof, Robert A. Bermel, Francois A. Bethoux, Dennis N. Bourdette, Richard K. Burt, Peter A. Calabresi, Zografos Caramanos, Tanuja Chitnis, Stacey S. Cofield, Jeffrey A. Cohen, Nadine Cohen, Alasdair J. Coles, Devon Conway, Stuart D. Cook, Gary R. Cutter, Peter J. Darlington, Ann Dodds-Frerichs, Ranjan Dutta, Gilles Edan, Michelle Fabian, Franz Fazekas, Massimo Filippi, Elizabeth Fisher, Paulo Fontoura, Corey C. Ford, Robert J. Fox, Natasha Frost, Alex Z. Fu, Siegrid Fuchs, Kazuo Fujihara, Kristin M. Galetta, Jeroen J.G. Geurts, Gavin Giovannoni, Nada Gligorov, Ralf Gold, Andrew D. Goodman, Myla D. Goldman, Jenny Guerre, Stephen L. Hauser, Peter B. Imrey, Douglas R. Jeffery, Stephen E. Jones, Adam I. Kaplin, Michael W. Kattan, B. Mark Keegan, Kyle C. Kern, Zhaleh Khaleeli, Samia J. Khoury, Joep Killestein, Soo Hyun Kim, R. Philip Kinkel, Stephen C. Krieger, Lauren B. Krupp, Emmanuelle Le Page, David Leppert, Scott Litwiller, Fred D. Lublin, Henry F. McFarland, Joseph C. McGowan, Don Mahad, Jahangir Maleki, Ruth Ann Marrie, Paul M. Matthews, Francesca Milanetti, Aaron E. Miller, Deborah M. Miller, Xavier Montalban, Charity J. Morgan, Ichiro Nakashima, Sridar Narayanan, Avindra Nath, Paul W. O’Connor, Jorge R. Oksenberg, A. John Petkau, Michael D. Phillips, J. Theodore Phillips, Tammy Phinney, Sean J. Pittock, Sarah M. Planchon, Chris H. Polman, Alexander Rae-Grant, Stephen M. Rao, Stephen C. Reingold, Maria A. Rocca, Richard A. Rudick, Amber R. Salter, Paula Sandler, Jaume Sastre-Garriga, John R. Scagnelli, Dana J. Serafin, Lynne Shinto, Nancy L. Sicotte, Jack H. Simon, Per Soelberg Sørensen, Ryan E. Stagg, James M. Stankiewicz, Lael A. Stone, Amy Sullivan, Matthew Sutliff, Jessica Szpak, Alan J. Thompson, Bruce D. Trapp, Helen Tremlett, Maria Trojano, Orla Tuohy, Rhonda R. Voskuhl, Marc K. Walton, Mike P. Wattjes, Emmanuelle Waubant, Martin S. Weber, Howard L Weiner, Brian G. Weinshenker, Bianca Weinstock-Guttman, Jeffrey L. Winters, Jerry S. Wolinsky, Vijayshree Yadav, E. Ann Yeh, Scott S. Zamvil
- Edited by Jeffrey A. Cohen, Richard A. Rudick
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- Book:
- Multiple Sclerosis Therapeutics
- Published online:
- 05 December 2011
- Print publication:
- 20 October 2011, pp viii-xii
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46 - Neuroprotection in multiple sclerosis
- from Section III - Clinical trials of multiple sclerosis therapies
- Edited by Jeffrey A. Cohen, Richard A. Rudick
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- Book:
- Multiple Sclerosis Therapeutics
- Published online:
- 05 December 2011
- Print publication:
- 20 October 2011, pp 535-546
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Summary
Cyclophosphamide is employed in autoimmune neuropathies, and vasculidities such as Wegener's granulomatosis and polyarteritis nodosa. Mycophenolate mofetil (Cellcept) is a potent immunosuppressant and has been used increasingly in post-transplant patients because it is considered less toxic than azathioprine and cyclophosphamide. Methotrexate is a general immunosuppressant that acts primarily by inhibition of dihydrofolate reductase. Azathioprine (Imuran) is a purine analog that is metabolized to 6-mercaptopurine and thioinosine acid, which compete with DNA nucleotides, causing immunosuppression. This chapter lists randomized trials of immunosuppressives in multiple sclerosis (MS). In the right patient, cyclophosphamide has been demonstrated effective, while work with methotrexate and mycophenolate mofetil has been less conclusive. Azathioprine also is likely to have a favorable effect on MS, and is relatively safe. Recent novel uses of immunosuppressives in active patients, or new disease populations have broadened the possible uses of these drugs.
190 - Rabies
- from Part XXIII - Specific Organisms – Viruses
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- By Anita Venkataramana, The Johns Hopkins School of Medicine, Nicoline Schiess, The Johns Hopkins School of Medicine, Anita Mahadevan, National Institute of Mental Health, Susarla K. Shankar, National Institute of Mental Health, Avindra Nath, The Johns Hopkins School of Medicine
- Edited by David Schlossberg
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- Book:
- Clinical Infectious Disease
- Published online:
- 05 March 2013
- Print publication:
- 12 May 2008, pp 1305-1310
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Summary
HISTORY
The first clear recognizable reference to rabies was from writings by Aristotle in circa 380 BC in which he described the symptoms and transmission of rabies in dogs. Despite centuries of observations on the transmission, symptoms, and a myriad of unsuccessful remedies, the disease remained invariably fatal until approximately 1885 when Louis Pasteur developed the first rabies vaccine in Paris. Unable to identify the intangible virus—indeed unaware at that time of even the difference between bacteria and viruses—he cultured it in the spinal cords of rabbits and, ultimately, injected it into Joseph Meister, a young boy severely attacked by a rabid dog on his way home from school. Given the severity of his wounds on his face, hands, and legs he undoubtedly would have died; however, he received a series of 13 injections, survived, and subsequently spent his life working as a guard at the Pasteur Institute.
EPIDEMIOLOGY
In 2001, the Centers for Disease Control and Prevention (CDC) reported that there were 7473 cases of rabies in animals in the United States but no human rabies infection. Hawaii has been the only state kept free of rabies infection in humans and animals. Ninety-three percent of cases were in wild animals. In the United States the largest reservoirs remain in raccoons followed by skunks, bats, foxes, and coyotes. Raccoon and fox reservoirs are mainly from the eastern states; bat and skunk cases were also found in parts of the south, Pacific Northwest, and California. Domestic animals only accounted for about 6.8% of rabies. Interestingly, cats are found to be infected with rabies almost double the infections of dogs.
Alzheimer's Disease is Rare in Cree
- Hugh C. Hendrie, Kathleen S. Hall, Neelan Pillay, Donald Rodgers, Carol Prince, James Norton, Harry Brittain, Avindra Nath, Arthur Blue, Joe Kaufert, Paul Shelton, Brian Postl, Benjamin Osuntokun
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- Journal:
- International Psychogeriatrics / Volume 5 / Issue 1 / March 1993
- Published online by Cambridge University Press:
- 07 January 2005, pp. 5-14
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- Article
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A community survey and subsequent clinical assessment of 192 Cree aged 65 years and over registered in two Reserves in Northern Manitoba identified only one case of probable Alzheimer's disease among eight cases of dementia, giving a prevalence of 0.5% for Alzheimer's disease and 4.2% for all dementias. This contrasted with an age-adjusted prevalence of 3.5% for Alzheimer's disease and 4.2% for all dementias in an age-stratified sample of 241 English-speaking residents of Winnipeg. Although it was not so for all dementias, the difference between the groups for prevalence of Alzheimer's disease was highly significant (p < .001). The age-specific patterns of all dementias in the two groups were significantly different, however (p = .0254).