Diagnosis of human rabies cases by polymerase chain reaction of neck-skin samples.
Rapid diagnosis of rabies in suspected human cases influences post-exposure prophylaxis for potential contacts of the patient and ensures appropriate patient management. Apart from the central nervous system (CNS), rabies virus (RABV) is usually present in small sensory nerves adjacent to hair follicles of infected humans. We used an RT-PCR, with primers targeted to the 3' terminal portion of the nucleoprotein gene (N), to test neck-skin samples of nine patients who had rabies in order to validate a diagnostic method that could serve as an additional tool for rabies diagnosis, particularly in antemortem samples. Six of eight postmortem samples were found to be positive for rabies by RT-PCR, and one of two samples collected antemortem was positive with this same technique. Results were confirmed by DNA sequencing; this validates RT-PCR and neck-skin as a suitable technique and type of sample, respectively, for use in the diagnosis of human rabies. RT-PCR applied to neck-skin biopsies could allow early diagnosis and lead to more effective rabies treatment.
Macedo
Carla Isabel
CI
Instituto Pasteur, SP, Brazil.
Carnieli
Pedro
P
Brandão
Paulo Eduardo
PE
Travassos da Rosa
Elizabeth S
ES
Oliveira
Rafael de Novaes
Rde N
Castilho
Juliana Galera
JG
Medeiros
Rita
R
Machado
Rosangela Rocha
RR
Oliveira
Rosely Cerqueira de
RC
Carrieri
Maria Luiza
ML
Kotait
Ivanete
I
D000818:Animals; D017931:DNA Primers; D004279:DNA, Viral / Q000032:analysis; D004285:Dogs; D005455:Fluorescent Antibody Technique; D006801:Humans; D051379:Mice; D009333:Neck / Q000821:virology*; D010802:Phylogeny; D012367:RNA, Viral / Q000032:analysis; D011818:Rabies / Q000175:diagnosis* / Q000821:virology; D011820:Rabies virus / Q000235:genetics* / Q000276:immunology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D012867:Skin / Q000821:virology*
D017931:DNA Primers; D004279:DNA, Viral; D012367:RNA, Viral