title: Diagnosis of human rabies cases by polymerase chain reaction of neck-skin samples.
abstract: 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.
authors.affiliation: Instituto Pasteur, SP, Brazil.
authors.forename: Carla Isabel
authors.initials: CI
authors.lastname: Macedo
authors.forename: Pedro
authors.initials: P
authors.lastname: Carnieli
authors.forename: Paulo Eduardo
authors.initials: PE
authors.lastname: Brandão
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Travassos da Rosa
authors.forename: Rafael de Novaes
authors.initials: Rde N
authors.lastname: Oliveira
authors.forename: Juliana Galera
authors.initials: JG
authors.lastname: Castilho
authors.forename: Rita
authors.initials: R
authors.lastname: Medeiros
authors.forename: Rosangela Rocha
authors.initials: RR
authors.lastname: Machado
authors.forename: Rosely Cerqueira de
authors.initials: RC
authors.lastname: Oliveira
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Carrieri
authors.forename: Ivanete
authors.initials: I
authors.lastname: Kotait
mesh_terms: 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*
chemical_list: D017931:DNA Primers; D004279:DNA, Viral; D012367:RNA, Viral