Rabies Revealed: Virus, Diagnosis, and Disease

Author: Margaret Reinhart, MS, MLS(ASCP)
Reviewer: Kayla Lichtenberger, BS, M(ASCP), MLT(ASCP)
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Serology/Immunology): 1 hour(s)

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Objectives

  • Describe the life cycle, classification, structure, and means of replication of the rabies virus.
  • Trace the progression of rabies virus transmission from the infected host to central nervous system infection in the new host.
  • Compare initial signs of symptoms of rabies with the inevitable central nervous system signs, and correlate optimum steps and timing of post-exposure treatment.
  • Identify available rabies diagnostic tests, distinguish those used to confirm versus exclude infection, and recognize the gold-standard methods.
  • Distinguish the main transmitters of rabies in the United States from those in other countries.
  • Correlate the structure of the rabies virus with some of its mechanisms to evade the immune system.

Course Outline

  • Introduction
    • The Terrible Truth About Rabies
    • Biology of Rabies Virus
    • What does the genome of rabies virus consist of?
    • What is the approximate fatality rate once rabies reaches the central nervous system and clinical symptoms develop?
  • Epidemiology, Life Cycle, and Transmission
    • Epidemiology
    • Life Cycle within a Human Host
    • What is the status of rabies in the United States?
    • Once a human or animal has been bitten, the rabies virus can replicate in muscle tissue and then, after a period of time, invade the central nervous system via which of the following?
  • Pathogenesis
    • Initial Signs and Symptoms
    • Central Nervous System Symptoms
    • What is the approximate incubation period for rabies?
    • Which of the following is a CNS symptom not observed in animals infected with rabies?
  • Rabies Testing
    • Introduction to Rabies Testing
    • Antemortem Testing in Humans
    • Postmortem Testing in Animals and Humans
    • Direct Fluorescent Antibody Test
    • Direct Rapid Immunohistochemistry Test
    • Real-Time Reverse Transcriptase Polymerase Chain Reaction Test
    • Immunohistochemistry Test
    • Histologic Examination
    • Serological Testing During Prophylactic Treatment
    • Specimen Submission to the CDC Laboratories
    • Which of the following specimens is not acceptable for human antemortem testing?
    • True or False: A gold-standard test is required to confirm a positive rabies test.
    • Which test gives accurate results on rabies testing of decomposed or formalin-fixed brain tissue?
    • In a routine histological exam of rabies-positive brain tissue, what are the eosinophilic inclusion bodies in neuronal cells infected with rabies called?
  • Prevention, Treatment, and Control
    • Recommendations for Prevention in Humans
    • Pre-Exposure Prophylaxis
    • Post-Exposure Treatment
    • Rabies Surveillance in the U.S.
    • Control of Rabies in Wildlife in the U.S.
    • Which group of people is at the greatest risk for rabies infection in the United States?
    • Which group of people is least likely to require rabies human immunoglobulin injections after exposure to a rabid animal?
    • Which of the following potential rabies carriers is currently found in all of the United States except Hawaii?
  • Selected Cases of Rabies
    • Introduction to Rabies Cases
    • Case #1
    • Further Discussion of Case #1: Rabies Immune Evasion and Subversion
    • Case #2
    • Further Discussion of Case #2
    • Which of the following is not a characteristic that is relatively unique to rabies virus infection?
    • Which animal is currently responsible for the most human rabies deaths in the U.S.?
  • References
    • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Margaret Reinhart, MS, MLS(ASCP), is a Senior Lecturer emerita of Biological Sciences at St. Joseph's University (formerly University of the Sciences), where she taught hematology, clinical immunology, microbiology, parasitology, and other related courses, as well as directed the MLS program for over 30 years. She also taught courses in Global Environmental Sustainability and Animal Studies. She is currently an adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia, PA. She holds a Master's Degree in Biology and a Master's Degree in Health Care Administration.
The author has no conflict of interest to disclose.
Reviewer Information: Kayla Lichtenberger, BS, M(ASCP), MLT(ASCP), has built a progressive career in clinical microbiology at Essentia Health. She began as a medical laboratory assistant, where she developed a strong foundation in diagnostic workflows before transitioning into the microbiology department. There, she advanced into leadership as the lead technologist, overseeing daily operations, guiding workflow efficiency, and supporting high‑quality diagnostic results. Kayla holds a Bachelor of Science in microbiology from North Dakota State University and a medical laboratory technician degree from Rasmussen College, grounding her leadership in both scientific training and hands‑on laboratory experience.