Harkess Graeme, Fooks Anthony R
Rabies and Wildlife Zoonoses Group, Veterinary Laboratories Agency, New Haw, Surrey, UK.
Methods Mol Biol. 2011;665:279-307. doi: 10.1007/978-1-60761-817-1_16.
Rabies is routinely diagnosed based on the clinical description and history of exposure in a rabies-endemic country. A negative diagnostic test for rabies virus or a related lyssavirus does not exclude the clinical diagnosis. Diagnostic tests are never optimal and are entirely dependent on the nature and quality of the sample supplied. Often, only a sample from a single time point is investigated reducing the overall sensitivity of any diagnosis. With the advent of molecular biology, tests have been developed that are rapid, robust, and sensitive in support of the rapid detection and strain identification of rabies virus from clinical specimens. These molecular tests complement conventional tests in rabies diagnosis, particularly for human cases, for which an early laboratory diagnosis is critical and may decrease the number of unnecessary contacts with the patient, reduce the requirement for invasive and costly interventions, and enable the appropriate medical treatment regimen to be administered for the patient. The barrier to success is in transferring the technology for the latest techniques in rabies diagnosis to rabies-endemic countries. These barriers are not insurmountable and in liaison with international organisations, especially OIE, FAO, and WHO, these diagnostic tests will be validated for rabies diagnosis and surveillance, and implemented in modern and well-equipped diagnostic laboratories throughout the world.
在狂犬病流行国家，狂犬病通常根据临床描述和暴露史进行诊断。狂犬病病毒或相关狂犬病病毒属病毒的诊断检测呈阴性并不能排除临床诊断。诊断检测绝非完美，完全取决于所提供样本的性质和质量。通常，仅对单个时间点的样本进行检测，这降低了任何诊断的总体敏感性。随着分子生物学的出现，已开发出快速、可靠且灵敏的检测方法，以支持从临床标本中快速检测狂犬病病毒并进行毒株鉴定。这些分子检测方法在狂犬病诊断中补充了传统检测方法，特别是对于人类病例，早期实验室诊断至关重要，可能会减少与患者不必要的接触次数，降低侵入性和昂贵干预措施的需求，并使患者能够接受适当的医疗治疗方案。成功的障碍在于将狂犬病诊断的最新技术转移到狂犬病流行国家。这些障碍并非无法克服，通过与国际组织，特别是世界动物卫生组织、联合国粮食及农业组织和世界卫生组织联络，这些诊断检测方法将在狂犬病诊断和监测中得到验证，并在全球现代化且设备完善的诊断实验室中实施。
