Le diagnostic de la rage

Rabies is an encephalitis due to a lyssavirus, a zoonotic agent. It is not yet controled and is even re-emerging in many African and Asian countries. In France, most of the animal and human cases are imported. The clinical diagnosis of rabies is often difficult and therefore the laboratory diagnosis remains the only diagnosis of certainty. In post-mortem diagnosis in animals or humans, brain biopsy or brain specimens will be analysed by direct immunofluorescence, cell culture isolation and rabies antigen capture by ELISA. In intra-vitam diagnosis in humans, nested RT-PCR will be performed on 3 saliva specimens collected at intervals and/or on a skin biospsy collected at the tap of the neck. The contribution of laboratory diagnosis methods is major for the control of rabies, its prevention and for the optimal delivery of the post-exposition prophylaxis in rabies-exposed patients.