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My friend was telling me about a case of a boy she saw who had been bitten by a dog and how the boy was behaving aggressively, I immediately figured out it could be a case of furious rabies.

That was how I learned some time ago that there are different clinical representations of rabies. Some people would even argue that, rabies shouldn't cause aggression but what they do not understand is that there are different forms and probably the type they have seen in action is not the same type the person they are arguing with has seen before. Rabies has two clinical representations, furious and paralytic rabies.

<center>https://upload.wikimedia.org/wikipedia/commons/8/8c/Rabies_virus_structure.jpg
[image source](https://commons.m.wikimedia.org/wiki/File:Rabies_virus_structure.jpg)</center></div>

Rabies is found to affect people from remote and poorer populations. Rabies gets into the body of a person when the saliva from an affected animal enters into an open wound. The virus moves slowly along the nerves into the central nervous system. All around the world, the number of cases of rabies that have been recorded is 59,000. Vaccination has helped countries like the United States where cases of rabies have become very rare.

The process of rabies goes through different phases, the incubation, the prodromal phase, the acute neurological phase, and the coma finally.
During the phase of incubation, the virus will take days to weeks before it enters the nervous system. During this phase, no symptoms are shown and a situation of rabies can still be salvaged at this point.

At the prodromal phase, the rabies virus travels through the nerve cells into the spinal cord and brain, causing damage as it proceeds. The prodromal phase begins when the rabies gains entry into the nervous system. The immune system tries fighting back, causing flu-like symptoms. 
A damage in the nerve would create a tingling pain, or numbness at the point where there is a bite. At this point, there is usually no effective treatment to save the day.

At the acute neurological phase, the rabies virus starts to damage the brain and spinal cord. At this stage, either the affected patient has furious or paralytic rabies. Furious rabies will come with aggression, delirium, and seizures. On the other hand, if it is a paralytic rabies type, then weakness and paralysis will be experienced while the virus spreads to other parts of the Furious rabies can last for a few days or a week while paralytic rabies on the other hand, could keep the victim for up to a month.

<center>https://upload.wikimedia.org/wikipedia/commons/f/f6/%22Rabies_and_hydrophobia...%22_George_Fleming_1872_Wellcome_L0018105.jpg
[image source](https://commons.m.wikimedia.org/wiki/File:%22Rabies_and_hydrophobia...%22_George_Fleming_1872_Wellcome_L0018105.jpg)</center>

After this stage, coma is the final stage, and eventually, a case of death is presented.
The vaccination of all animals is very important when it comes to preventing rabies. Even puppies need to be vaccinated. Also, creating awareness about rabies and bite prevention is important in preventing the spread and existence of rabies.

There are existing vaccines that can immunize people before and after exposure. For patients who have been vaccinated before the attack, they are given two shots of the vaccine, but for others who have not been, four shots of the vaccine are administered after exposure.  The vaccine teaches the body to destroy rabies before it even enters the brain.

Also, human rabies immune globulin (HRIG), can be administered around the wound area providing antibodies that would destroy the virus around the wound area until the body is ready to take over. HRIG is only given to those who have not been previously vaccinated before the infection.

There is a blood-brain barrier which serves as a layer between the brain and the blood vessels in the head. The function of this layer is to protect the brain by keeping out toxins and other dangerous substances from getting into the brain from the blood. Researchers say, rabies locks down this barrier further so there is no room for any type of medication that may want to destroy it to get through. This is the reason why once rabies infection gets into the brain, no treatment can be carried out, it can only lead to death.

#### <center>References</center>

[detail/rabies](https://www.who.int/news-room/fact-sheets/detail/rabies)

[Furious-Rabies-vs-Dumb-Rabies](https://www.news-medical.net/health/Furious-Rabies-vs-Dumb-Rabies.aspx)

[diseases/13848-rabies](https://my.clevelandclinic.org/health/diseases/13848-rabies)

[cdc.gov/eid/article](https://wwwnc.cdc.gov/eid/article/31/2/ac-3102_article)