Changes in clinical diagnosis

Rabies has been eradicated in Japan, but is still prevalent worldwide, killing more than 50,000 people each year.

There is no established method of rabies diagnosis, and research continues. The clinical diagnosis method reported by Dr. Veera of the Thai Red Cross Research Institute in 2005 can diagnose rabies with a high accuracy rate of 94.6%.

▶ Clinical diagnostic methods of the Thai Red Cross Institute

 The Thai Red Cross Institute makes the diagnosis by checking the following six criteria in the following order.

 1.Age of the dog at the time of the accidental bite

      Incubation period of rabies is 2–6 weeks. Therefore, if the dog is less than one month old, it is excluded from the rabies diagnosis.

       2.Duration of disease maintenance until the start of observation

      Dogs that develop rabies die within 10 days. If the dog survives longer than 10 days from the onset, it will be excluded from the rabies diagnosis.

       3. Progression of symptoms


       4. Clinical course during the first 3–5 days of observation

      Since rabies progresses gradually and does not recover. If the condition is stable or recovering, it is excluded from the rabies diagnosis.

       5. Presence of circling movements as if the animal were blind

      If the animal is circling while bumping into the cage as if it is blind, it is removed from the rabies diagnosis, as it is often another disease.

       6. Two or more of the 17 signs are applicable

      The probability of rabies is high if two or more of the 17 signs described below apply,

      Although these signs may be present in normal dogs or other diseases, observation after sorting by 1–5 can diagnose rabies with a high probability.

      …17 signs of clinical diagnosis…

       1. Drooping mandible: Lowering of the lower jaw and opening of the mouth due to paralysis.

         2. Abnormal vocalizations: Distinctive, hoarse, hoarse cry.

        3. Dry, hanging tongue: Dark red to orange-red, dry, drooping tongue. Dirty tongue.

           4. Licking of own urine

           5. Abnormal licking of water: Behavior of repeated attempts to drink due to difficulty swallowing or tongue paralysis.

           6. Regurgitation: Behavior of vomiting, choking, and scratching around the mouth with paws.

           7. Abnormal behavior: Unusual behavior that has not been seen before

           8. Allotriophagy: Prefers to eat stones, wood chips, etc.

           9. Aggression: Very aggressive behavior in the last 3 days.

           10. Unexplained biting: Aggressive behavior without clear reason.

           11. Running without reason: Uncontrolled running outside or around the house. Insomnia at night.

             12. Stiffness while walking: Stiffness in both hind limbs while running or walking.

               13. Restlessness

               14. Biting of cage or other objects

               15. 嗜眠:静かにしているときの嗜眠傾向。

               16. Staggering when walking: Loss of balance due to paralysis of both hind limbs.

               17. Frequent dog-sitting posture: Repeated sitting posture with one hind limb flexed and the outside in contact with the ground.

                A comparison of the 17 symptoms described above with the criteria for clinical diagnosis used in Japan until now reveals many similarities.

                2. Abnormal vocalizations, 3. dry and hanging tongue, 8. allotriophagy, 9. aggression, 10. unexplained biting, 13. restlessness, 14. biting cages, 15. lethargy, and 16. staggering when walking have been consistently described since 1879, suggesting that these symptoms are characteristic of rabies and have been used for diagnosis for a long time.