Infection à Lyssavirus à l'exclusion de la rage

Human lyssavirus infection explicitly excluding rabies virus refers to illness caused by rabies-like viruses such as Australian bat lyssavirus, which are maintained in bat populations and were newly discovered in recent years ^[1][2]. These agents are diagnostically and preventively handled in a manner analogous to classical rabies ^[1].

Affected patients may present with a progressive neurological illness following a history of bat exposure, as described for Australian bat lyssavirus ^[3]. The clinical presentation is suspected when a person with bat contact develops such neurological deterioration, though detailed human pathogenesis remains poorly characterized ^[1][3].

Bats constitute about 24% of known mammalian species and frequently serve as lyssavirus vectors, with insectivorous bats important in rabies-like virus ecology and vampire bats as the main rabies vector in Latin America ^[1]. The contribution of fruit bats to Australian bat lyssavirus epidemiology is only now being delineated, and natural lyssavirus infection in bats shows low mortality with seroconversion among survivors ^[1]. Australian bat lyssavirus is among viruses discovered nearly yearly, underscoring its emerging infectious disease status ^[2].

Transmission from infected bats to humans can occur through bites, and other routes such as scratches or mucous membrane contact appear possible ^[1][3]. Post-exposure prophylaxis with rabies vaccine and immunoglobulin is advised after bat bite, scratch, or mucosal exposure, reflecting the transmission pathways involved ^[3].

Preventive and control measures for non-rabies lyssavirus infections mirror those used for rabies, including post-exposure rabies vaccine and immunoglobulin following bat bite, scratch, or mucous membrane exposure ^[1][3]. Additional innovative approaches have been examined, particularly for managing vampire bat-associated rabies, though their specific application to other lyssaviruses is not detailed ^[1]. Avoiding close contact with bats and seeking prophylaxis after exposure are central to reducing human risk ^[3].

1. 1 McColl KA et al. Bat lyssavirus infections. Rev Sci Tech. 2000 Apr. PMID: 11189715. doi: 10.20506/rst.19.1.1221. PubMed: https://pubmed.ncbi.nlm.nih.gov/11189715/
2. 2 Holland DJ et al. Emerging viruses. Curr Opin Pediatr. 1998 Feb. PMID: 9529635. doi: 10.1097/00008480-199802000-00007. PubMed: https://pubmed.ncbi.nlm.nih.gov/9529635/
3. 3 McCormack JG et al. Emerging viral infections in Australia. Med J Aust. 2002 Jul 1. PMID: 12088481. doi: 10.5694/j.1326-5377.2002.tb04637.x. PubMed: https://pubmed.ncbi.nlm.nih.gov/12088481/