In humans, rabies is an acute encephalomyelitis that almost always progresses to coma and death within 10 days of the first symptom. Laboratory confirmation of the illness can be made in any of the following manners (although the CDC strongly recommends confirming the diagnosis by all the suggested methods): (1) direct fluorescent antibody of viral antigen in clinical specimen (preferably the brain or the nerves surrounding hair follicles in the nape of the neck), (2) isolation in cell culture or in a laboratory animal of rabies virus from saliva, cerebrospinal fluid, or CNS tissue, or (3) identification of a rabies neutralizing antibody titer of greater than 5 in the serum or cerebrospinal fluid of an unvaccinated person.
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