ABSTRACTRabies virus (RABV) isolated from different mammals seems to have unique characteristics that influence the outcome of infection. RABV circulates in nature and is maintained by reservoirs that are responsible for the persistence of the disease for almost 4000 years. Considering the different pattern of pathogenicity of RABV strains in naturally and experimentally infected animals, the aim of this study was to analyze the characteristics of RABV variants isolated from the main Brazilian reservoirs, being related to a dog (variant 2),Desmodus rotundus (variant 3), crab eating fox, marmoset, and Myotis spp. Viral replication in brain tissue of experimentally infected mouse was evaluated by two laboratory techniques and the results were compared to clinical evolution from five RABV variants. The presence of the RABV was investigated in brain samples by fluorescent antibody test (FAT) and real time polymerase chain reaction (qRT-PCR) for quantification of rabies virus nucleoprotein gene (N gene). Virus replication is not correlated with clinical signs and evolution. The pattern of FAT is associated with RABV replication levels. Virus isolates from crab eating fox and marmoset had a longer evolution period and higher survival rate suggesting that the evolution period may contribute to the outcome. RABV virus variants had independent characteristics that determine the clinical evolution and survival of the infected mice.

Rabies is a zoonotic disease that affects all mammals and leads to more than 55,000 human deaths every year, caused by rabies virus (RABV) (Mononegavirales: Rhabdoviridae: Lyssavirus). Currently, human rabies treatment is based on the Milwaukee Protocol which consists on the induction of coma and massive antiviral therapy. The aim of this study was to assess the decrease in the titer of rabies virus both in vitro and in vivo using short-interfering RNAs. To this end, three siRNAs were used with antisense strands complementary to rabies virus nucleoprotein (N) mRNA. BHK-21 cells monolayers were infected with 1000 to 0.1 TCID50 of PV and after 2 hours the cells were transfected with each of tree RNAs in separate using Lipofectamine-2000. All three siRNAs reduced the titer of PV strain in a least 0.72 logTCID50/mL and no cytotoxic effect was observed in the monolayers treated with Lipofectamine-2000. Swiss albino mice infected with 10.000 to 1 LD of PV strain by the intracerebral route were also transfected after two hours of infection with a pool 3 siRNAs with Lipofectamine-2000 by the intracerebral route, resulting in a survival rate of 30% in mice inoculated with 100 LD50, while the same dose led to 100% mortality in untreated animals. Lipofectamine-2000 showed no toxic effect in control mice. These results suggest that intracerebral administration of siRNAs might be an effective antiviral strategy for rabies.

In Brazil, bats have been assigned an increasing importance in public health as they are important rabies reservoirs. Phylogenetic studies have shown that rabies virus (RABV) strains from frugivorous bats Artibeus spp. are closely associated to those from the vampire bat Desmodus rotundus, but little is known about the molecular diversity of RABV in Artibeus spp. The N and G genes of RABV isolated from Artibeus spp. and cattle infected by D. rotundus were sequenced, and phylogenetic trees were constructed. The N gene nucleotides tree showed three clusters: one for D. rotundus and two for Artibeus spp. Regarding putative N amino acid-trees, two clusters were formed, one for D. rotundus and another for Artibeus spp. RABV G gene phylogeny supported the distinction between D. rotundus and Artibeus spp. strains. These results show the intricate host relationship of RABV's evolutionary history, and are invaluable for the determination of RABV infection sources.

A raiva é uma doença neurológica, mas o vírus da raiva se dispersa para diversos órgãos fora do sistema nervoso central (SNC). Antígeno ou RNA do vírus da raiva já foram detectados em vários órgãos, tais como glândula salivar, pulmão, rim, coração e fígado. O presente trabalho teve como objetivo identificar a presença do vírus da raiva em órgãos não neuronais de morcegos hematófagos infectados naturalmente, e pesquisar a presença do vírus na glândula salivar de morcegos hematófagos sadios. Dos cinco morcegos positivos para a raiva no SNC pelas técnicas de imunofluorescência direta e isolamento viral em células N2A, 100% (5/5) foram positivos para a raiva nas amostras de língua e coração, 80% (4/5) no rim, 40% (2/5) nas amostras de glândula salivar e pulmão, e 20% (4/5) no fígado pe la técnica de RT-PCR. Todos os nove morcegos negativos no SNC, pela imunofluorescência e isolamento viral, foram negativos na glândula salivar pela RT-PCR. Possíveis consequências para a epidemiologia e patogênese da raiva são discutidas.

Rabies is a neurological disease, but the rabies virus spread to several organs outside the central nervous system (CNS). The rabies virus antigen or RNA has been identified from the salivary glands, the lungs, the kidneys, the heart and the liver. This work aimed to identify the presence of the rabies virus in non-neuronal organs from naturally-infected vampire bats and to study the rabies virus in the salivary glands of healthy vampire bats. Out of the five bats that were positive for rabies in the CNS, by fluorescent antibody test (FAT), viral isolation in N2A cells and reverse transcription - polymerase chain reaction (RT-PCR), 100% (5/5) were positive for rabies in samples of the tongue and the heart, 80% (4/5) in the kidneys, 40% (2/5) in samples of the salivary glands and the lungs, and 20% (1/5) in the liver by RT-PCR test. All the nine bats that were negative for rabies in the CNS, by FAT, viral isolation and RT-PCR were negative for rabies in the salivary glands by RT-PCR test. Possible consequences for rabies epidemiology and pathogenesis are discussed in this work.

O Programa Nacional de Controle da Raiva Humana do Ministério da Saúde preconiza o esquema profilático pré-exposição (PEP) para profissionais envolvidos com animais expostos ao risco de contraírem raiva. O presente trabalho relata o diagnóstico de raiva (ante e post-mortem) em veterinário infectado por manipulação de herbívoros raivosos. O diagnóstico laboratorial ante-mortem foi efetuado a partir da saliva e biópsia de folículo piloso, utilizando técnicas de biologia molecular e o post-mortem a partir do tecido cerebral e de técnicas convencionais. O médico veterinário coletou amostras para diagnóstico de raiva em herbívoros (bovinos e caprinos) suspeitos que, posteriormente, foram confirmados positivos em laboratório. Após a apresentação dos sintomas clássicos de raiva e realizadas as provas de diagnóstico ante-mortem com saliva e folículo piloso, ambas as amostras apresentaram resultados positivos pelo nested-RT-PCR. O sequenciamento genético revelou que a infecção se deu pela variante 3 do Desmodus rotundus, resultados estes confirmados com a amostra do cérebro. É indispensável que profissionais expostos ao risco de infecção pelo vírus da raiva realizem a profilaxia pré-exposição. Ressalta-se, também, que as técnicas de biologia molecular apresentaram bons resultados para a realização de diagnóstico ante-mortem, propiciando o desenvolvimento de métodos terapêuticos, e determinando com precisão e rapidez a fonte de infecção dos casos de raiva humana.

The Ministry of Health's National Human Rabies Control Program advocates pre-exposure prophylaxis (PEP) for professionals involved with animals that are at risk of contracting rabies. We report an antemortem and postmortem diagnosis of rabies in a veterinarian who became infected when handling herbivores with rabies. The antemortem diagnosis was carried out with a saliva sample and a biopsy of hair follicles using molecular biology techniques, while the postmortem diagnosis used a brain sample and conventional techniques. The veterinarian had collected samples to diagnose rabies in suspect herbivores (bovines and caprines) that were subsequently confirmed to be positive in laboratory tests. After onset of classic rabies symptoms, saliva and hair follicles were collected and used for antemortem diagnostic tests and found to be positive by RT-PCR. Genetic sequencing showed that the infection was caused by variant 3 (Desmodus rotundus), a finding confirmed by tests on the brain sample. It is essential that professionals who are at risk of infection by the rabies virus undergo pre-exposure prophylaxis. This study also confirms that molecular biology techniques were used successfully for antemortem diagnosis and therefore not only allow therapeutic methods to be developed, but also enable the source of infection in human rabies cases to be identified accurately and quickly.

INTRODUÇÃO: A raiva é uma doença aguda do sistema nervoso central e é responsável por mortes de milhares de humanos, animais silvestres e animais de criação - especialmente bovinos - além de causar elevadas perdas econômicas. Este trabalho descreve a caracterização genética das variantes do vírus da raiva que circulam em populações de Desmodus rotundus e são transmitidas aos herbívoros. MÉTODOS: Cinquenta isolados de vírus da raiva de bovinos e equinos provenientes dos Estados de São Paulo e Minas Gerais, Brasil, foram caracterizadas geneticamente e comparadas com sequências recuperadas do GenBank. RESULTADOS: Dois clusters, I e II, apresentando identidades médias de nucleotídeos de 99,1 e 97,6%, foram obtidos, sendo o primeiro composto de quase a totalidade das amostras analisadas. Linhagens de outros estados do Brasil "clustered" no II. CONCLUSÕES: A análise das sequências de aminoácidos da proteína N revelou que existem marcadores genéticos que podem determinar uma possível regionalidade embora as regiões biologicamente ativas apresentem-se conservadas dentro das espécies ao longo do tempo e espaço.

INTRODUCTION: Rabies is an acute disease of the central nervous system and is responsible for the deaths of thousands of humans, wild animals and livestock, particularly cattle, as well as causing major economic losses. This study describes the genetic characterization of rabies virus variants that circulate in Desmodus rotundus populations and are transmitted to herbivores. METHODS: Fifty rabies virus isolates from bovines and equines in the States of São Paulo and Minas Gerais, Brazil, were genetically characterized and compared with sequences retrieved from GenBank. RESULTS: Two clusters (I and II) with mean nucleotide identities of 99.1 and 97.6% were found. The first of these contained nearly all the samples analyzed. Lineages from other Brazilian states grouped in cluster II. CONCLUSIONS: Analysis of the amino acid sequences of the N proteins revealed the existence of genetic markers that may indicate possible variations between geographic regions, although the biologically active regions are conserved within the species over space and time.

A raiva é uma zoonose viral que acomete o sistema nervoso central (SNC) de mamíferos, considerada um grave problema de saúde pública. Herbívoros (bovinos e equinos) são frequentemente acometidos pela in-fecção após serem atacados por morcegos hematófagos (Desmodus rotundus). A técnica de imunofluorescência direta (IFD) realizada em tecidos frescos, recomendada pela Organização Mundial de Saúde (OMS), é utilizada para o diagnóstico da raiva. A técnica de imuno-histoquímica (IHQ) é utilizada para detectar antígenos em tecidos fixados, pelo uso de anticorpos monoclonais/policlonais. O objetivo deste trabalho foi avaliar a sensibilidade da IHQ na detecção de antígenos do vírus da raiva em amostras de SNC de herbívoros fixadas em formol, analisando a distribuição antigênica em diferentes fragmentos do SNC. Os resultados demonstraram concordância das técnicas de IFD e IHQ. A IHQ mostrou maior sensibilidade em amostras de bovinos em relação às de equinos, especialmente quando realizada em fragmentos de cerebelo e tronco encefálico. A detecção de antígeno nestes fragmentos foi mais consistente para ambas as técnicas, nas duas espécies. Estes resultados demonstram que a IHQ pode ser empregada para a vigilância epidemiológica da raiva, entretanto, recomenda-se cautela ao se empregar a IHQ para diagnóstico de doença em herbívoros, especialmente quando o fragmento encaminhado ao laboratório for apenas o hipocampo.

Rabies is a viral zoonosis that causes disease in the central nervous system (CNS) of mammals and it is considered a serious problem of public health. Herbivorous (bovines and equines) are often infected after being attacked by vampire bats (Desmodus rotundus). The direct fluorescent antibody technique is used as a diagnostic test to detect viral antigens in fresh tissues and is recommended by the World Health Organization. The immunohistochemistry technique (IHC) is used to detect the viral antigen through the use of monoclonal/policlonal antibodies in formalin-fixed tissues. The aim of this work was to evaluate the sensitivity of the IHC in samples of CNS of herbivorous fixed in formol, analyzing the antigenic distribution in different fragments of the CNS. The results demonstrated good agreement between the two techniques for the rabies diagnosis. The IHC presented higher sensitivity in samples of cattle comparing to horse samples, especially in fragments of cerebellum and brain stem. These fragments demonstrated to be more suitable for antigen detection by both techniques in the two species. These data demonstrate that the IHC is suitable for rabies vigilance yet cautions should be taken in examining cattle and horses samples, when the submitted specimen is only the hippocampus.

Identification of animals that are decomposing or have been run over or burnt and cannot be visually identified is a problem in the surveillance and control of infectious diseases. Many of these animals are wild and represent a valuable source of information for epidemiologic research as they may be carriers of an infectious agent. This article discusses the results obtained using a method for identifying mammals genetically by sequencing their mitochondrial DNA control region. Fourteen species were analyzed and identified. These included the main reservoirs and transmitters of rabies virus, namely, canids, chiroptera and primates. The results prove that this method of genetic identification is both efficient and simple and that it can be used in the surveillance of infectious diseases which includes mammals in their epidemiologic cycle, such as rabies.

This article reports on the identification of a group 2 coronavirus (BatCoV DR/2007) in a Desmodus rotundus vampire bat in Brazil. Phylogenetic analysis of ORF1b revealed that BatCoV DR/2007 originates from a unique lineage in the archetypical group 2 coronaviruses, as described for bat species elsewhere with putative importance in Public Health.

No Brasil, embora os principais transmissores da raiva sejam cães e morcegos hematófagos, o papel de outras espécies, tais como morcegos insetívoros e frugívoros, merece atenção especial, uma vez que o vírus da raiva já foi isolado em 36 espécies de morcegos. Este estudo descreve o primeiro isolamento do vírus da raiva em um morcego insetívoro Eumops perotis. O animal infectado foi encontrado na cidade de Ribeirão Preto, São Paulo. O vírus foi identificado pelo teste de imunofluorescência direta (IFD) em amostras de sistema nervoso central (SNC), e o isolamento foi realizado em cultura de células N2A e em camundongos adultos. A amostra foi submetida à tipificação antigênica, utilizando um painel de oito anticorpos monoclonais (CDC/Atlanta/USA). A seqüência de DNA do gene da nucleoproteína, localizada entre os nucleotídeos 102 a 1385, foi alinhada com seqüências homólogas presentes no GenBank, usando o método CLUSTAL/W e o alinhamento foi utilizado para a construção da árvore filogenética de distância "neighbor-joining" com o modelo K-2-P. O SNC testado foi negativo por IFD, e somente um camundongo morreu após inoculação com a suspensão do SNC do morcego. A tipificação antigênica apresentou resultado não-compatível com os padrões definidos pelo painel. A análise filogenética mostrou que o vírus isolado segregou no mesmo grupo relacionado com outros vírus isolados de morcegos insetívoros, gênero Nyctinomops ssp. (98,8% de identidade de nucleotídeos entre elas).

Although the main transmitters of rabies in Brazil are dogs and vampire bats, the role of other species such as insectivorous and frugivorous bats deserves special attention, as the rabies virus has been isolated from 36 bat species. This study describes the first isolation of the rabies virus from the insectivorous bat Eumops perotis. The infected animal was found in the city of Ribeirão Preto, São Paulo. The virus was identified by immunofluorescence antibody test (FAT) in central nervous system (CNS) samples, and the isolation was carried out in N2A cell culture and adult mice. The sample was submitted to antigenic typing using a panel of monoclonal antibodies (CDC/Atlanta/USA). The DNA sequence of the nucleoprotein gene located between nucleotides 102 and 1385 was aligned with homologous sequences from GenBank using the CLUSTAL/W method, and the alignment was used to build a neighbor-joining distance-based phylogenetic tree with the K-2-P model. CNS was negative by FAT, and only one mouse died after inoculation with a suspension from the bat's CNS. Antigenic typing gave a result that was not compatible with the patterns defined by the panel. Phylogenetic analysis showed that the virus isolated segregated into the same cluster related to other viruses isolated from insectivorous bats belonging to genus Nyctinomops ssp. (98.8% nucleotide identity with each other).

Este relato tem por objetivo fazer o primeiro registro de morcego hematófago (Desmodus rotundus) infectado com o vírus da raiva, encontrado em área urbana de um município do Brasil e, até onde os autores têm conhecimento, na América Latina. Um munícipe de Ubatuba, São Paulo, solicitou a visita da equipe do Centro de Controle de Zoonoses em sua residência, após ter encontrado um morcego em seu quintal, às 10:00 horas da manhã. No mesmo dia o animal foi recolhido, ainda vivo, para ser encaminhado ao Laboratório do Instituto Pasteur. No Laboratório foi feita a identificação do espécime, Desmodus rotundus, e realizadas as provas clássicas para diagnóstico da raiva (Imunofluorescência Direta e Isolamento Viral), que resultaram positivas. A identificação de diferentes espécies de morcegos em áreas urbanas, predominantemente espécies insetívoras, representa um sério problema para a saúde pública. Este caso, no entanto, por tratar-se de espécie com hábitos hematofágicos, indica um risco ainda maior, tendo em vista a baixa reserva energética destes animais e a necessidade que têm de se alimentarem diariamente

The purpose of this report is to record the first case of a hematophagous bat (Desmodus rotundus) infected with rabies virus in an urban area in Brazil. To the authors' knowledge, this is the first such case in Latin America. After discovering a bat in his garden at 10 o'clock in the morning, a resident of Ubatuba municipality asked the Zoonosis Control Center team to visit his home. The animal was caught alive on the same day and sent to the Pasteur Institute laboratory, where it was identified as a Desmodus rotundus specimen. Standard tests for rabies diagnosis were carried out (direct immunofluorescence and viral isolation), and the results were positive. The presence of different species of (primarily insectivorous) bats in urban areas represents a serious public health problem. This case, however, is indicative of a much greater risk because the species in question has hematophagous habits, what means this animals has a low energy reserves and, therefore, its need to feed daily.

OBJETIVO: Identificar as espécies de morcegos envolvidas na manutenção do ciclo da raiva, verificar a distribuição do vírus da raiva em tecidos e órgãos de morcegos e os períodos de mortalidade dos camundongos inoculados. MÉTODOS: A positividade para o vírus da raiva foi avaliada por imunofluorescência direta em morcegos de municípios do Estado de São Paulo, de abril de 2002 a novembro de 2003. A distribuição do vírus nos morcegos foi avaliada pela inoculação de camundongos e infecção de células N2A, com suspensões a 20% preparadas a partir de fragmentos de diversos órgãos e tecidos, além de cérebro e glândula salivar. A mortalidade dos camundongos foi observada diariamente, após inoculação intracerebral. RESULTADOS: Dos 4.393 morcegos pesquisados, 1,9% foram positivos para o vírus da raiva, pertencentes a dez gêneros, com predomínio de insetívoros. A média do período máximo de mortalidade dos camundongos pós-inoculação a partir de cérebros e glândulas salivares de morcegos hematófagos foi de 15,33±2,08 dias e 11,33±2,30 dias; insetívoros, 16,45±4,48 dias e 18,91±6,12 dias; e frugívoros, 12,60±2,13 dias e 15,67±4,82 dias, respectivamente. CONCLUSÕES: As espécies infectadas com o vírus da raiva foram: Artibeus lituratus, Artibeus sp., Myotis nigricans, Myotis sp., Eptesicus sp., Lasiurus ega, Lasiurus cinereus, Nyctinomops laticaudatus, Tadarida brasiliensis, Histiotus velatus, Molossus rufus, Eumops sp. e Desmodus rotundus. A pesquisa de vírus em diferentes tecidos e órgãos mostrou-se que os mais apropriados para o isolamento foram cérebro e glândulas salivares.

OBJECTIVE: To identify the species of bats involved in maintaining the rabies cycle; to investigate the distribution of the rabies virus in the tissues and organs of bats and the time taken for mortality among inoculated mice. METHODS: From April 2002 to November 2003, bats from municipalities in the State of São Paulo were screened for the presence of the rabies virus, by means of direct immunofluorescence. The virus distribution in the bats was evaluated by inoculating mice and N2A cells with 20% suspensions prepared from fragments of different organs and tissues, plus the brain and salivary glands. The time taken for mortality among the mice was monitored daily, following intracerebral inoculation. RESULTS: Out of the 4,395 bats received, 1.9% were found positive for the rabies virus. They belonged to ten genera, with predominance of insectivores. The maximum mean times taken for mortality among the mice following inoculation with brain and salivary gland material were 15.33±2.08 days and 11.33±2.30 days for vampire bats, 16.45±4.48 days and 18.91±6.12 days for insectivorous bats, and 12.60±2.13 days and 15.67±4.82 days for frugivorous bats, respectively. CONCLUSIONS: The species infected with the rabies virus were: Artibeus lituratus, Artibeus sp., Myotis nigricans, Myotis sp., Eptesicus sp., Lasiurus ega, Lasiurus cinereus, Nyctinomops laticaudatus, Tadarida brasiliensis, Histiotus velatus, Molossus rufus, Eumops sp. and Desmodus rotundus. Virus investigation in the different tissues and organs showed that the brain and salivary glands were the most suitable sites for virus isolation.

OBJETIVO: Identificar as espécies de morcegos envolvidas na manutenção do ciclo da raiva, verificar a distribuição do vírus da raiva em tecidos e órgãos de morcegos e os períodos de mortalidade dos camundongos inoculados. MÉTODOS: A positividade para o vírus da raiva foi avaliada por imunofluorescência direta em morcegos de municípios do Estado de São Paulo, de abril de 2002 a novembro de 2003. A distribuição do vírus nos morcegos foi avaliada pela inoculação de camundongos e infecção de células N2A, com suspensões a 20% preparadas a partir de fragmentos de diversos órgãos e tecidos, além de cérebro e glândula salivar. A mortalidade dos camundongos foi observada diariamente, após inoculação intracerebral. RESULTADOS: Dos 4.393 morcegos pesquisados, 1,9% foram positivos para o vírus da raiva, pertencentes a dez gêneros, com predomínio de insetívoros. A média do período máximo de mortalidade dos camundongos pós-inoculação a partir de cérebros e glândulas salivares de morcegos hematófagos foi de 15,33±2,08 dias e 11,33±2,30 dias; insetívoros, 16,45±4,48 dias e 18,91±6,12 dias; e frugívoros, 12,60±2,13 dias e 15,67±4,82 dias, respectivamente. CONCLUSÕES: As espécies infectadas com o vírus da raiva foram: Artibeus lituratus, Artibeus sp., Myotis nigricans, Myotis sp., Eptesicus sp., Lasiurus ega, Lasiurus cinereus, Nyctinomops laticaudatus, Tadarida brasiliensis, Histiotus velatus, Molossus rufus, Eumops sp. e Desmodus rotundus. A pesquisa de vírus em diferentes tecidos e órgãos mostrou-se que os mais apropriados para o isolamento foram cérebro e glândulas salivares.

OBJECTIVE: To identify the species of bats involved in maintaining the rabies cycle; to investigate the distribution of the rabies virus in the tissues and organs of bats and the time taken for mortality among inoculated mice. METHODS: From April 2002 to November 2003, bats from municipalities in the State of São Paulo were screened for the presence of the rabies virus, by means of direct immunofluorescence. The virus distribution in the bats was evaluated by inoculating mice and N2A cells with 20% suspensions prepared from fragments of different organs and tissues, plus the brain and salivary glands. The time taken for mortality among the mice was monitored daily, following intracerebral inoculation. RESULTS: Out of the 4,395 bats received, 1.9% were found positive for the rabies virus. They belonged to ten genera, with predominance of insectivores. The maximum mean times taken for mortality among the mice following inoculation with brain and salivary gland material were 15.33±2.08 days and 11.33±2.30 days for vampire bats, 16.45±4.48 days and 18.91±6.12 days for insectivorous bats, and 12.60±2.13 days and 15.67±4.82 days for frugivorous bats, respectively. CONCLUSIONS: The species infected with the rabies virus were: Artibeus lituratus, Artibeus sp., Myotis nigricans, Myotis sp., Eptesicus sp., Lasiurus ega, Lasiurus cinereus, Nyctinomops laticaudatus, Tadarida brasiliensis, Histiotus velatus, Molossus rufus, Eumops sp. and Desmodus rotundus. Virus investigation in the different tissues and organs showed that the brain and salivary glands were the most suitable sites for virus isolation.

This study aimed to test in vitro a RNA-interference based antiviral approach for rabies with short-interfering RNAs (siRNAs) against rabies virus nucleoprotein mRNA. BHK-21 cells were infected with serial dilutions of PV rabies virus strain and transfected with a pool of three siRNAs. Direct immunofluorescence staining showed a 5-time decrease in virus titer when compared to a non-treated plate, showing a promising new approach to the development of antivirals for rabies treatment.

Rapid diagnosis of rabies in suspected human cases influences post-exposure prophylaxis for potential contacts of the patient and ensures appropriate patient management. Apart from the central nervous system (CNS), rabies virus (RABV) is usually present in small sensory nerves adjacent to hair follicles of infected humans. We used an RT-PCR, with primers targeted to the 3' terminal portion of the nucleoprotein gene (N), to test neck-skin samples of nine patients who had rabies in order to validate a diagnostic method that could serve as an additional tool for rabies diagnosis, particularly in antemortem samples. Six of eight postmortem samples were found to be positive for rabies by RT-PCR, and one of two samples collected antemortem was positive with this same technique. Results were confirmed by DNA sequencing; this validates RT-PCR and neck-skin as a suitable technique and type of sample, respectively, for use in the diagnosis of human rabies. RT-PCR applied to neck-skin biopsies could allow early diagnosis and lead to more effective rabies treatment.