Intravitam Diagnosis of Rabies in Patients with Acute Encephalitis: A Study of Two Cases

Round 1

Reviewer 1 Report

Two case reports of human rabies with a focus on intra vitam diagnostic testing, especially ELISA assays.

 Lines 31 – 33 – Dispute that rabies diagnosis is challenging because rabies virus is confined to neurons …

 Line 36 – Lack of clinical recognition of the disease by physicians is important in delaying or missing the diagnosis of rabies.

 Line 40 – The role of laboratory testing to prevent tissue/organ-transplant-mediated rabies is a very complex issue because delays and false-positives are problematic.

 Table 1 – Superscript 1 should follow ELISA Result and the * should be deleted

 Lines 86/87 – Indicate when the post-exposure prophylaxis was administered

 Table 2 – The days post onset in text are different from what is in the table. Indicate that High Seroconversion is >4 EU/ml in a footnote

 130 – 133 – There can be severe disease in rabies with no antibodies in the serum or CSF.

 Minor Specific Points:

 Line 69 – suspicion rather than suspension

 Line 89 – “long-ending” is incorrect

 Line 99 – Table 2 rather than Table 1

 Line 114 – neurological symptoms

 Line 117 – delete “up”

Author Response

Dear Sir,

Thanks for providing the inputs. Please find attached the pointwise response.

Regards

Dr Monil 

Author Response File: Author Response.pdf

Reviewer 2 Report

Introduction: line 31-32: lab diagnosis of rabies is challenging.

3.1 case study 1 type of bite not mentioned.

Table 1 quantitative estimation of ELISA test details about sample collection either from onset of prodromal symptom or from days of hydrophobia/irritability developed. why serum and CSF sample  should not taken on same days.

3.2 Case study 2: site of bite not mentioned. CSF sample is not taken on D1 and RTPCR not done on D1.

Author Response

Dear Sir,

Thanks for providing the inputs. Please find attached pointwise response

Regards

Dr Monil

Author Response File: Author Response.pdf