The presence of mania alternating with lethargy and episodes of irritability and abnormality are caused by disease factors such as pediatric rabies. Rabies is a zoonotic acute infectious disease of the central nervous system caused by the rabies virus. Because of the prominent clinical manifestation of fear of drinking water in rabies patients, this disease has also been called hydrophobia, but the affected animals do not have this characteristic. The main clinical manifestations are characteristic mania, fear and anxiety, fear of wind and water, salivation and pharyngeal muscle spasms, and eventually paralysis and life-threatening. What is the main causative factor for alternating mania and lethargy? Rabies virus belongs to the family of bullet viruses, genus Rabies virus. The shape of the virus resembles a bullet, with a diameter of 75-80 nm and a length of 175-200 nm. The inner layer is a nucleocapsid containing a 40 nm core, and the outer layer is a dense envelope with many filamentous protrusions on the surface, and the distal end of the protrusions is mallet-shaped. The entire surface of the virus is a honeycomb hexagonal structure. The viral genome is a negative-stranded single-stranded RNA with a molecular weight of 4.6106. The viral genome is 11,932 nucleotides long, of which about 91% are involved in encoding five known structural proteins, namely, glycoprotein (GP), envelope matrix protein (M2P), capsid matrix protein (M1P), nucleoprotein (NP), and transcriptase protein (LP). Genomic RNA binds to 180 NP molecules to form ribonucleoproteins, which keep the RNA well protected from degradation and also provide a suitable structural basis for genome replication and transcription. It is now believed that the local presence of the virus is not the only factor contributing to the differences in clinical manifestations; humoral and cell-mediated immunity have a protective effect in the early stages of the disease, but when the virus enters the neuronal cells in a large number of proliferating cells, then the immune-mediated damage and the onset of the disease are also related, and the delayed death of immunosuppressed mice after vaccination with the rabies virus is accelerated by the passive importation of immune serum or immune cells. In human rabies, those whose lymphocytes are positive for the proliferative response to rabies virus cells tend to be manic and die more rapidly. Those with an autoimmune response to myelin basic protein (MBP) are also manic, with rapid progression and immune damage mediated by antibodies, complement, and cytotoxic T cells seen in brain tissue.