Rabies

Rabies.  Photo from www.cdc.gov

Everyone knows that if bitten by a stray dog, they do forty shots in the stomach. Actually that knowledge about rabies in the vast majority of the population to an end. So what is this disease and what it is like to face it treated?

What is it?

Rabies— Is disease viral nature that occurs after the bite of an infected animal, characterized by severe damage to the nervous system and the ending is usually fatal. Rabies virus (Neuroryctes rabid) refers to a group of myxoviruses kind Lyssavirus of the family Rhabdoviridae. Detected in the saliva and in tears and urine.

Virus is unstable in the environment — killed by heating to 560With 15 minutes at the boil for 2 minutes. Sensitive to UV and direct sunlight, to ethanol and to many disinfectants. However, resistance to low temperatures, to phenol antibiotics.

After penetrating into the body rabies virus spreads along nerve endings, affecting almost the entire nervous system. Observed edema, hemorrhage, necrosis and degenerative changes in the nerve cells of the brain and spinal cord.

Sources of infection

The source of the rabies virus are both wild and domestic animals. To include wild wolves, foxes, jackals, raccoons, badgers, skunks, bats, rodents, and to home — dogs, cats, horses, pigs, sheep and cattle. However, the greatest danger to humans of foxes and stray dogs in the country inSpring and Summer period.

Considered contagious for animals3-10 days before signs of disease and further during the entire period of disease. Most patients with rabies animals can be distinguished by copious salivation and tearing, as well as by observing signs of rabies. Infection of humans occurs through the bite of "rabid" animal. And also in contact with saliva of an infected animal to broken skin or mucous membranes.

In recent years, described airborne, alimentary (through food and water), and transplacental (through the placenta during pregnancy) transmission of the virus. A lot of discussion raises a number of human cases of rabies through organ transplants.

What if this happens?

The incubation period (time from bite to onset) is on average 30-50 days, although it may last 10-90 days, in rare cases — more than 1 year. And the farther the bite of the head, the longer the incubation period. Especially dangerous is a bite to the head and hands. The longest incubation period lasts through the bite of his feet. Distinguish 3 stages of the disease: I — initial, II — excitement, III — paralytic.

The first stage begins with a general malaise, headache, slight increase in body temperature, muscle pain, dry mouth, loss of appetite, sore throat, dry cough, may be nausea and vomiting. In the site of the bite an unpleasant sensation — a burning sensation, redness, dragging pain, itching, increased sensitivity. The patient depressed, closed, refuses to eat, he has the inexplicable fear, anguish, anxiety, depression, rarely — increased irritability. Characterized as insomnia, nightmares, olfactory and visual hallucinations.

Through 1-3 of the day the patient with rabies comes the second stage — the excitement. There is worry, anxiety, and most characteristic of this stage, rabies attacks. If you try to drink, and soon even the sight and sound of running water, there is a feeling of horror and muscle spasms of the pharynx and larynx. Breathing becomes noisy, accompanied by pain and cramps. At this stage of the disease the person becomes irritable, excitable, very aggressive, "mad". During the attack the patient screaming and rushing can break furniture, displaying superhuman strength to throw at people. Indicated an increased flow and salivation, the patient is difficult to swallow saliva and he constantly spits it. This period usually lasts 2-3 day.

Then comes the third stage of the disease, which is typical for the beginning of solace — disappear fear, rabies attacks, there is hope for recovery. Thereafter, the body temperature rises above 40-42° C, paralysis of limbs, disturbance of consciousness, seizures. Death occurs from paralysis of the respiratory or cardiac arrest. Thus, disease duration rarely exceeds week.

How to treat?

Treatments such as rabies is not present. If the disease in the first step, another outcome than lethal, probably would not. Although in the world are single cases of cure for rabies. But as long as it is exotic. However, there is a way to prevent the disease by killing it in the bud. This particular method of prevention — the vaccine against rabies, not later 14th days from the time of the bite. The best prevention — is the introduction of specific immunoglobulin and / or active immunization (vaccination).

The vaccine is administered intramuscularly in 1 ml of 5 times: the day of infection, and then at 3, 7, 14 and28th day. In such a scheme creates a good immune system, but WHO also recommends6th injection 90 days after the first. Vaccination is the best place deltoid or thigh. In that case, if a person bitten but bite was grafted to the full circuit and it has a sufficient level of antibodies to it were vaccinated special scheme without immunoglobulin. Therapy can be stopped if found that animal remains healthy throughout 10 day observation period or if the animal was found rabies virus. Some individuals who are at risk (veterinarians, dog breeders, hunters), you need to be vaccinated in advance. Vaccinations are also carried out by a specially established pattern with the first booster at 12 months. and then every 5 years.

What to do if you are bitten by an animal?

The first thing you need to do is to immediately wash the bite with soap. Wash have intensively for 10 minutes. Deep wounds recommended flush the soapy water, for example using a syringe or catheter. No need to cauterize the wound or suture. Then you need to immediately contact the nearest fracture clinic, because the success of rabies vaccination is highly dependent on how quickly you sought help from a doctor. It is advisable to inform the doctor in the emergency room the following information — a description of the animal, its appearance and behavior, the presence of a collar, the circumstances of the bite. This is followed by a course of vaccinations prescribed by a doctor. Forty shots in the stomach for a long time no one does, you will introduce the vaccine and go home. And so five or six times.

If the owner of the dog or cat can not provide proof of vaccination, there are two ways of determining whether the pain animal rabies. In the first case the animal is killed, a tissue sample to obtain its brain. In the second case, the animal is placed in quarantine for a veterinary clinic for 10 days. If during this time the symptoms of rabies in animals do not appear, it is considered healthy.

In a hospital may leave the bitten when the state is particularly difficult, as well as persons with diseases of the nervous system or allergic diseases of people re-grafting, graft other vaccines in the past two months pregnant. At the time of vaccination and at 6 months after it is necessary to abstain from drinking alcoholic beverages. Also, if you are undergoing rabies vaccination, you can not overwork, supercool, or, conversely, to overheat. During the vaccination should be carefully monitored for health. And for all the complaints on the deterioration of the need to see a doctor, and to suspend the vaccination. Only after inspection neurologist and therapist decided whether to continue vaccinations.

Prophylaxis

There are two Russian rabies vaccine — "culture rabies vaccine" (CAV) (concentration of 0.5 IU / ml) and "concentrated culture rabies vaccine"(COCA) (concentration of 2.5 IU / ml). At CAV vaccine has another name — Rabivak-Vnu
kovo-32
or just Rabivak. CAV is introduced in large volumes and a greater number of times, so if there is a choice, choose a cook.

In the Russian market still represented the French Verorab vaccine (manufactured by Aventis Pasteur), which contains an inactivated virus (strain Wistar, Rabies PM / Wi38-1503-3M) — 2,5 IU and German Rabipur (from Ciron Behring), consisting of an inactivated (killed) rabies virus (strain Flury LEP).

There is a French vaccine, called Imogen rage. This immunoglobulin, which is entered only once, at the same time with the vaccine and is indicated for persons with suspected infection with rabies, especially in the case of significant damage (in accordance with the recommendations of the WHO — Single or multiple transdermal bites or scratches with a violation of the integrity of the skin).

The side effects of the vaccines at approximately the same and include local reactions such as pain, swelling and induration, swelling of the lymph nodes, malaise, weakness, headache, disturbance of sleep and appetite, fever, and sometimes it happens allergic to components of the vaccine.

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