The rabies virus is the causative agent of the disease of the same name, which is characterized by a severe course and death. To recover from such an ailment is very difficult. However, in the nineteenth century, science took a step forward, inventing a rabies vaccine, the use of which made it possible to effectively defeat dangerous pathogens and preserve human health. What is such a disease, how is it transmitted and how is it treated? We will try to answer these questions in as much detail as possible.
The structure of the virus and its interaction with the environment
Let's talk about the structure of the rabies virus. Despite the fact that this information is very specific, it can also be very useful even in everyday life.
So, the causative agent of the disease belongs to the family of rhabdoviruses. It is bullet shaped and has two unique antigens (soluble and surface). Among other things, speaking about the virus, we can note the following distinctive characteristics:
- The presence of a shell;
- The diameter is about 80 nm (may be slightly smaller).
- One RNA helix (1%).
- The composition includes protein (74%), lipids (22%), carbohydrates (3%).
Interaction of the virus and environmental conditions
The structure of the rabies virus is disrupted by exposure to high temperatures. Be sure to remember this information. Just two minutes of boiling will completely destroy the deadly pathogen. But it tolerates low temperatures just fine, it can be stored in the freezer for up to 120 days (about 4 months). A number of chemical reagents (among them, carboxylic acid) and ultraviolet radiation also have a detrimental effect on the virus. In decaying flesh, the pathogen can be active for up to 3-4 weeks.
The rabies virus in the external environment is subject to significant destruction by many factors. Let's analyze them in a little more detail. Under the influence of high temperatures, the causative agent of the disease dies:
- 100 degrees - instantly;
- 60 degrees - within 10 minutes;
- 50 degrees - in an hour and a half.
Low temperatures contribute to the conservation of the virus. So, in the brain at a slightly positive temperature (about 4 degrees), it can retain its dangerous properties for several months. But lower temperatures help the virus live for years. Concerning chemical substances, then the most effective drugs are such as:
- formalin;
- hydrochloric acid;
- ether,
- potassium permanganate solution;
- a solution of laundry soap (it is quite convenient to use for home treatment of a wound).
Iodine, brilliant green, antibiotics and phenol have a weak effect on the pathogen, but can also be used in the absence of other drugs. The resistance of the rabies virus to putrefaction and decay makes it even more dangerous. So, picking up dead, bloody corpses, hunters, employees of animal trapping services are more likely than others to pick up a deadly disease. The greatest risk exists in the cold season, because the virus can live in the corpse of an animal throughout the season, before the onset of heat.
Methods of transmission of the disease
It is very important to know how the rabies virus is transmitted. With a high probability, such information will help you properly organize the prevention of infection and provide first aid to the victim, which can later save his life and stop the spread of the disease.
The main source of infection is the secret of an infected animal (in most cases it is saliva, possibly blood). It enters the body of a person or other animal during a bite. Cases of transmission of the disease between people are the exception rather than the rule; in official medicine, such precedents are almost not recorded. Much less often, the rabies virus is transmitted when:
- transplantation of infected organs or tissues (a case was recorded during corneal transplantation);
- eating the meat of sick animals in raw form or with insufficient processing (in any case, it is not recommended to use such products).
The rabies virus dies in air in about one hour. However, cases of infection were also recorded during transmission by airborne droplets. So, inhaling air in a very limited space with an infected animal or several individuals, there is a certain probability of infection. Such a phenomenon is usually possible in a closed room, cave, etc.
By the way, rabies can be transmitted not only through a bite. There is a small risk even if a sick animal simply licks your skin, which has open wounds or scratches.
The main spreaders of rabies
The disease, characterized by an acute course, is observed only in mammals, frogs, toads and other freshwater animals are not susceptible to it. Mostly its peddlers are wild animals. So, in the forests it can be wolves, foxes, skunks and raccoons, as well as very often bats. In urban conditions, stray dogs are the main danger, less often - pets and large cattle, horses. Rabies is extremely rare in rodents, although rats, mice, hamsters, and rabbits can also carry the disease.
Spread of rabies on earth
Currently, the rabies virus is most widespread in the countries of the African continent, India, the Philippines and southeastern Asia. These regions are characterized not only by the highest percentage of recorded diseases, but also by a large proportion of mortality. So, according to the World Health Organization, every year around the world there are about 800 deaths due to this disease. Mortality among animals is much higher, about 5,000 individuals die per year. The safest area in relation to this disease is Australia and New Zealand.
How to recognize rabies? The main phases and symptoms of the disease
How can you tell if a person has contracted the rabies virus? Symptoms of the disease make it quite easy to understand that an infection has occurred. However, after their manifestation, the probability of recovery is significantly reduced, it is actually equal to zero. A person is characterized by the allocation of three main stages of the disease:
- Harbingers of illness. For the most part, the symptoms are expressed at the site of the bite, if any. The wound swells significantly, begins to blush, there is an unpleasant sensation of itching and pain in the place of its localization. In addition, there may be an increase in body temperature (at first insignificant), weakness, moderate headaches. Also quite often groundless fear, insomnia, episodic lack of air can appear.
- Excitation. Comes in a couple of days (2-3) after the first phase. The most characteristic symptoms are seizures. Occur under the influence of any external stimulus. It could be light or sound. A sick person often becomes very aggressive, begins to rave, see or hear hallucinations. Such phenomena are accompanied by a sharp increase in body temperature (up to 41 degrees). Abundant salivation, sweating, tearing of the eyes are noted, breathing is difficult and foam from the mouth appears. Quite often, a person dies already at this stage due to temporary paralysis of the respiratory organs.
- Paralysis. The final stage caused by the rabies virus. Symptoms final stage reduced to a deceptive temporary calm. There is a slight improvement. The person calms down, can take a little nap, begins to breathe more freely, to eat. At the same time, paralysis of the limbs is noted, and then the central nervous system, cardiac arrest, death.
timing of the spread of the disease. The incubation period and the factors that determine it
The appearance of external symptoms of the disease usually occurs 6-12 days after the moment of infection. The virus penetrates through the skin to the mucous membranes, then into the central nervous system, the brain and actively spreads throughout the body. The incubation period for the rabies virus is usually one to two months. In some cases, this period may vary from ten days to one year. This period depends on many factors, which include:
- the amount of virus that has entered the human body;
- volume of the affected area (bite size);
- the level of immunity of a person (young people tend to carry the disease in a more severe form);
- localization of the wound.
The last of these points is extremely important. How dangerous the rabies virus is in humans is largely determined by the site of the bite. So, if there was a defeat of the head, neck, arms, upper body, then the risk of death is much higher than if the wound was on the legs.
Time cycle of disease
How long does the rabies virus live and how does the disease develop? The first symptoms begin to appear within a week after infection. As a rule, in this case, a person or animal can no longer be saved. The active stage of the disease is short-lived, it lasts only 5-7 days, then complete paralysis and death occurs. Each of the three stages is given no more than 2-3 days, the symptoms of each phase are clearly expressed and easily determined even by a simple person.
The course of rabies in animals is also very fast. Please note that a change in the behavior and appearance of animals occurs already at the final stage, they become contagious much earlier. So, five days before the first manifestations, pathogens are already circulating in the saliva of animals that can provoke infection.
Prevention and vaccination
How can the rabies virus be stopped? The first thing to consider is prevention. To do this, it is necessary to limit contact with stray animals, vaccinate pets in time, and in case of an emergency, provide the necessary treatment. Among other things, government programs free vaccination of wild dogs can significantly improve the situation and reduce any possible risks to zero.
Timely vaccination is of great importance in the fight against rabies. The anti-rabies medicine was first used in France on July 6, 1885. Its developers were the great scientist Louis Pasteur. The experiment turned out to be quite successful, as a result of which it was possible to save a little village boy who had been bitten by a dog. In Russia, treatment with this serum has also gained considerable popularity. It is necessary to carry out therapy with its help within 14 days after the bite of a sick animal, but the sooner the better. Such measures will help to avoid the fatal outcome of the disease, they should be carried out both under conditional (you were bitten by an animal without signs of rabies), and according to unconditional indications (an infected animal attacked you). As a rule, doctors prescribe up to 6 vaccinations indicated for holding at certain intervals. If you have the opportunity to bring an animal that has shown aggression for observation, this should definitely be done.
Additional Treatment
Among other things, it is necessary to treat the wound. The sooner you do this, the better. Wash it thoroughly with soap and water, use iodine and other disinfectants (alcohol is very effective). Be sure to carry out the processing of clothing (causative agents of the disease can be in the blood or saliva on clothing, thereby transmitting them will continue for about 60 minutes). The rabies virus dies when things are boiled, be sure to expose them to such an effect. Such measures will help you avoid the further spread of the disease.
There is no special treatment (tablets, ointments, etc.). In severe cases of the disease (multiple bites, extensive wounds), immunoglobulin is introduced into the body, and the infected person should be observed in medical institution. Must be supported vitality the patient with symptomatic remedies, relieve pain, give sleeping pills (for healthy sleep and recuperation), reduce convulsions, and, if possible, provide the necessary nutrition.
Rabies is the most dangerous disease with a fatal outcome, which is quite possible to prevent today. Despite the availability of effective vaccines, a significant number of people and animals still die from the disease. A similar phenomenon is associated primarily with the negligence of a person who is not serious about his health. Stop the spread of the disease in our power! Prevention, vaccination, compliance with first aid measures, timely access to a doctor can save lives.
Even 150 years ago, a man bitten by a rabid animal was doomed. Today, scientists are improving weapons in the war against an ancient and extremely dangerous enemy - the rabies virus.
Know the enemy by sight
The causative agent of rabies Rabies virus) belongs to the family of rhabdoviruses (Rhabdoviridae) containing a single-stranded linear RNA molecule, the genus Lyssavirus. In shape, it resembles a bullet with a length of about 180 and a diameter of 75 nm. There are currently seven known genotypes.
Insidious virus
The rabies virus has a tropism (affinity) for nervous tissue, just like influenza viruses for the epithelium of the respiratory tract. It penetrates the peripheral nerves and travels to the central parts of the nervous system at a speed of approximately 3 mm/h. Then, in a neurogenic way, it spreads to other organs, mainly to the salivary glands.
The likelihood of the disease depends on the location and severity of bites: when bitten by rabid animals in the face and neck, rabies develops on average in 90% of cases, in the hands - in 63%, and in the hips and arms above the elbow - only in 23% of cases.
Sources of infection
The main wild animals - sources of infection - are wolves, foxes, jackals, raccoon dogs, badgers, skunks, the bats. Among domestic cats and dogs are dangerous, and it is the latter that account for the maximum confirmed cases of rabies transmission to humans. Most sick animals die within 7–10 days, the only exception described is yellow, also known as the fox-shaped mongoose. Cynictis penicillata, capable of carrying a virus without developing a clinical picture of infection for several years.
The most characteristic and reliable sign of the presence of a virus in a human or animal body is the detection of the so-called Negri bodies, specific inclusions in the cytoplasm of neurons with a diameter of about 10 nm. However, Negri bodies cannot be found in 20% of patients, so their absence does not exclude the diagnosis of rabies.
The first, but extremely important step towards the fight against rabies was made by the brilliant French chemist and microbiologist Louis Pasteur. He began developing a vaccine against this disease in 1880, after he had to watch the agony of a five-year-old girl bitten by a rabid dog.
Rabbits and dogs
Although rabies was first described in the 1st century BC. Roman Cornelius Celsus, after almost 2000 years, little was known about this disease. It wasn't until 1903, eight years after Pasteur's death, that French physician Pierre Remlenger established that rabies was caused by a submicroscopic life form, a filterable virus.
How do viruses reproduce
To get into the cell, the rabies virus uses the endosomal transport system: the cell itself must capture it and draw the vesicle formed from the cell membrane - the endosome, the “inner body” - into the cytoplasm. The activation of this process occurs after the binding of the virus to specific receptor proteins on the cell membrane. The resulting endosome disintegrates over time, the viral particle releases RNA, then everything goes according to the standard scenario.
Pasteur, not having this information, nevertheless was not going to give up: to create a vaccine, he chose a workaround - to find a container for the "poison" and turn it into an antidote. It was reliably known that something transmitted from a sick animal to another animal or person along with contaminated saliva affects the nervous system. During the experiments, it was found that the disease has a very long incubation period, but this only spurred Pasteur and his colleagues, because it meant that doctors had the opportunity to influence the slowly developing pathological process - the “poison” had to get to the spinal nerves through the peripheral nerves. and then the brain.
Then experiments began on rabbits in order to obtain the most deadly "poison" of rabies in large quantities. After dozens of transfers of brain tissue from a sick animal to a healthy one, from it to the next, and so on, scientists managed to achieve that a standard extract from the brain killed a rabbit in exactly seven days instead of the usual 16–21. Now it was necessary to find a way to weaken the causative agent of rabies (the method of creating vaccines - weakening the pathogen - was also Pasteur's discovery). And they found a way: a two-week drying of virus-impregnated rabbit brain tissue over moisture-absorbing alkali.
After the introduction of the suspension from the resulting preparation, the rabies-infected dog not only recovered, but also became completely immune to rabies, no matter how much "poison" was injected into it.
Finally convinced that the same seven-day laboratory “poison” does not affect the vaccinated dogs, the researchers conducted a cruel experiment: their rabies-sick relatives were sent to the vaccinated dogs. The bitten mongrels didn't get sick!
40 injections in the stomach
Then it was the turn of the people. But where to find volunteers? Driven to despair, Pasteur was ready to sacrifice himself for the sake of science, but, fortunately, His Majesty Chance intervened.
On July 6, 1885, a tearful woman appeared on the threshold of Pasteur's Parisian laboratory, holding the hand of her nine-year-old son, Joseph Meister. Three days earlier, the boy had been bitten by a rabid dog, inflicting 14 open wounds on him. The consequences were quite predictable: at that time it was already known that death in such cases was almost inevitable. However, the boy's father had heard of Pasteur's work and insisted on bringing the child from Alsace to Paris. After serious hesitation, Pasteur injected the little patient with an experimental drug, and Josef became the first person in history to be saved from rabies.
From the laboratory diary of Louis Pasteur, 1885
“The death of this child seemed inevitable, so I decided, not without serious doubts and anxiety, which is well explained, to test on Josef Meister a method that I found successful in treating dogs. As a result, 60 hours after the bites, in the presence of Dr. Villepot and Grandchet, the young Meister was vaccinated with half a syringe of an extract from the spinal cord of a rabbit that had died of rabies, previously treated with dry air for 15 days. I did 13 injections in total, one every other day, gradually introducing an increasingly lethal dose. Three months later, I examined the boy and found him completely healthy.
People from all over the world flocked to Paris - Algerians, Australians, Americans, Russians, and often in French they knew only one word: "Pasteur". Despite such success, the discoverer of a vaccine against a deadly disease had to hear the word “killer” in his address. The fact is that not all bitten survived after vaccination. In vain, Pasteur tried to explain that they applied too late - some two weeks after the animal attack, and some even a month and a half later. In 1887, at a meeting of the Academy of Medicine, colleagues directly accused Pasteur of simply killing people with pieces of rabbit brain. The scientist, who gave all his strength to science, could not stand it - on October 23 he developed a second stroke, from which he never recovered until his death in 1895.
But he was supported simple people. By subscription for a year and a half, residents of many countries of the world collected 2.5 million francs, for which the Pasteur Institute was created, officially opened on November 14, 1888. On its territory there is a museum and a tomb of a researcher who saved humanity from a deadly infection. The date of Pasteur's death, September 28, has been chosen by the World Health Organization (WHO) for the annual world day fight against rabies.
For a long time, the vaccine was administered under the skin of the anterior abdominal wall, and a full course required up to 40 injections. A modern immunopreparation is injected intramuscularly, into the shoulder, six visits to the emergency room are enough.
Miracle of Milwaukee
During the 20th century, the situation with rabies was unequivocal: if the victim was not vaccinated on time or he did not receive the vaccine at all, the matter ended tragically. According to WHO estimates, every year 50-55 thousand people die in the world after the attack of rabid animals, 95% of them are in Africa and Asia.
The possibility of a full-fledged treatment of infection was discussed only in the 21st century. This was due to the case of American Gina Geese, who for the first time in the history of medicine did not receive a vaccine, but survived after the onset of symptoms of rabies. On September 12, 2004, 15-year-old Gina caught a bat that bit her finger. Parents did not go to the doctor, considering the wound to be trifling, but after 37 days the girl developed a clinical picture of the infection: a rise in temperature to 39 ° C, tremor, double vision, difficulty in speech - all signs of damage to the central nervous system. Gina was referred to the Wisconsin Children's Hospital, and to the laboratory of the Centers for Disease Control and Prevention ( Centers for Disease Control and Prevention, CDC) in Atlanta confirmed rabies.
Parents were offered to try an experimental method of treatment on the girl. Having received consent, doctors with the help of ketamine and midazolam introduced the patient into an artificial coma, effectively turning off her brain. She also received antiviral therapy in the form of a combination of ribavirin and amantadine. In this state, the doctors kept her until the immune system began to produce enough antibodies to cope with the virus. This took six days.
A month later, tests confirmed that there was no virus in the girl's body. Moreover, brain functions were minimally impaired - she graduated from high school, and a year later she received a driver's license. Currently, Gina has graduated from college and intends to continue her studies at the university. It is not surprising that his future profession she sees biology or veterinary medicine, and she plans to specialize in the field of rabies.
The treatment protocol that was applied to the girl was called "Milwaukee", or "Wisconsin". It has been repeatedly attempted to be reproduced in other medical institutions... but, alas, without much success. The first version of the protocol was tested on 25 patients, of whom only two survived. The second version, which removed ribavirin but added drugs to prevent vasospasm, was applied to ten patients and prevented the death of two of them.
When conducting epidemiological investigations, it turned out that patients who were cured using the Milwaukee Protocol were bitten by bats. It was this fact that allowed some scientists to suggest that, in fact, the method of treatment had nothing to do with it, but the point was precisely in these mammals, or rather, in the fact that they are infected with another strain of the virus that is less dangerous to humans.
Bat riddle
In 2012, this assumption received the first confirmation. AT American Journal of Tropical Medicine and Hygiene An article appeared by a group of experts from the CDC, American military virologists and epidemiologists from the Peruvian Ministry of Health. The results of their research produced the effect of an exploding bomb: in the Peruvian jungle, people were found who had antibodies to the rabies virus in their blood. These people have never been given any vaccines, in fact, they do not even remember being sick with anything serious. This means that rabies is not 100% fatal!
“From this area of the Peruvian Amazonian jungle, there have been many reports of contact with vampire bats and cases of rabies in humans and pets over the past 20 years,” Dr. . - Villages and farms, which we examined, are located in places very remote from civilization - to the nearest hospital, for example, two days' journey, and in some areas, movement is possible only by boat on the water.
In a survey of residents, 63 out of 92 people reported bat bites to scientists. Blood samples were taken from these people, as well as from local flying vampires. The results of the tests were unexpected: in seven samples, antibodies neutralizing the rabies virus were found.
The presence of antibodies could be explained by the introduction of anti-rabies (lat. rabies- rabies) vaccines, but as it turned out, only one in seven people received such a vaccine. The rest were ill with rabies, not only without a fatal outcome, but even without any serious symptoms. In two Peruvian villages, more survivors of this infection were found than described in all the medical literature! Not surprisingly, Gilbert's group spent two years rechecking the findings before they decided to publish them.
“Most likely, there is a unique set of circumstances where the local population regularly comes into contact with a special non-lethal strain of the rabies virus,” says Dr. Gilbert. - At the same time, natural vaccination occurs, which is confirmed by sufficiently high antibody titers. However, this still requires additional confirmation and clarification.
Her point of view is shared by Russian colleagues. Virologist Alexander Ivanov from the Laboratory of Molecular Basis for the Action of Physiologically Active Compounds of the Institute of Molecular Biology. V. A. Engelgardt, who was asked by PM to comment on the findings of CDC experts, emphasized that these seemingly strange results could have a completely scientific explanation: “Based on the available data, it can be assumed that local residents were infected with variants of the virus that causes had low replicative activity (ability to reproduce) and low pathogenicity (“poisonousness”). In my opinion, this may be due to several factors. First, each virus has a huge number of variants due to its relatively high variability. Infectionists suggest that even for a successful transition from bats to other species, the rabies virus must undergo several specific mutations. If this is the case, then many strains of the virus carried by bats may be of little concern to humans. Secondly, mutations in the virus genome affect its recognition by the immune system, as well as the ability of the virus to block the immune response to infection. At the same time, it is precisely those variants of the rabies virus that are able to elude the innate immune system that have increased pathogenicity. Thus, these facts really suggest the existence in the bat population of such strains of the rabies virus that are recognized in time and destroyed by the human immune system without causing fatal consequences.
But in no case - this is emphasized by all experts, including the authors of the study - should one refuse to administer the rabies vaccine when bitten by wild animals. Firstly, it may indeed turn out that another version of the virus lives in bats, a weaker one, and the luck of the Peruvian peasants does not apply to strains transmitted by dog or raccoon bites. Secondly, the results and conclusions of this study may turn out to be erroneous, so there is no point in taking risks once again.
So what is this disease, what does it threaten and how to treat it?
What it is?
Rabies is a viral disease that occurs after the bite of an infected animal, characterized by severe damage to the nervous system and usually ends in death. The rabies virus (Neuroryctes rabid) belongs to the group of myxoviruses of the Lyssavirus genus of the Rhabdoviridae family. It is found in saliva, as well as in tears and urine.
The virus is unstable in the external environment - it dies when heated to 56 0 C in 15 minutes, when boiled in 2 minutes. Sensitive to ultraviolet and direct sunlight, to ethanol and to many disinfectants. However, it is resistant to low temperatures, to phenol, antibiotics.
After entering the body, the rabies virus spreads along the nerve endings, affecting almost the entire nervous system. Edema, hemorrhages, degenerative and necrotic changes in the nerve cells of the brain and spinal cord are observed.
Sources of infection
The source of the rabies virus is both wild and domestic animals. Wild animals include wolves, foxes, jackals, raccoons, badgers, skunks, bats, rodents, and domestic animals include dogs, cats, horses, pigs, small and large cattle. However, the greatest danger to humans is posed by foxes and stray dogs outside the city in the spring and summer.
Animals are considered infectious 3-10 days before the onset of signs of the disease and then during the entire period of the disease. Often animals with rabies can be distinguished by profuse salivation and lacrimation, as well as by observing signs of rabies. Human infection occurs when bitten by a "rabid" animal. And also when the saliva of a sick animal gets on damaged skin or mucous membranes.
In recent years, airborne, alimentary (through food and water) and transplacental (through the placenta during pregnancy) routes of transmission of the virus have been described. A lot of discussion is caused by several cases of human infection with rabies as a result of organ transplants.
What is happening?
The incubation period (the period from the bite to the onset of the disease) averages 30-50 days, although it can last 10-90 days, in rare cases - more than 1 year. Moreover, the further the bite from the head, the longer the incubation period. Of particular danger are bites to the head and hands. The longest incubation period is for a leg bite. There are 3 stages of the disease: I - initial, II - excitation, III - paralytic.
The first stage begins with general malaise, headache, mild fever, muscle pain, dry mouth, loss of appetite, sore throat, dry cough, nausea and vomiting. Unpleasant sensations appear at the bite site - burning, redness, pulling pains, itching, hypersensitivity. The patient is depressed, closed, refuses to eat, he has an inexplicable fear, melancholy, anxiety, depression, less often - increased irritability. Insomnia, nightmares, olfactory and visual hallucinations are also characteristic.
After 1-3 days, a patient with rabies enters the second stage - excitation. There is anxiety, anxiety, and, most characteristic of this stage, attacks of hydrophobia. When trying to drink, and soon even at the sight and sound of running water, there is a feeling of horror and spasms of the muscles of the pharynx and larynx. Breathing becomes noisy, accompanied by pain and convulsions. At this stage of the disease, a person becomes irritable, excitable, very aggressive, "mad". During attacks, patients scream and rush about, they can break furniture, showing superhuman strength, and throw themselves at people. There is increased sweating and salivation, it is difficult for the patient to swallow saliva and he constantly spits it out. This period usually lasts 2-3 days.
Then comes the third stage of the disease, the beginning of which is characterized by sedation - fear disappears, attacks of hydrophobia, there is hope for recovery. After that, the body temperature rises above 40-42 ° C, paralysis of the limbs, impaired consciousness, convulsions occur. Death occurs from respiratory paralysis or cardiac arrest. Thus, the duration of the disease rarely exceeds a week.
How to treat?
There is no cure for rabies as such. If the disease is already in the first stage, there will most likely be no other outcome than a lethal one. Although there are isolated cases of cure for rabies in the world. But for now, it's exotic. However, there is a way to prevent the disease by killing it in the bud. This is a method of specific prevention - the introduction of a rabies vaccine, no later than the 14th day from the moment of the bite. The best prevention is the administration of a specific immunoglobulin and/or active immunization (vaccination).
The vaccine is administered intramuscularly, 1 ml 5 times: on the day of infection, then on the 3rd, 7th, 14th and 28th day. With this scheme, good immunity is created, but WHO also recommends a 6th injection 90 days after the first. best place inoculation is the deltoid muscle or thigh. In the event that a person is bitten, but before the bite was vaccinated according to the full scheme, and he has a sufficient level of antibodies, he is vaccinated according to a special scheme without the use of immunoglobulin. Therapy may be discontinued if the animal is found to remain healthy during the 10-day observation period or if the animal has not been found to have rabies virus. Some individuals who are at risk (veterinarians, dog handlers, hunters) need to be vaccinated in advance. Vaccinations are also carried out according to a specially established scheme with the first revaccination after 12 months. and then every 5 years.
What to do if you are bitten by an animal?
The first thing to do is to immediately wash the bite with soap. It is necessary to wash intensively, for 10 minutes. Deep wounds are recommended to be washed with a stream of soapy water, for example, using a syringe or catheter. Wounds do not need to be cauterized or stitched. After that, you should immediately contact the nearest emergency room, because the success of rabies vaccination highly depends on how quickly you seek help from a doctor. It is advisable to inform the doctor in the emergency room of the following information - a description of the animal, its appearance and behaviour, presence of a collar, circumstances of the bite. Followed by a course of vaccinations prescribed by a doctor. Forty injections in the stomach have not been given for a long time, you will be vaccinated and let go home. And so five or six times.
If the owner of a dog or cat cannot provide vaccination certificates, then there are two ways to determine whether the animal is sick with rabies. In the first case, the animal is killed to obtain a sample of its brain tissue. In the second case, the animal is placed in quarantine at the veterinary clinic for 10 days. If during this time the animal does not show symptoms of rabies, then it is considered healthy.
The bitten person can be left in the hospital if his condition is especially severe, as well as persons with diseases of the nervous system or allergic diseases; people who are revaccinated, vaccinated with other vaccines within the last two months and pregnant. At the time of vaccination and 6 months after it, you must refrain from drinking alcohol. In addition, if you are undergoing a course of vaccination against rabies, you should not overwork, overcool or, conversely, overheat. During vaccinations, it is necessary to carefully monitor the state of health. And in case of any complaints of a deterioration in the condition, it is necessary to consult a doctor, and temporarily stop vaccinations. Only after an examination by a neuropathologist and a therapist is the issue of continuing vaccinations decided.
Prevention
There are two Russian rabies vaccines - "cultural anti-rabies vaccine" (CAV) (concentration 0.5 IU / ml) and "concentrated cultural anti-rabies vaccine" (CoCAV) (concentration 2.5 IU / ml). The CAV vaccine has another name - Rabivak-Vnukovo-32 or simply Rabivak. CAV is administered in large volumes and more times, so if you have a choice, choose KoKAV.
On the Russian market the French vaccine Verorab (Aventis Pasteur) containing an inactivated virus (Wistar strain, Rabies PM / Wi38-1503-3M) - 2.5 IU and the German Rabipur (Ciron Behring) consisting of an inactivated (killed) rabies virus ( strain Flury LEP).
There is also a French inoculation called Imogam Rage. This is an immunoglobulin that is administered once, simultaneously with the vaccine, and is indicated for persons suspected of being infected with the rabies virus, especially in case of significant damage (in accordance with WHO recommendations - single or multiple bites or scratches with violation of the integrity of the skin).
Side effects for all vaccines are approximately the same and include local reactions in the form of soreness, swelling and induration, swollen lymph nodes, general malaise, weakness, headache, sleep and appetite disturbance, fever, and sometimes there is an allergy to vaccine components.
