Rabies in humans: the first symptoms, the symptoms of rabies after being bitten

Rabies - an acute infectious disease caused by a virus, enters the body through the bite of a sick animal or contact with the skin of his saliva. Clinically characterized by severe damage to the nervous system. It is one of the most dangerous infectious diseases.

Without specific treatment - the introduction of vaccines against rabies - a disease fatal. The sooner people seek medical attention after the bite, the less likely to get sick. Let's look at the causes, symptoms of rabies in people who talk about the principles of its diagnosis and treatment, as well as how to avoid this dangerous disease.

What it is?

Rabies - infectious viral zoonosis, characterized predominant severe central nervous system threatening fatal. A person infected with rabies through the bite of animals.

Pathogenesis

The virus is unstable in the environment - are killed by heating to 56 ° C for 15 minutes under reflux - for 2 minutes. Sensitive to UV and direct sunlight, to ethanol and to many disinfectants. However, resistant to low temperatures and phenol.

The virus replicates in the nerve cells of the body, forming a calf Babes-Negri. Copies virus transported across neuronal axons at a rate of about 3 mm per hour. Reaching the spinal cord and brain, they cause meningoencephalitis. In the nervous system, the virus causes inflammatory, degenerative and necrotic changes. The death of animals and humans occurs due to asphyxiation and cardiac arrest.

Symptoms of rabies in humans

The incubation period for rabies ranges from 10 days to 3-4 (more often 1-3) months, in some cases - up to one year, that is, the virus can exist in the body without symptoms. In immunized individuals, on average, it lasts 77 days, is not immunized - 54 days.

Described isolated cases of very long incubation period. So, he was 4, and 6 years after immigrating to the US in two immigrants from Laos and the Philippines; isolated from these patients were no strains in animals in the US, but were present in the regions of origin of immigrants. In some cases, the long incubation period of rabies developed under the influence of any external factor: the fall from the tree 5 years after infection, electric shock through 444 day.

Duration mainly depends on the location of the injury. The longer the virus have to get to the brain, the longer people will stay healthy in appearance. In medicine it has been described cases where the disease manifests itself even 4 years after the bite of an infected cow.

Rabies a human passes through three stages, each of which is manifested by various symptoms.

stage 1

The initial stage of rabies (1-3 days):

1. The earliest symptoms of rabies in humans occur at the site of the bite. By this time the wound may scar completely, but the man begins to "feel" the bite. It felt a nagging pain with the biggest manifestation in the center of the bite, burning and itching, increased sensitivity of the skin. Scar can become inflamed again and pripuhnut.
2. There subfebrilitet - the temperature ranges from 37 ° C -37.3 C but not exceeding them.
3. Marked weakness, headaches, vomiting and diarrhea.
4. If the bite occurred in the area of ​​the person, the person starts to disturb the visual and olfactory hallucinations - intrusive odors, which are actually not, nonexistent visual picture.
5. There have been typical mental disorders: the patient overcomes the irrational fear, sadness, depression. In rare cases, the anxiety is replaced by irritability. Person becomes withdrawn and apathetic about what is happening.
6. Disturbed sleep and appetite. In rare moments of sleep the patient overcome the terrible dreams.

stage 2

Next step lasts from 2 to 3 days, it is called the excitation step. It is characterized by:

1. Because of damage to the nervous system, it is an increase in the excitability of the neuro-reflex system. The tone of the autonomic nervous system prevails.
2. Bright symptom progression of the disease - the development of hydrophobia. When you try to do a sip of fluid from an infected person has a spasm. He exposed the breathing and swallowing muscles, until the occurrence of vomiting. As the disease progresses like a spasm will occur in response to the sound of running water, and even in her appearance.
3. the patient's breathing becomes rare and convulsive.
4. Appear facial spasms. Any external stimuli evoke strong reactions of the nervous system.
5. Seizures are a response even to minor irritants for a healthy person: bright light, wind or draft, sharp sound. This causes the patient's fear.
6. Pupils dilate eyeballs bulge (exophthalmos), the sight is fixed at one point. Pulse quickens, speaks perspiration, saliva flows continuously, its volume increases significantly.
7. Mental disorders progresses, the patient overly excited, it becomes violent. He is a threat to themselves and others, behave aggressively and even violently. Infected rush on others, they fight and bite, tearing their belongings, hair, beating against the walls. In fact, people during this terrible attack suffers from haunting creepy images and sounds. During the attack, a person may stop breathing peak, as well as stop the heartbeat.

When an attack takes place, people behave adequately, noninvasively, their speech is logical and correct.

stage 3

Paralysis are caused by loss of function of the cerebral cortex. Paralysis exposed to certain groups of muscles and organs (tongue, larynx, etc.). Fade Motor and sensory functions, seizures, convulsions and phobias cease. The patient apparently calmed down.

It showed a significant increase in temperature to 40-42 C. There is a rapid heartbeat on the background of the pressure drop. patient death occurs due to heart failure or respiratory center.

Thus, the total duration of the clinical manifestations of 3-7 days. In some cases, the above stages and symptoms of rabies in humans can be erased, and the disease very quickly progresses to paralysis (death occurring during the first days after the first manifestations).

See also: 10 facts about rabies

Diagnostics

Diagnosis is based on anamnesis: animal bite or skin or licks. Then, play the role of specific signs of rabies: rabies, increased sensitivity to stimuli (sound, light, drafts), profuse salivation, seizures, psychomotor agitation with cramps (even in response to the slightest movement air).

From laboratory detection methods may be mentioned the rabies virus antigens in prints corneal surface. In the analysis of blood marked leukocytosis by increasing the content of lymphocytes. After the death of a patient at autopsy in the matter of the brain detect calf Babes-Negri.

rabies treatment in humans

Until 2005, it was not known effective methods for treatment of rabies in the case of the onset of clinical signs of disease. It had to be limited to purely symptomatic agents to relieve the painful condition. Motor excitation removed soothing (sedative) means, convulsions eliminated kurarepodobnymi preparations. Respiratory disorders compensated through a tracheostomy and connect the patient to a respirator.

there were reports in 2005 that the 15-year-old girl from the United States Gina Giese was able to recover after virus infection of rabies without vaccination, when treatment was initiated after the onset of clinical symptoms. When treating Gis was put into an artificial coma, and then it was introduced drugs that stimulate the immune activity of the organism. The method was based on the assumption that the rabies virus does not cause irreversible lesions of the central nervous system and causes a temporary disorder it functions, and thus, if temporarily "turn off" most of the functions of the brain, the body will gradually be able to develop enough antibodies to to defeat the virus. After a week of being in coma and subsequent treatment, Gis a few months later she was discharged from the hospital with no signs of destruction of rabies virus.

However, rabies is incurable in the last stage. The probability of death after infection - 99.9%.

vaccination Features

Since rabies treatment in step appearance of signs have not effectively to prevent spread of the virus requires disease prevention, by introducing special vaccine.

Vaccinated against rabies person appointed in such cases:

• if he is injured subjects, which was infected saliva;
• when he was attacked by the animal is clearly unhealthy and received open injuries of the skin;
• if he had been bitten by wild rodents;
• if he had been in contact with the patient's saliva, such pathology, as rabies, human, and in other cases when an open wound could get saliva alleged media;
• if it has scratches on the body, resulting from contact with animals, which soon after their deposition were killed for no apparent reason.

Rabies vaccination shall be appointed immediately, with a certain periodicity. They are carried out as an outpatient and inpatient - depending on the wishes of the patient and the severity of the bites.

It should be remembered that the vaccination could cause side effects such as redness of the injection site, fever, diarrhea disorders, impaired general condition. There are special instructions regarding rabies vaccination and reception of alcohol - to prevent the development vaccine-related complications, people are prohibited for a period of six months after the vaccination and her drink alcoholic beverages.

prevention

Specific prophylaxis is carried out by combined administration of a course of rabies vaccine and the rabies immunoglobulin after a sting or an animal or licks. After a bite wound treatment should be carried out and consult a doctor, a surgeon.

wound treatment is carried out as follows:

• boiled wound rinse with soapy water or hydrogen peroxide;
• treat the wound with iodine or 70 ° alcohol;
• suturing wounds, as well as the excision of its edges, is contraindicated;
• around the wound and the wound itself is introduced rabies immunoglobulin;
• after 24 hours. introduced rabies serum.

The first two points of processing should be carried out at home before visiting a doctor; other wires surgeon.