Rabies - a viral infection that occur with the development of severe progressive lesion of the brain and spinal cord with a fatal outcome.
rabies virus variants
- Street (wild) circulating in vivo in animals;
- Fixed used for preparing rabies vaccines (which does not cause disease).
Virus multiplication of rabies occurs in the cells of the medulla oblongata, the hippocampus, the lumbar portion of the spinal cord.
Rabies virus is unstable in the environment, rapidly killed by boiling and by various disinfectants; However at low temperatures, able to persist for a long time.
The main reservoirs of the virus and the sources of infection - patients carnivorous wild and domestic animals: foxes (the most significant reservoir), wolves, raccoon dogs, jackals, dogs, cats. Human infection occurs through the bite or contact with saliva rabid animal on damaged skin. From person to person the virus is not transmitted. The most dangerous bites the head, neck and hands. Susceptibility to rabies not universal, and the incidence of disease is determined by the bite of a rabid zone animals: bites in the face of rabies occurs in 90% of cases, bites into the brush - 63%, bites in the leg - 23 %.
The virus enters the body via damaged skin, usually bites of infected animals. Keep in mind that attack infected animal does not always lead to the development of rabies: frequency of reported cases does not exceed 15%, which can be explained by the relative stability of the body human virus.
Reproduction of the rabies virus is carried in the muscle and connective tissues, where it is stored for weeks or months. Virus then migrates through the nerves to the brain where propagated in the gray matter and migrates back into various tissues (including salivary glands).
symptoms of rabies
Infection with rabies possibly by the bite or saliva contact with a rabid animal on damaged skin.
- The incubation period - from 10 days to 1 year; considerable variability of this period is determined by the following factors: localization of the bite (the shortest - bites in the head, hands), age bitten (in children is shorter than in adults), size and depth wounds.
- The total duration of the disease - 4-7 days in rare cases - 2 weeks or more.
- In the initial period of the first signs of rabies are found in the site of the bite: the scar again swells, turns red, itching, pain along the nerves closest to the bite site. There was a general malaise, fever, sleep disorders.
- During the height of rabies: rabies attacks occurring with painful spasmodic contractions of the muscles of the pharynx and larynx, noisy breathing, sometimes stop breathing when you try to drink, and later at the sight or sound of running water, a verbal mention of her. Attacks may be provoked by the movement of air, bright lights, loud sound. View the patient during an attack he shouting he throws back his head and body, throws a forward trembling hands, pushes a vessel of water; develops shortness of breath (the patient inhales air with a whistle). Seizures last a few seconds, after which muscle spasms are.
- Bouts of agitation: patients become aggressive, shouting and rushing about, scratching furniture, showing superhuman strength; possible development of auditory and visual hallucinations; note increased sweating, salivation; the patient can not swallow the saliva and it constantly spits.
- The paralytic rabies occurs during sedation: disappear fear, anxiety and melancholy state, rabies attacks, there is hope for recovery (ominous calm). Appear limb paralysis and cranial nerves different localization, increase in body temperature above 40 ° C, sweating, lowering blood pressure (hypotension), Slowing of the heart rate.
Death occurs from heart failure or paralysis of the respiratory center.
diagnosis of rabies
Laboratory confirmation of the diagnosis of rabies can only be posthumously on the basis of the following methods:
- Detection Babes-Negri bodies in hippocampal cells;
- Detection of rabies virus antigen in cells by immunofluorescence and ELISA;
- Formulation biological sample with infection of newborn mice or hamsters Syrian virus from the saliva of patients slurry brain tissue or submandibular glands;
- Fundamentally possible during the lifetime of the patient virus isolation from the saliva or cerebrospinal fluid, as well as posing a fluorescent antibody response to prints with the cornea or skin biopsies, but in clinical practice, this is difficult, and diagnosis is based on clinical manifestations disease.
Treatment
Rabies is no specific therapy. Carry supportive treatment (hypnotics, anticonvulsants, analgesics, etc.).
Vaccination against rabies
For vaccination use
- dry culture inactivated rabies vaccine Rabi HAC-Vnukovo-32
- dry inactivated concentrated purified culture rabies vaccine
- rabies immunoglobulin.
Detailed schemes therapeutic and prophylactic immunization for each vaccine bite into account the severity and nature of contact with animals (or licks, osadnenie et al.), Data about the animal, and others.
Vaccination is only effective at the beginning of the course no later than the 14th day from the date of the bite. Vaccinations carried out by an absolute (for bites of rabid animals clearly, in the absence of an animal bite data) and suspended (by the bite of an animal with no signs of rabies and the opportunity to observe him for 10 days) indications.
If you suspect a short incubation period (extensive destruction of soft tissues, the localization of the bite is close to the brain) conduct an active-passive protection of the victim: in addition to the vaccine injected and rabies immunoglobulin. The duration of post-vaccination immunity - 1 year.
Prevention of rabies
- Fight with the source of infection (compliance with rules for keeping dogs and cats, vagrancy warning among them, the preventive vaccination of domestic animals against rabies, control of the wild population animals);
- When a suspicious animal bites need to give immediate assistance to the victim. It should be abundantly wash the wound and places the animal's saliva-soaked, running water and soap, treat the edges of the wound with tincture of iodine, apply a sterile bandage to the wound edges are not excised during the first three days and not zashivavyut (except for vital Dangerous); necessary to provide immunization against rabies.
