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period of infection with rabies. Rabies: incubation period in humans, symptoms and diagnosis

The causative agent is the rabies virus.

Resistant to low temperature, dies from UV radiation, 3-5% carbolic acid, from the action of high temperature, 3% lysol and chloramine, alkalis and acids. Distinguish virus "wild" - highly pathogenic for warm-blooded, and "fixed", obtained in the laboratory. The reproduction of the virus is accompanied by the formation of Babes-Negri bodies, specific inclusions in neurons.

Epidemiology of rabies in humans

Sources and reservoirs of infection: dogs, bats, cats, wolves, foxes, arctic foxes, corsacs, raccoon dogs, badgers, ferrets, beavers, martens, elks, rats, lynxes, wild cats, squirrels, cattle, pigs, hamsters, bears, nutria, muskrats. Domestic animals are usually infected from wild ones. A person becomes infected with bites, saliva on the skin, mucous membranes. There may be infection through objects on which the saliva of animals has fallen, and contaminated with the brain of animals. Risk groups are hunters, foresters, veterinarians, dog catchers, taxidermists.

Symptoms and signs of rabies in humans

Rabies is a viral encephalomyelitis. The incubation period varies. The prodromal stage is characterized by non-specific manifestations: fever, nausea, vomiting, paresthesias and pain in the bite area. The stage of excitation is accompanied by muscle spasms, spasm of the pharynx, rabies and a state of psychomotor agitation. Less commonly, there is a paralytic course with a gradual increase in flaccid paresis. In all cases, a fatal outcome is observed (the time from bite to death is in 84% of cases from 10 days to 3 months).

More often - 30-90 days. It is shorter if the bite is localized on the head, neck, arms, perineum.

Excitation period - 2-3 days, lowering blood pressure, increased sweating, agitation, aggression, violence, muscle spasms. This manifests itself in the form of seizures - paroxysms. Between them consciousness clears up. Characteristic: salivation, convulsions of the pharynx, larynx, diaphragm, impaired swallowing and breathing. Attacks occur due to attempts to drink (hydrophobia), acousticophobia (reaction to loud sounds), photophobia (to light), aerophobia (to air).

Paralytic stage: convulsions and phobias stop. In 20% of patients, the excitation period is absent and paralytic, or silent, rabies develops. Paralysis can be diffuse and symmetrical.

Paralytic rabies often develops after being bitten by bats. The duration of the illness is 1 week. Lethality - 100%.

Diagnosis of rabies in humans

Diagnosis is based on the detection of rabies virus in saliva, pharyngeal swab, corneal biopsy, skin biopsy, CSF, brain biopsy, increased antibody titer in serum and CSF

Diagnosis based on:

passport data (profession from the risk group);
clinics (salivation, scarring at the site of the bite, inability of the patient to swallow water, disorientation, hallucinations, phobias, convulsions, muscle vasculations, stupor, coma);
epidemiological anamnesis (bites, wounds, saliva, brain tissue). Find out the fate of the animal (healthy, died, got sick, disappeared);
histological studies of the brain of deceased people;
radioimmune test;
tissue culture research;
RNGA, RSK;
biological test on mice;
fluorescent antibody method for antigen detection.

Treatment of rabies in humans

Symptomatic intensive care.
Hospitalization and constant monitoring for suspected rabies.

Prevention of rabies in humans

Immunoprophylactic measures, including vaccination with an inactivated virus cell culture, carried out in a timely manner after an animal bite, reliably prevent the disease.

Before infection: immunization is carried out among representatives of professions in contact with animals. Repeated immunization is carried out in a year, subsequent - in 2-5 years.
After infection: the wound is treated with soap and water (or detergents), as well as a 70% alcohol solution or tincture of iodine.

Indications for rabies vaccination after an animal bite

When touching animals, giving them food, getting the saliva of an animal on intact skin: vaccination is not carried out.
In the presence of superficial scratches on the skin, caused by the teeth or claws of the animal, not accompanied by the release of blood and if the saliva of the animal gets on the skin in places of its irritation, active immunization is carried out.
In the presence of any wound caused by the claws or teeth of the animal, immunization is performed.
Active immunization is carried out by introducing 1 ml of rabies vaccine intramuscularly on days 1, 3, 7, 14, 30 and 90 after infection.
Passive immunization is carried out by the introduction of human immunoglobulin, with half the dose injected intramuscularly (in the gluteal muscle, the contralateral side of active immunization), and half is installed in and around the wound.

Among infectious diseases, the most dangerous for humans is rabies (rabies).

The disease belongs to acute contact zoonoses with prolonged incubation. It is manifested by a rapid lesion of the central nervous system and the development of progressive, severe encephalitis with high mortality in patients.

The causative agent of the disease is a virus of the genus Lyssavirus, belonging to a large family of rhabdoviruses containing a single-stranded RNA molecule.

There are two versions of the virus - wild (or street), circulating in the natural environment, highly pathogenic for animals and mammals, and fixed - a non-pathogenic strain used to make vaccines.

Virions of the virus are quite sensitive, at high temperatures (above 60 degrees) they quickly die. They do not tolerate the influence of standard disinfectants, but at the same time, they are resistant to one-time frosts, known chemotherapeutic drugs and antibiotics.

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The infection enters the human body through a bite, when the saliva of an infected animal comes into contact with the human mucosa, or through wounds on the skin, penetrating into the muscle tissue. Here begins the active phase of their reproduction and intensive movement along the fibers of the nerves to the brain. Having reached the final goal, the process of tissue destruction begins.

Transmission of infection by aerosol, through things or household items is impossible. But if there was a bite from an animal that showed atypical aggression for it, with signs of foam at the mouth, you should immediately seek medical help. By the way, infection in animals, in the latent period, can be asymptomatic for a long time.

This is of particular danger to humans, the symptoms of rabies in cats, for example, in the initial period may be manifested by difficulty in swallowing food and increased rabies, while the animal is in an absolutely calm state, which should be paid close attention.

Classification of rabies infection

Rabies in humans is manifested by several types, which are classified according to the source of infection:

Development of rabies in humans after dog bites.
Natural typical fox rabies.
Caused by bats.
Provoked by African representatives - shrews "overseas bats", insects - Lyss-like variant (in zoos and living corners of collectors).

Also, different types of manifestations of rabies in humans are distinguished, according to the characteristics of the clinical course.

Bulbar, due to pronounced symptoms of damage to the bulb of the medulla oblongata - manifestations of neurogenic dysphagic disorders and respiratory dysfunction.
Cerebral-manic type, manifested by delusional and manic-depressive states, and psychoses with possible convulsive attacks.
The cerebellar view, which is characterized by signs of "Vertigo" (dizziness) and the Leydei-Westphal syndrome - acute ataxia, due to cerebellar damage, manifested by impaired muscle and motor functions, and their coordination.
A paralytic type that manifests itself at an early stage of the disease with various types of paraplegia (upper, lower body paralysis or tetraplegia combining both types)

With any type of rabies, the patient has symptoms of hydrophobia (fear of water) and signs of swallowing disorders.

The first signs and symptoms of rabies in humans

After a bite, the symptoms of rabies in humans manifest themselves in stages, regardless of the type of pathology.

During the incubation period of rabies, there may be no signs at all, since the virions are at the stage of reproduction and cannot yet have a negative effect and cause any consequences due to their presence.

The latent period can last a week or a year. Acute severe symptoms usually appear after three weeks, or after three months.

The duration of the incubation of the virus is affected by its amount and the remoteness of the site of infection from the head. The higher it is, the faster the virions will overcome the path to the brain, because they move on average up to 3 mm/hour.

Initial stage of development

The manifestation of the first symptoms of rabies in humans is noted already at the initial stage of infection, within one to three days. They are more reminiscent of the symptoms of colds or intestinal infections, manifesting themselves in a group or selectively:

weakness, malaise, depression and fatigue;
muscle pain and fever;
signs of dry cough, or rhinitis;
intoxication symptoms that provoke food refusal;
unpleasant burning and itching in the bite area;
stomach upsets and migraines.

Excitation stage

The stage of excitation lasts from two to three days, but sometimes, it can last for weeks. The symptoms are on. Appear:

constant feeling of anxiety and anxiety;
increased sensitivity to noise and light, hydrophobia;
painful noisy breathing;
profuse salivation and difficulty swallowing;
patient's aggressiveness.

At this stage, there is a high risk of patient mortality.

Stage of paralysis

It is characterized by a decrease in aggression and a visible calmness of the patient, giving false hope for recovery. In fact, the patient's lethargy and calmness indicate the onset of a period of paralysis. Control over salivation is lost, the processes of muscle atrophy in the limbs begin.

All this is due to the death of various areas of the brain, ultimately leading to paralysis of the respiratory center and cardiac arrest. This period of illness does not exceed 9 days.

Regardless of the type of clinical course of the infection, it leads to the death of the patient if it was not stopped at the initial stage of development.

Vaccination of people against rabies after 10 days from the moment of infection is in most cases untenable.

Diagnostic methods

The diagnosis of rabies in humans involves questioning the patient about his contact with a possible carrier of the infection over the next year.

Bite factors, contact with the saliva of the animal, production factors associated with contact with fresh skins are identified. The symptoms characteristic of the infection are considered. If the culprit of the infection is caught, an appropriate analysis is carried out.

The possible infection of a person with rabies is determined by analyzing the detection of antibodies to the virus from the cornea of the eye (an imprint is taken), or by examining a biopsy sample taken from a portion of the back surface of the cervical zone;
For the same purpose, an analysis of the PRP of saliva and cerebrospinal fluid is carried out;
Analysis of the clinic of blood and cerebrospinal fluid to determine the monocyte level, their elevated level indicates the presence of infection.

But such a diagnosis can only be a conditional confirmation of this infection, since a final 100% diagnosis of rabies is possible only with a post-mortem examination of the brain of a deceased patient for the presence of characteristic, special dotted eosinophilic inclusions, called “Babes-Negri” bodies, containing viral antigens. Their presence is a confirmation of rabies.

Treatment of rabies is possible and what is the prognosis?

The tactics of treating rabies in humans is due to the urgent administration of anti-rabies immunoglobulin and a vaccine against infection. At the same time, surgical treatment of wounds is performed.

The formed edemas are opened, the affected areas of the muscles are excised, the wound is thoroughly cleaned with a solution of peroxide and soapy water. Three days later, the vaccine is given again.

There is currently no effective medical treatment for rabies in humans.

After the manifestation of the first signs of the disease, it becomes incurable and eventually, the person dies of rabies. All prescribed drug therapy performs only a supporting and facilitating function of the last days of the patient, without providing any therapeutic effect. Its purpose is due to:

the appointment of standard painkillers - "Paracetamol" or "Nurofen".
Silin preparations of sedative properties - "Seduxen" and "Diazepam";
anticonvulsants - "Phenobarbital";
muscle relaxant - "Aloferin".

The patient is provided with parenteral nutrition and artificial respiration - mechanical ventilation. But no measures can prevent death. With pronounced signs of rabies and a reliable diagnosis, the prognosis is hopeless.

Rabies is an acute viral pathology that develops in a dog or a person whom it has bitten. The insidiousness of this disease is that it may not manifest itself in any way even when the infection has already occurred. But from the moment the first signals of the disease appear, hopes for a full recovery are reduced. Therefore, it is important to identify canine rabies in a timely manner, as well as to recognize the signs of this condition in a person who has been bitten.

Signs of rabies in dogs

There are general and particular manifestations. Here are the main behaviors that can be used to recognize that a pet is sick:

skinny appearance;
increased salivation from the mouth;
protrusion of the tongue out;
probably the development of strabismus;
clouding of the cornea;
paralysis of the limbs.

As for private signs, they depend on one form or another of the disease.

Violent form of the disease

This type of disease is characterized by the following distinguishing features:

duration - 5-11 days;
division into prodromal (up to 3 days), manic (duration is the same) and paralytic (up to a week) stage;
apathy and desire to hide from others;
excessive thirst for affection, licking the hands of the owner;
the next stage develops aggression;
attack "silently" without preceding barking;
paralysis of the laryngeal region;
at the last stage - problems with swallowing;
coma.

Silent variety

This is an atypical variant of the development of the disease. The dog does not behave aggressively, there is no loss of appetite. There is a possibility of difficulty in swallowing. They are similar to the situation when an animal chokes on a bone. Paralysis of the pharynx, lower jaw appears, and subsequently they lose motor functions and hind limbs.

return form

In this case, symptoms and remissions are observed in cycles. At one time, it seems that the dog has completely recovered, and after 2 weeks the signs of this disease again make themselves felt. The set of symptoms remains the same, and they consist in bouts of apathy, aggression, paralysis.

After all these signs, the animal is completely paralyzed and dies.

Symptoms of rabies in humans after being bitten by a dog

The existence of the virus in the body can be asymptomatic for 1-3 months. Sometimes there is a reduction in the incubation time to 10 days or, conversely, an increase to a year. In medicine, cases were described when the manifestation of the disease occurred several years after the bite.

In the usual manifestation, the disease goes through several stages of development, and each of them has its own signs.

The first symptoms of rabies in humans

The initial stage of rabies lasts a minimum of 24 hours and a maximum of 3 days. It is characterized by the following set of symptoms:

a wound is the first wake-up call, because even if it has already healed, a person feels pain and itching at the site of injury;
change in body temperature: usually it is not 37.3 degrees, but it cannot drop to the mark of 36.6 C;
the occurrence of headaches, feelings of weakness, intestinal disorders, nausea and vomiting;
if a sick dog has bitten a person’s face, there is a high probability of developing hallucinations in vision and smell: he sees images, smells that are not really there;
mental deviations also become pronounced;
loss of appetite is another important symptom of rabies in humans after being bitten by an infected dog;
sleep disturbance implies problems with nighttime rest, nightmares and a state of delirium.

Signs of the second stage

The duration of the next stage is 2-3 days, it is called the stage of excitation. It is characterized by the following symptoms:

hydrophobia develops: with every attempt to drink a little liquid, a spasm begins in the muscles of breathing and swallowing, sometimes the condition is accompanied by a gag reflex;
facial cramps;
dilated pupils and protrusion of the eyeballs, fixing the gaze at one point, also against this background, the pulse quickens, profuse sweat appears;
progression of mental abnormalities associated with excessive agitation, riot, aggression, rage, while after an attack the person returns to his previous state and behaves adequately.

Symptoms of the third stage of rabies

The third stage of the disease is the final one. Its duration is no more than three days. The stage is accompanied by the impossibility of performing a motor function. As a result, the patient suffers from a violation of sensitivity, there are no more seizures and hallucinations. This is just the phase when the paralysis of muscles and internal organs begins. Outwardly, the patient appears calm. But the temperature rises to a mark of 42 degrees, while blood pressure decreases. When paralysis of the heart or respiratory organs occurs, death occurs.

From the moment the symptoms begin to appear until death, 3-7 days pass, depending on the individual situation. Sometimes the disease is characterized by rapid progression and confusion of the overall clinical picture. The death of the victim can sometimes occur within the first days after the onset of the first unexpressed symptoms.

First aid for a bite

The first thing to do if you have been bitten by a dog is to thoroughly wash the affected area with ordinary soap with a minimum amount of fragrances and dyes. Washing should be very intense, and its duration is 10 minutes. If the wounds are deep, you need to wash them with a stream of soapy water, to simplify the procedure, you can use a catheter or syringe. It is not recommended to cauterize wounds with improvised means and sew them up. The best solution is to go to the nearest trauma center immediately after the bite.

The doctor will examine the patient and prescribe vaccinations. Previously, I had to do 40 painful injections, now the issue is resolved with just a few injections. When talking with a doctor, you must provide the following information:

general description of the animal;
appearance features;
behavior;
the presence of a collar;
the circumstances under which the incident occurred.

Based on these data, the doctor will decide on further actions. Most often, the patient is given a vaccine and sent home, and then the injections are repeated about 5-6 times. If the condition of the bitten person is extremely severe, he may be left for inpatient treatment. The same applies to situations where the patient is re-vaccinated, suffers from diseases of the nervous system or from allergic pathologies. Pregnant women, as well as people who have been vaccinated with other vaccinations over the past months, should also be under the close supervision of a doctor.

Vaccinations after a dog bite

Vaccinations are given if a person has been bitten by a homeless animal. Vaccination of people can be planned and emergency. The first type of injections is used for employees of veterinary clinics, persons who are engaged in trapping and euthanizing animals that do not have a home, employees of slaughterhouses and children. Emergency vaccination acts as a life-saving measure in case of an animal bite and should be carried out as soon as possible.

The doctor prescribes anti-rabies drugs, which in a volume of 1.0 ml are administered according to a certain scheme, including:

day of treatment;
third day;
seventh day;
14th;
30th;
90th.

It turns out that during the vaccination period, 6 injections are injected into the victim. Solutions are injected into the shoulder. During the course of procedures and within six months after their termination, alcohol should not be consumed, since it neutralizes the effect of the vaccine. The total number of injections can also be dependent on the location of the wound. The most dangerous are bites in the face, upper limbs, chest, neck. If it turns out that the animal that bit the person is not rabid and does not suffer from diseases, vaccination is immediately stopped. If it is sick, or there is no possibility of observing it in the laboratory at all, the course continues until the completion of the scheme.

Rabies vaccination for dogs

The rabies vaccine for dogs is an effective preventive measure and can also be a curative measure. The vaccination process consists of several fundamental steps.

Training. Regardless of whether the dog is a puppy or an adult, some preparatory activities are needed. A week before the vaccine is given, it is important to carefully monitor the health of the pet. It is necessary to regularly change the body temperature, avoid new acquaintances and physical overwork. Protect your dog from stress. And it is better not to feed him directly on the day of vaccination.
Accounting for contraindications. Just like humans, dogs have some vaccination restrictions. They concern the following conditions:

increase in body temperature;
immunodeficiency;
worms;
general exhaustion;
any other illness;
previous injuries;
individual intolerance to individual components.

If during the medical examination of the pet no restrictions and contraindications are found, vaccination is carried out in accordance with the schedule and the selected drug. Most drugs are administered intramuscularly. After the procedure, the doctor enters the appropriate list of data in the pet's individual passport.
Following actions. It is not recommended to take the dog home immediately after the introduction of the substance, it is worth waiting 15-20 minutes. This is the time when there is a possibility of an allergy. If it is not observed, you can go home. It is worth noting that the development of immunity to the virus after the vaccine occurs within 21 days.

Thus, the bite of a rabid dog is fraught with serious consequences for a person. To prevent the worst complications, vaccination should be carried out in a timely manner, this applies to both people and animals.

The video will discuss the main symptoms of rabies in dogs. They will help identify the disease and take action.

Rabies is an acute infectious (viral nature) disease of humans and animals, characterized by damage to the brain substance: when infected, an inflammatory process (encephalitis) develops.

Despite the fact that rabies is one of the oldest infections, there is still no tendency to reduce it, as well as effective treatments have not been developed. Rabies remains a deadly disease.

The symptoms of the disease are specific, but a rather long time can pass between infection and the first manifestations of the disease. In this article we will talk about the treatment and prevention of rabies in humans, because it is very important to know how to protect yourself and your children from a dangerous disease.

The widespread occurrence of rabies among many species of warm-blooded animals poses a risk of infection to humans, including children. Most often, infection occurs, but it is possible to get the disease from wild animals.

Cause of the disease

Infection occurs through the bite of an animal with rabies.

The source of infection is sick animals. Wild animals (foxes, wolves, bats) and domestic animals (cats, horses, dogs, pigs, cattle) also get rabies. In this regard, a distinction is made between urban and forest types of rabies.

Rare cases of virus infection from a sick person have also been registered.

A person receives the virus when bitten by sick animals or when salivating the skin and mucous membranes. At present, the possibility of infection by airborne droplets has been proven.

In this way, people can become infected by breathing air in caves with a lot of bats. The rabies virus can be obtained through food (). It is impossible to exclude the contact route of infection through things that have come into contact with the saliva of a sick animal.

The most susceptible to the disease are children from 5-7 years to 14-15 (more often boys): it is at this age that children fearlessly contact animals, strive for such contact, including with stray cats and dogs.

The group of high occupational risk of infection includes hunters, foresters, veterinarians, stray animal traps. They can also become infected from dead animals. Often cases of infection are recorded through any microtrauma of the hands when skinning, butchering the carcass of a sick animal.

The seasonality of the disease is noted: from May to September. During this period, people (including children) spend more time outside than in winter. Rural residents are more likely to get sick, as they have more opportunities for contact with different animals.

Natural foci of rabies are everywhere! Wild animals with rabies often run into nearby settlements where they can attack people.

Animals are contagious already 10 days before they show signs of rabies, but the greatest danger of infection occurs during the period of manifestation of the disease.

Not every bite from an infected animal results in rabies. Approximately 30% of the bites of sick dogs and about 45% of wolf attacks are infectious to humans. The risk of infection is higher with bites in the face and head, neck, perineum, fingers of the upper and lower extremities. Deep and lacerated wounds are very dangerous.

Infection can occur even in cases where there is no bite as such, there is just a scratch mark from the teeth, or only salivation of the skin and mucous membranes. The virus enters the body through the skin and mucous membranes.

Symptoms

The incubation period for rabies is long, from 1 to 6 months. With extensive wounds and massive infection, the incubation period can be reduced to 9 days. With bites of the face, head and neck, the latent period is short, with bites of the lower extremities it is longer. Cases of the development of rabies a year or more after being bitten are described.

In the rabies clinic, 3 periods of the disease are distinguished:

premonitory;
excitation period;
period of paralysis.

AT prodromal period diseases, aching pains appear in the area of saliva or bite, even if the wound has already healed. There may be reddening of the scar, itching and burning.

The child's temperature rises within 38 ° C, worries, vomiting may occur. The child refuses food, his sleep is disturbed (insomnia appears). If the baby still falls asleep, then he sees frightening dreams.

The child during this period is closed, indifferent to what is happening, the mood is depressed, anxious. The facial expression is sad. A teenager is worried about an unfounded feeling of fear, heaviness in the chest, accompanied by breathing.

The duration of the prodromal period is 2-3 days (may be extended up to 7 days). Subsequently, mental disorders intensify, depression and indifference are replaced by anxiety.

AT excitation period the most characteristic symptom of rabies disease appears: hydrophobia (or hydrophobia). When the patient tries to swallow any liquid, even saliva, there is a muscle spasm of the larynx and pharynx.

The sight and even the sound of running water, and even talking about water, cause a feeling of fear and the development of such a spasm. When trying to give a drink to a patient, he pushes the cup away, arches, and throws his head back.

At the same time, the patient's face turns blue, expresses fear: the eyes are somewhat bulging, the pupil is dilated, the gaze is fixed at one point, breathing is difficult, sweating increases. Attacks of convulsive muscle contraction, although short-lived (lasting a few seconds), but they often recur.

An attack can provoke not only the type of liquid, but also a stream of air, a loud knock or sound, a bright light. Therefore, the patient develops not only hydrophobia (hydrophobia), but also aerophobia, acousticophobia, photophobia.

In addition to increased sweating, there is a profuse formation and secretion of saliva. There is psychomotor agitation and manifestations of aggression and rage. Patients can bite, they spit, they can hit, tear their clothes.

It is this inappropriate violent and aggressive behavior that is implied when people say: "behaves like a madman."

During an attack, confusion is noted, frightening visual and auditory hallucinations appear. Between attacks, consciousness may clear up.

Vomiting, sweating and salivation, the inability to take fluids lead to dehydration (this is especially pronounced in children) and weight loss. The temperature may remain elevated.

The excitation period lasts 2 or 3 days, rarely up to 5 days. At the height of any of the attacks, respiratory and cardiac arrest may occur, that is, death.

In rare cases, the patient can survive until the third stage of the disease - period of paralysis. Attacks in this stage stop, the patient can already drink and swallow food. Eliminates hydrophobia. Consciousness during this period is clear.

But this is an imaginary improvement. Body temperature rises above 40°C. Pulse is quickened. Excitement is replaced by lethargy. Depression and apathy are on the rise.

Then the function of the pelvic organs is disturbed, paralysis of the limbs and cranial nerves develop. Death occurs as a result of paralysis of the centers of respiration and cardiac activity.

In addition to the typical form, there is also atypical form rabies. With this form, there is no clear manifestation of periods of the disease; convulsive attacks of rabies and a period of excitement may not develop. Clinical manifestations of the disease are reduced to a depressive, drowsy state, followed by the development of paralysis.

Rabies child in early age has some distinctive features:

the disease develops after a short incubation period;
hydrophobia is not noted;
the excitation period is sometimes absent;
the death of a baby can occur on the very first day of the development of the disease.

In children older than 2-3 years, the clinical manifestations of rabies are the same as in adults.

Diagnostics

Rabies is diagnosed clinically. Even in highly developed countries, it is difficult to confirm the diagnosis in vivo. As a rule, it is confirmed after the death of the patient.

The main symptoms for clinical diagnosis are:

the fact of biting or saliva of the patient's skin by an animal;
pain at the site of the bite after the wound has healed;
hydrophobia;
photophobia;
aerophobia;
acousticophobia;
psychomotor agitation;
swallowing and breathing disorders;
mental disorders;
paralysis.

Due to the lack of intravital laboratory diagnostics, atypical forms of the disease in the absence of arousal and hydrophobia are practically not diagnosed. Diagnosis of rabies in children is especially difficult, because it is not always possible to establish the fact of contact of a child with a sick animal.

In 2008, French scientists managed to develop and offer for life-time diagnostics a study of a biopsy of the skin area of the neck (on the border with hair growth) using the ELISA method.

The method is highly specific (98%) and highly sensitive (100%) from the first day of the disease. The study allows you to detect the antigen of the virus in the nerve endings near the hair follicle.

If it is possible to carry out the method of fluorescent antibodies, the imprints of the cornea are examined to detect the antigen of the virus.

When deciding on the need for immunoprophylaxis, it is necessary to diagnose rabies in the animal that inflicted the bite. This study is carried out as soon as possible after the bite of the patient (if the corpse of the animal is available for sampling of biological tissues). In this case, the virus can be detected in the cells of the brain and cornea of the eyes or sections of the skin of animals using serological reactions and the method of fluorescent antibodies.

Treatment

Treatment of a patient with rabies is carried out only in a hospital. The conditions of the patient should exclude exposure to bright light (room with darkened windows), loud noise stimuli and air currents.

An effective therapy for rabies has not been developed. Anti-rabies immunoglobulin, anti-rabies serum and large doses have a weak therapeutic effect.

Symptomatic treatment is carried out:

painkillers to reduce pain;
anticonvulsants;
sleeping pills for sleep disorders;
the introduction of solutions to normalize the water-salt balance;
drugs to stimulate the heart and respiratory system;
treatment in a pressure chamber (hyperbaric oxygenation);
cerebral hypothermia (ice pack on the head);
connection of an artificial respiration apparatus (according to indications).

The outcome of the disease is unfavorable, patients die. Single worldwide cases of recovery of children are described.

Prevention

In our country, specific and non-specific prevention of rabies is carried out.

Non-specific prophylaxis provides for the following measures:

capture and isolation of stray animals;
identification of rabid animals by the veterinary service with their subsequent euthanasia;
extermination of predatory animals near settlements;
quarantine measures and laboratory diagnostics in the focus of infection;
sanitary and educational work among the population.

Specific prophylaxis is carried out by conducting a course of combined administration of an anti-rabies vaccine and anti-rabies immunoglobulin after a bite or saliva by an animal. After a bite, you should treat the wound and consult a surgeon.

Wound treatment is carried out as follows:

wash the wound abundantly with boiled soapy water or hydrogen peroxide;
treat the wound or 70 ° with alcohol;
suturing the wound, as well as excision of its edges, is contraindicated;
anti-rabies immunoglobulin is injected around the wound and into the wound itself;
after 24 hours, anti-rabies serum is introduced.

The first two points of treatment should be carried out at home, even before visiting a doctor; the rest is performed by a surgeon.

Given the detrimental effect of high temperature on the virus, in the field, you can use the old method of treating wounds after an animal bite: cauterization of the bite wound with a red-hot iron.

To destroy the virus, you can put a crystal of permanganate or carbolic acid in the wound.

In the case of a pet bite, the doctor specifies under what circumstances the bite was received, whether it was provoked by the patient's behavior, whether the animal was vaccinated against rabies and where the animal is now. If the bitten animal is healthy (there is a certificate of vaccination), then vaccination is not carried out.

If the animal disappears after the bite, or if the patient is bitten by a wild animal, vaccination with an anti-rabies vaccine and anti-rabies immunoglobulin is carried out.

The vaccination scheme is selected for the patient (especially the child) by the doctor individually: depending on the depth and location of the bite, the duration of the bite, on which animal caused the bite and whether it is possible to observe it.

If, after 10 days of observation of a pet that has bitten a person, it remains healthy, then the administration of the vaccine is canceled after 3 injections already received (if salivation or a shallow single bite has occurred).

But if the bite was inflicted in dangerous places (listed above), as well as in the absence of the opportunity to observe or examine the animal, continue to administer the vaccine until the end of the prescribed regimen.

salivation of mucous membranes;
bites (of any depth and quantity) to the dangerous places listed above;
deep single or multiple bites inflicted by pets;
any damage or saliva by wild animals or rodents.

The rabies vaccine is injected intramuscularly into the shoulder area, and for children under 5 years old - into the area of the upper third of the anterolateral surface of the thigh. The vaccine should not be injected into the buttocks. The vaccine has a preventive effect even in the case of multiple severe bites.

Persons from the occupational risk group are given primary prophylaxis with the rabies vaccine. Prophylactic administration of the vaccine is also recommended for young children, given that they may not tell about the contact with the animal.

Preliminary prevention can also be carried out for children when planning vacations in the countryside or at a health summer camp.

The vaccine is administered 1 ml intramuscularly 3 times: 7 and 28 days after the first injection. Persons at risk of infection are revaccinated every 3 years. Adults and children after vaccination should avoid overheating, avoid overwork. During vaccination and within six months after it, it is necessary to categorically exclude the use of any types and doses. Otherwise, there may be complications from the CNS.

Summary for parents

Given that rabies is almost impossible to cure, all measures must be taken to prevent infection of the child. Children should be taught from an early age the dangers of contact with stray cats and dogs. Small children should not be left unattended to prevent attacks and animal bites.

Rabies is one of the most terrible diseases common to humans and dogs. And the worst thing is that the disease can manifest itself even six months after the bite, when a person forgot to think about torn trousers and a hematoma long gone. The symptoms of rabies after being bitten by a dog are a death sentence. There is no cure.

The first mention of rabies (rabies, hydrophobia) dates back to the beginning of the 16th century. And even then people understood that it was impossible to save the sick person. Five centuries later, the situation remains the same: yes, scientists know almost everything about rabies, but not how to deal with this virus.

In almost all cases, rabies infection from a dog, cat or wild animal occurs as a result of a bite. Wounds on the head, neck, face - 90% probability of developing the disease, on the trunk, hips - about 50%, on the hands (feet) - 30%. The deeper and more extensive the pocus, the higher the likelihood of infection. The more saliva that gets into the wound, the faster the symptoms appear: in very rare cases, signs of rabies after a dog bite develop after a year, with an average incubation period of 4 to 9 weeks

lose their sense of self-preservation. They are not afraid of screams, are not sensitive to pain and show excessive, inexplicable aggression. Do not try to cope with such a dog, immediately hide in the nearest entrance or car! If there is a suspicion that a pet is infected with rabies, do not approach him: lock the door and call the sanitary service.

In addition to the bite, saliva itself is also dangerous: in the early stages of the disease, periods of isolation are replaced by periods of excessive affection, especially in cases with dogs. A pet licks the owner's cheeks and palms, saliva gets on the microcracks of the skin and mucous membranes of the nose, mouth, eyes - the virus enters the body.

signs of rabies

The rabies virus infects the nerve cells of the brain, which leads to encephalitis, a specific inflammation of the brain tissue. The consequences are irreversible. The symptoms of rabies after being bitten by a dog vary depending on the stage of the disease. On average, the duration of the disease is about a week, rarely up to 12 days.

The first stage or period of harbingers:

duration from one day to three days;

pain appears at the bite site, even if the wound has healed;

the temperature rises to 37.5;

restless sleep;

irritability.

The second stage or peak period:

duration from 1 to 5 days;

hydrophobia, spasms at the sight of food and water;

panic, excitability when feeling air currents;

convulsions with sharp unexpected sounds;

pain in the eyes even in low light;

causeless aggression;

delusions, hallucinations, panic attacks.

The third stage or period of "ominous calm":

duration up to three days;

paralysis of the lower extremities;

paralysis of the eye muscles;

respiratory distress, palpitations;

death due to paralysis of the respiratory system.

Bitten by a dog, what to do?

Remember that if signs of rabies have already appeared after a dog bite, treatment is impossible! It is extremely important to prevent infection by taking all possible measures to destroy the virus that has entered the body. Procedure:

Rinse the bite site thoroughly with running water (large amounts) and soap (preferably the most common household soap). Treat the edges (around, not the bite itself) with alcohol, do not bandage;

do not stop bleeding unless it is life threatening. Together with the blood, saliva is washed from the surface of the wound, possibly containing the virus;

immediately (every hour is important) go to the nearest emergency room for help. The doctor will treat the wound with a special anti-rabies liquid (immunoglobulin). Then there is a course of anti-rabies vaccine (today it is 6-7 injections on days 0, 3, 7, 14, 30, 90) and an injection of immunoglobulin;

if possible, a suspicious animal is caught and monitored. If there are no signs of rabies within ten days, you can breathe easy. Most likely, this is just an aggressive, but not rabies-sick dog.

Never skip the rabies vaccine course. Carefully follow all the prescriptions of the doctor, without violating the regimen and schedule of vaccinations. In this case, the risk of contracting rabies from a dog is minimal. Especially if you consult a doctor in a timely manner, immediately after the bite - time plays a crucial role! And remember that every pet must be vaccinated against rabies without fail - this is the law.

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