OverviewRabies - is one of the most dangerous infectious diseases of viral, occurs with severe damage to the nervous system and ends are usually fatal. Rabies is found on all continents except Australia. As of 2009, each year in the world 55,000 people die from the disease. About 95% of deaths occur in Asia and Africa. According to statistics, in 2008 in the Russian Federation registered 17 cases of rabies.
There are a natural type of rabies, the centers of which are formed by wild animals (wolf, fox, raccoon dog, jackal, fox, skunk, mongoose, bats), and the urban type of rabies (dogs, cats, farm animals). Most human deaths follow a bite from an infected dog.
In people infected with rabies virus inevitably leads to death in the event of symptoms. However, emergency vaccination after infection usually prevents the development of the disease. Cases of recovery from symptoms of rabies are rare and usually associated with a false diagnosis.
The causes of the diseaseVirus released into the environment with the saliva of infected animals or humans. Infection of humans occurs through the bite of an animal or oslyunenii damaged skin or mucous membranes. There are cases of disease in humans by the bite of apparently healthy animals that continue to remain so for a long time.
Symptoms of rabiesThe incubation period averages 1-2 months (from 7 days to 1 year or more). Its duration depends on the localization of damage (the distance from the brain) and the number of viral particles that fall into the wound. Of the injury rabies virus along nerve fibers to reach the brain where it causes encephalitis. The speed of the virus along the nerves of 3 mm/h.
There are three stages of the disease1) The prodrome lasts 1-4 days and is manifested fever, headache, fatigue, loss of appetite. There have been neuralgia along the nerves next to the site of the bite, the increased sensitivity of the skin at the site of the bite, slight twitching of the muscles.
2) The stage of excitement - lasts 4 to 7 days and is manifested by periodic bouts of agitation. Expressed in dramatically increased sensitivity to the slightest irritation of the senses: a bright light, a different sound, noise. Patients become aggressive, violent, there are hallucinations, delusions, feelings of fear, there are convulsions, paresis, and paralysis of the muscles. The stage of excitement is usually accompanied by fever of up to 40 oC. As the disease attacks occur more often, and shorter intervals between attacks.
3) The stage of paralysis, during which align signs of cranial nerves: diplopia, facial nerve paresis, paresis of facial muscles. Paralysis of eye muscles, impaired swallowing function. Drooling, combined with the ingestion leads to the appearance of foam in the mouth, so characteristic of patients with rabies. In half of cases there is fear of water: when you try to drink there are abrupt involuntary contraction of the diaphragm and other respiratory muscles.
The total duration of illness 58 days now and then in 1012. Death usually occurs from respiratory failure due to damage to the respiratory system.
DiagnosisIf you or your loved ones after being bitten by an animal observed the above symptoms should immediately seek medical attention.
Diagnosis is based on the history of the disease (the presence of the bite or saliva of rabid animals from entering the damaged skin), the presence of specific symptoms and laboratory diagnostic techniques. Confirmation of the diagnosis when it detects an antigen of rabies virus in the prints from the cornea of the eye or skin biopsies, as well as the identification of antibodies in the serum.
Treatment for rabiesTreatment for rabies is usually performed in the ICU. Treatment is symptomatic. We recommend an active supportive care (hypnotics, anticonvulsants, analgesics, parenteral nutrition, etc.).
What you can do?If you are bitten by a dog, you should immediately wash the wound with soap and water, then treated with hydrogen peroxide and immediately contact the emergency room. You should not delay the treatment of a doctor. Vaccination is effective only if it was held not later than 14 days from the time of the bite or oslyuneniya rabid animal. If possible, you have to watch the dog for 10 days. Vaccination can be stopped only if, within 10 days of life the dog did not die, and she did not appear the main symptoms of rabies.
What will help the doctor?Depending on the location, depth and other parameters of the wound the doctor decides on the method of prevention. In the simplest cases, prevention includes passive immunization with rabies rabies immune globulin, or serum, followed by vaccination.
Immunoglobulin and serum is injected only once. Vaccines currently in use, usually introduces six times a day injections are done to see a doctor (day 0) and then at 3, 7, 14, 30 and 90 days.
Pregnancy is not a contraindication for vaccination.
It should be remembered that in order to ensure an adequate immune system and prevent the complications of vaccination, vaccinated contraindicated the use of any alcoholic beverages during the course of vaccination and 6 months after graduation. It is necessary that during the vaccination of a patient not to overwork, avoiding overcooling and overheating. The meaning of these restrictions is to avoid those factors, which could reduce the effectiveness of developing immunity.