Symptoms of rabies and ways to prevent infection with the virus

Article updated 09.27.2019

Over the past 3 years, 60 cases of human rabies infection have been recorded in Russia.

The largest number of such cases are registered in the Central, Volga, North Caucasus and Southern federal districts, as well as in the Republic of Tatarstan and the Chelyabinsk region.

In September 2015, a quarantine was declared in 6 Moscow veterinary clinics due to the occurrence of rabies in domestic animals. If rabies was found in domestic animals, this is the most dangerous, since their contact with humans is likely.

Is rabies a fatal disease?

The rabies virus affects the central nervous system of animals and humans. Rising along the nerve pathways, it reaches the brain and causes inflammation (specific encephalitis).

Until 2005, rabies was considered a fatal infection for humans. There are only a few known cases of people being cured of this terrible infectious disease.

However, a timely vaccination or certain measures, which will be discussed later, can save the patient’s life.

The main carriers of the rabies virus are:

1. Wild animals (wolves, foxes, wild cats, lynxes, bats, hedgehogs, rodents)
2. Farm animals
3. Pets

• Statistics of rabies incidence in Russia by animal carrier species for 1997 - 2007

The diagrams show that the main sources of rabies are wild animals. Recently, due to the spread of rabies among wild animals, the virus penetrates simultaneously into several biological species. For example, it is transmitted from a wolf to a fox or marten. Therefore, you need to be especially careful and attentive in the forest. We have previously written about safety rules in the forest.

Approximately half of all cases of rabies infection occur in domestic and farm animals that come into contact with wild animals. The most dangerous wild animals in terms of rabies infection are foxes (first diagram).

Moreover, you can meet mad foxes both in the forest and in the city. When infected with rabies, foxes can manifest themselves in two ways. Some may behave aggressively and attack people. Others, on the contrary, are drawn to people and show affection, like domestic cats.

This behavior is not typical for a healthy fox.

If you encounter such a fox, you must immediately leave the forest or area in which it is located. Under no circumstances should you pick them up.

How can a person become infected with rabies?

A person becomes infected with rabies when an animal attacks him and then bites him. When analyzing the bulletin on rabies, it was revealed that it is the street type of rabies that occurs on the territory of our country. 99% of people who died of rabies (WHO) were infected by street stray dogs. It is also possible to become infected with rabies when animal saliva comes into contact with damaged human skin.  

The second source of human infection is forest foxes. If the saliva of an infected animal gets on forest edible grass (for example, sorrel, sorrel) or berries, then eating them unwashed can lead to infection. For prevention purposes, it is necessary to thoroughly wash any forest products.

You can become infected with rabies if a motorist hits an infected forest animal and touches dirty parts of the car or the animal itself with unprotected hands.

Ideally, it is necessary to report the incident to specialists at animal disease control stations, who should treat the area with disinfectant solutions and prescribe quarantine.

If the blood of, for example, a downed fox gets on a person’s skin, it is necessary to immediately go to the nearest emergency room.

In addition, humans can be infected by pets that have been bitten by rabid wild animals.

Symptoms of rabies in animals

Once a dog or cat is infected with rabies, it usually takes about 15 days before the animal begins to behave aggressively.

The most common symptoms dogs exhibit are:

1. Starts gnawing or licking the bite site.
2. The dog's pupils dilate, and it begins to behave aggressively and even runs away from the house.
3. While maintaining an appetite, the dog can swallow inedible things.
4. The animal may have severe salivation with foam and vomiting (doctors consider this to be the main symptom of rabies).
5. Hydrophobia (may not manifest itself).

1. After these signs appear, as a rule, on the third day, paralysis of all muscles and death of the animal occurs.
2. in cats are drooling and extreme agitation.
3. The cows' limbs become paralyzed and death occurs.

Symptoms of rabies in humans

For rabies, the incubation period ranges from 8 days to 1 year. Most often, the disease does not manifest itself in any way for 40 days.

The duration of the incubation period and the course of the disease directly depend on the location of the bite on the body, the age of the victim, the depth of the wound and penetration of the virus, and the rapid use of the vaccine.

It is believed that the shortest incubation period for a person when bitten by a wolf. As for the location of the bite, the most dangerous are the injuries to the head, face and arms during an animal attack, since the rabies virus infects the nerve fibers and cells of a person, then moving along the spinal cord to the brain.

A person's death occurs due to suffocation and cardiac arrest.

Symptoms of rabies in humans:

1. The primary symptoms of rabies include: low-grade body temperature (above 37, but below 38 degrees), malaise, convulsions during breathing and the desire to swallow food, headache, nausea, lack of air. The bite site turns red, and increased salivation is observed.
2. Nervous excitement, irritability, anxiety, headache, insomnia, depression, and poor appetite appear. All this lasts approximately 1-3 days.
3. Then a characteristic symptom of rabies appears - “foaming at the mouth”; excitement is accompanied by muscle cramps, which can occur even from bright light. Patients may become aggressive, scream, tear their clothes, use force, and break furniture. Body temperature rises to 39-41 degrees, tachycardia, increased lacrimation, salivation, and sweating are observed.
4. Subsequently, hydrophobia and severe breathing spasms appear. Most often at this moment the pupils dilate, and convulsions can distort the face.
5. Then the face turns blue. At the last stage of the disease, hallucinations with changes in mood and attacks of anger, which are very dangerous, are possible. During a rage, a sick person may even bite others.

It is worth knowing that there is “ silent rabies” , when a person’s disease can be practically asymptomatic, he does not show agitation. It is most often transmitted by the bite of humans by bats found in South America.

What to do if you are bitten by a rabid animal or a stray dog?

1. At the first symptoms of rabies, it is almost impossible to save a person. Therefore, if you are bitten by a forest or stray animal, or by an unvaccinated pet, you should immediately seek medical help.
2. If the rabid animal is domestic, then it must be tied up and isolated.

3. Before the ambulance arrives, wash the wound with water and laundry soap and cause profuse bleeding from the wound, as there is a possibility that the virus will come out of it in the blood (virus penetration is 3 mm per hour)
4. You cannot stitch the wound, treat it with alcohol, iodine, or any other antiseptic.

5. You should not drink alcohol after a bite.
6. Animals that have bitten people should be examined by a veterinarian.
7. If the animal is aggressive and there is no way to tie it up, then it is necessary, without touching it, to call the sanitary service through the rescue telephone number 112.

Prevention of rabies

In the prevention of rabies, a very important role is played by the owner's compliance with the rules for keeping pets. The very first thing you need to do when you decide to take an animal into your home is to find out if it is vaccinated against rabies.

Preventive vaccination using rabies vaccines for pets is mandatory in our country, and in any city or town, even a small one, they are required to do it free of charge in state veterinary clinics. The rabies vaccine is given at an early age.

Repeated vaccinations must be carried out every year.

If you suspect your pet has rabies, you should immediately take it to a veterinarian for examination and testing. If an animal is not vaccinated, then it should not be allowed to participate in exhibitions and livestock farms, or go hunting with it in the forest.

• If you want to sell, buy or transport dogs, you must obtain a veterinary certificate indicating that the animal was vaccinated against rabies no more than 11 months and no less than 30 days before the trip.
• If your pet has been bitten by wild animals or stray dogs, you must immediately report this to the veterinary services so that it can be examined by a doctor.
• The material was prepared with the participation of a veterinary paramedic
• Maria Pletnyova

Article updated 09.27.2019

Source: https://azbyka.ru/zdorovie/simptomy-beshenstva-u-zhivotnyx-i-cheloveka-kak-ne-zarazitsya

Rabies: symptoms in humans and animals

HomeVirus symptomsRabies: symptoms in humans and animals

Rabies is a particularly dangerous infectious disease caused by infection with the neutropic virus Rabiesvirus. Provokes the occurrence of encephalitis (inflammatory process of the brain) of a specific origin. When it enters a living organism, the virus spreads through the cells of the central nervous system, initiating the destruction of their structural integrity, followed by death. The pathology is characterized by a rapid course of the active phase, severe symptoms and a high risk of death.

Human infection occurs due to the bite of an infected animal. The evolutionary frequency of the disease depends on the site of infection and the severity of local damage. The disease itself is characterized by specific symptoms at all stages of development.

The etiology of the virus has not been thoroughly studied. There is handwritten evidence of the origin of the disease dating back to ancient times. At that time, the disease was called “hydrophobia” (hydrophobia) - ancient people noticed a panicky fear of water in infected animals. At that time, no effective drugs against rabies had been invented, so a person who was bitten was doomed to death in advance.

Rabies virus, routes of infection

The rabies virus is classified into the myxovirus group Lyssavirus, family Rhabdovtridae. It has the shape of a rifle bullet measuring up to 200 nm with single-stranded RNA. It is pathogenic for warm-blooded animals and humans. There are two types of virions: circulating (natural, dangerous to humans) and fixed (synthesized in the laboratory, harmless to humans).

The source of human infection can be dogs (up to 60%), cats, wild animals (up to 35%), wolves (3%), other animals (2%). There is a hypothesis of the original source of the rabies virion - rodents that did not die immediately after viral penetration.

An infected animal is infectious 10 days before the initial symptoms of rabies appear and continues to shed virion throughout the acute phase of the disease.

The rabies virion is concentrated in the salivary glands, and the active microbe is released through saliva. The probability of a person being infected by a sick animal through a bite is 95%, and through salivation it is 60%. The virion that causes rabies has a high tropism (organic attachment to a specific type of tissue) to nerve cells.

Initially, the microbe activates activity in the muscle fibers of the wound, then moves to the nerve endings. Through division and reproduction, the bacterium destroys the nervous system, forming Babes-Negri bodies in place of dead cells. Organic formations are specific inclusions of the cytoplasm at replication sites.

Convulsions and paralysis of an infected person are caused by the virus reaching the nervous system of the brain, followed by rapid destruction of life-supporting areas of the brain matter. At this stage, the patient cannot be cured; the patient falls into a coma and dies.

Why is the rabies virus dangerous?

• the microbe is resistant to low temperature changes and retains active vital functions when frozen;
• kept in animal corpses for up to 4 months;
• Any strong antibiotics, antibacterial drugs, or antiviral agents are powerless against rabies;
• moving through nerve cells, it causes inflammatory processes that destroy their structure.

The development and progression of rabies after a bite is directly related to the late date of the bitten person seeking medical help, violation of the vaccination regimen or complex course of therapy. The greatest prevalence of the pathogen is determined by the presence of people in rural areas near forest plantations.

Incubation time of illness

The incubation period for rabies lasts from 10 days to 4 months, most often the period is reduced to 1 month. In practice, cases of longer incubation periods have been recorded - from a year to 5 years.

The likelihood of disease progression depends on influencing factors: the type of infected animal, the number of virions entering the wound, the resistance of the immune system, the site of infection (the most susceptible are areas of the body with a cluster of nerve endings).

Symptoms of rabies in humans

Specific symptoms of the development of the disease are conventionally divided into several stages, distinguishable from each other by the characteristic signs and behavior of the patient.

Typical stages of development and symptoms of rabies in humans

1. Early (prodromal). Duration up to three days. Low-grade fever, absence or disturbance of sleep, apathy, depression, and restless behavior of the patient are observed. Painful symptoms are felt at the site of infection, even if the bite has healed.
2. Heat (aggression). Lasts up to 4 days.

   Sharp hypersensitivity to any external irritant - bright lighting, loud sound and noise. The patient is afraid of water, aggressive, experiences a wild feeling of fear, and shudders convulsively. During this period, hallucinations and delusional visions, inappropriate behavior and reactions of the patient, and increased salivation appear.

   Sometimes the patient freezes, begins to breathe heavily and look at one point with dilated pupils of the eyes.

3. Paralysis (rabies). Due to paralysis of the zygomatic and ocular muscles, the lower part of the jaw droops. The late stage is characterized by an unnatural appetite (the patient eats inedible and dangerous things).

   There is complete degradation of the patient as a conscious individual. Due to paralysis of the respiratory tract, suffocation occurs.

The total duration of the active phase of the disease ranges from 8 to 12 days.

However, atypical progression of the disease cannot be excluded - the absence of a prodromal stage or the onset of the disease from a paralytic period. In most atypical cases, the disease can only be diagnosed posthumously.

Diagnosis of rabies

Diagnosis of rabies symptoms is carried out by collecting and carefully analyzing the disease history of the affected person.

1. Of fundamental importance is the length of time between the incubation period and the appearance of visible signs at the time of infection. The patient is examined for the characteristic features of the wound, the depth of penetration of the animal’s teeth, and the degree of salivation.
2. The patient is visually diagnosed by the doctor based on the initial signs of the disease - whether the pupils are dilated, how the patient behaves, how he feels.
3. For microexamination, salivary gland cells are collected and laboratory mice are infected with them. The presence of rabies is determined by the rapidly developing signs of paralysis and death of rodents.
4. Since a specific study of the rabies virus is difficult to perform while the patient is alive in the acute stage of the disease, the final diagnosis is made after the death of the patient.

Symptoms of rabies in animals, how to tell if an animal is dangerous

The appearance of visible symptoms of the disease in pets is preceded by the appearance of a viral pathogen in the saliva.

Any pet becomes infectious about a week before the characteristic signs of rabies appear and remains dangerous throughout the entire period of the acute course of the disease.

Rabies in dogs

Dogs become infected by biting other dogs, dogs or cats. The standard incubation period for dogs is 3 to 7 days.

The prodromal stage begins with restless behavior of the dog. The animal develops an unusual appetite - eating completely inedible objects. The bark is howling with a hoarse tone. The dog tries to chew the bite, signs of excitement or excessive affection appear, and drooling is typical.

The excitation phase begins on the 2-3rd day of illness. It is accompanied by strange behavior of the animal - outbursts of aggression are abruptly replaced by an attack, the dog gnaws the ground, convulsive muscle contractions, vomiting and squint appear periodically.

The appearance of the stage of depression (paralysis) is determined by the following signs: the dog is exhausted, weakened. On the 4th day, paralysis and death of the animal occurs.

Rabies in cats

Infection of a furry pet occurs from the bites of sick rodents, dogs, hedgehogs and other cats. The latent period of incubation lasts from 10 days to 3 weeks, in kittens up to 7 days maximum.

Symptoms of rabies in cats develop over 3-10 days. In the initial period, the animal is lethargic, does not eat, and is very affectionate. Then fearfulness, restless behavior and causeless nervousness begin to develop. The cat bites and gnaws inedible things, looks around, tries to scratch the bite site. Nausea, vomiting, and loose stools cannot be ruled out. An attack of aggression can be caused by loud noise, knocking, or bright light.

On the 3rd day, the manic stage develops and lasts up to 5 days. Profuse salivation is replaced by spasms of the pharyngeal muscles. The cat cannot drink on its own and tries to attack and bite.

The duration of the depressive stage is no more than 2 days. The animal falls into apathy and does not move. The cat cannot meow, the lower jaw droops, the tongue falls out, and the cornea of ​​the eyes becomes cloudy. Numbness of the limbs and death of the animal occurs from paralysis of the respiratory muscles.

Immunity and prevention of rabies

Many people wonder whether it is worth getting a rabies vaccination at all? In practice, there has long been a free veterinary service - vaccination of animals against rabies. Annual use of the rabies vaccine for preventive purposes is the key to your health and the life of your pet.

The fundamental rules of preventive measures include annual universal vaccination of domestic animals and the introduction of quarantine when a source of infection is detected.

The only way to escape death is to prevent the appearance of visual manifestations of the disease. The rabies vaccine must be administered within 14 days of the animal being bitten. The most recommended form of vaccination is an injection of a specific immunoglobulin or active periodic immunization, after which alcohol consumption is strictly prohibited for up to six months.

From the moment of infection through a bite, modern vaccines are used no more than 6 times: on the first day of visiting a doctor, then on days 3, 7, 14, 30 and 90, respectively. The bitten animal is isolated and is under medical observation for 10 days. If the animal's behavior does not cause suspicion, vaccination of the victim is stopped.

Registered foci of rabies in Russia of natural etiology

1. Volga region (western and central regions). In 72% of cases, the source of infection is foxes. Spread by wolves, raccoons and badgers.
2. Polar region (Arctic circulation). The virus is spreading among Arctic foxes.
3. Urban hotspots.

   The virus is popularized among dogs; cats and farm animals are the most common sources of infection.

Infecting a person with rabies is like playing with death, not today and not tomorrow. But no luck. If you are bitten by an animal, you cannot think that everything will heal and be fine.

 Remember, immediately seek medical help before 14 days after the bite has passed - there is a 99% chance of survival even if infected with the rabies virion.

Source: https://virus-proch.ru/simptomy-virusov/beshenstvo-simptomy/

Myths about rabies: how you can and cannot get infected - Ask a Doctor

The article was checked by doctor Victoria Druzhikina

Neurologist, Therapist

Over the past 2 decades, the number of cases of referrals to infectious disease specialists with phobias associated with the fear of contracting rabies has increased significantly. Panic often conjures up the most incredible ways. However, there are clear criteria that determine the risks of the disease.

Rabies - why is everyone afraid of it?

Everyone knows that rabies is a terrible disease that cannot be treated, and can be contracted through the bite of a sick animal.

Most often, the source of the virus is foxes, less often dogs, cats, hedgehogs, bats, horses, birds and other animals that contain the pathogen in their saliva. There is no cure for the disease and the outcome is always fatal.

Every year, cases of rabies are recorded in different areas. How does a person become infected with rabies?

• when bitten by a sick animal;
• when saliva gets on mucous membranes or damaged skin.

In this case, it is necessary that the wound has damaged the skin until it bleeds. The only way to protect against the disease is vaccination. In case of even minimal risk, you need to go to the emergency room as early as possible.

Symptoms and signs of infection

The typical form includes the stage of initial manifestations with headaches, nausea, vomiting, and pain at the site of the bite. Then aggression, fear of hydrophobia, convulsions and spasms appear. After this, the patient dies from cardiac or respiratory arrest.  

There are atypical forms that occur without paralysis and hydrophobia; patients are quiet and apathetic. In children, all stages usually pass in 3–5 days, i.e. the duration of illness is shortened.

When and how to get vaccinated against rabies

There are special rules establishing the rules for vaccination. Vaccinations are given in the following cases:

• compression when biting open areas of the skin, minor scratches or abrasions without bleeding;
• one or more bites that penetrate the skin or scratches;
• licking damaged skin;
• wounds caused by birds' beaks;
• damage to the skin by claws;
• contamination of mucous membranes with saliva.

In all cases, except the first, a special immunoglobulin is first introduced, then a course of vaccinations begins.

For vaccination, vaccines of different names, but identical in composition, are used, usually “KOKAV”. The standard regimen is used, injections are given on days 1, 3, 7, 14, 30 and 90 from treatment. Sometimes changes may be made at the discretion of the doctor.

During the vaccination period, you should not drink alcohol-containing liquids - they reduce the immune defense against rabies, increase the likelihood of allergies, and put a strain on the liver. A sick animal dies in a short time - up to 10 days.

If the bitten animal is domestic and does not look suspicious, and its owner claims that it has been vaccinated, then it will be monitored for 10 days.

In the event of his sudden death, they begin a course of vaccinations; if everything is fine with the pet, then vaccination is not required, because he is healthy.

  If vaccination has begun and the animal is alive after 10 days, the course of vaccination can be interrupted.

According to WHO, vaccination is not necessary in the following cases:

• touching an animal or feeding it;
• animals licking intact skin;
• contact of intact skin with secretions of rabid animals or humans.

Vaccinations are not carried out only in the case of truly confirmed facts of absence of damage to the skin. However, prevention is extremely important, so often such contacts with an animal suspected of rabies are regarded as a threat of possible infection, and vaccination is carried out.

Myths about rabies

The terrible disease has become overgrown with various rumors and beliefs:

1. The larger the animal, the greater the danger. It makes no difference who bites - a wolf or a cat, the point is one thing - the virus must get into the blood.
2. All people with rabies are afraid of water. This is not so - such fear develops in less than half of the cases.
3. You can become infected if the saliva of a sick animal gets on your skin with the wind. No you can not.
4. If an animal's saliva gets on things and dries, then you can become infected by touching the area with your hand. This is not possible, the virus dies when it dries out, but persists for a long time in corpses at subzero temperatures.
5. Rabies can be contracted through food. No, the virus is not transmitted by consuming milk or cooked meat from sick animals.  
6. The disease is transmitted by bat bites. Yes, this is true, but it is only relevant for vampire mice living in South Africa.

When to see a doctor

In all doubtful cases, you need to wash the wound, treat it with peroxide and immediately go to the nearest emergency room. The surgeon will examine the wound surface and decide whether there is an indication for vaccination or not. You can’t take risks – we are talking about a threat to life.  

Source: https://sprosivracha.com/articles/news/146-mify-o-beshenstve-kak-mozhno-i-nelzya-zarazitsya

Rabies

Epidemiology of rabies

Cases of the disease are observed in all countries of the world, with the exception of Australia. Every year, more than 50,000 people die from rabies worldwide. However, about 95% of deaths occur in Africa and Asia.

In the epidemiology of rabies, two types of foci are distinguished:

- Urban type. It is formed by farm animals, cats and dogs.

— A hotbed formed by wild animals (bats, skunk, arctic fox, jackal, raccoon dog, fox, wolf).

In humans, the disease usually develops as a result of a bite from a sick dog. It is most often observed in children and adolescents.

In humans, infection with the rabies virus always leads to death if clinical symptoms develop. Therefore, it is so important in the event of a bite or contact with an infected (or possibly infected) animal to begin urgent vaccination, which will prevent the development of the disease and the death of the patient.

Ways of transmission of rabies

Neuroryctes rabid is a virus that causes rabies and belongs to the myxoviruses of the family Rhabdoviridae. It is found in the urine, tear fluid and saliva of sick and infected people.

This virus is very unstable in the external environment. When heated to 56 degrees C, it dies in a quarter of an hour, and when boiled in two minutes. Very sensitive to ethanol and other disinfectants and sunlight. However, it is quite resistant to antibiotics, phenol and low temperatures.

The route of transmission of rabies is associated with the bite or contact of saliva of a sick animal with the skin or mucous membranes. The virus is capable of infecting all types of mammals. But the most sensitive to it are representatives of the canine family (foxes, dogs, wolves).

An infected animal becomes dangerous to others already 7–10 days before the first symptoms of rabies appear. During this period, it begins to release the virus into the environment, infecting other animals and humans that come into contact with it.

Therefore, even if you are suddenly, for example, bitten by a dog that at first glance does not have any symptoms of this terrible disease, you should definitely consult a doctor and, if necessary, undergo emergency rabies prophylaxis.

• Currently, other routes of transmission of rabies are described in the literature:
• — Nutritional (through food and drink);
• — Airborne;

— Through the placenta (transplacental). In this case, the disease is transmitted from mother to fetus.

There are very large discussions among specialists about the possible route of transmission of rabies associated with organ transplantation, as well as transfusion of blood and its components.

Pathogenesis of rabies

Rabies infection most often occurs as a result of the saliva of a sick animal coming into contact with damaged skin (wounds, abrasions, scratches) or mucous membranes, as well as through bites.

In this case, the virus contained in saliva quickly attaches to the ends of nerve fibers and then penetrates them.

After this, it begins to gradually ascend along the nerve fibers to the brain and spinal cord.

Thus, the pathogenesis of rabies is quite complex and lengthy.

Clinical picture of rabies

The duration of the incubation period is largely determined by the depth of the bite and its location. The closer the bite was to the head, the shorter the incubation period.

The patient is contagious to others from the first day of the incubation period until his death.

There are several periods in the clinical picture of rabies:

1. Stage of depression or initial. Pain and a burning sensation appear in the area of ​​the bite (although in most cases the wound has completely healed by this time). In some cases, the scar becomes inflamed, red and swollen.

If the bites were inflicted on the face and/or neck, visual and olfactory hallucinations may occur. Body temperature rises slightly (up to 37.0 - 3.5 degrees C).

At the same time, the first signs of mental disorders begin to appear: depression, melancholy, anxiety, inexplicable and incomprehensible fear. Increased irritability is observed much less frequently in patients.

Patients become apathetic, withdrawn, refuse to eat, and complain of poor sleep, which is accompanied by nightmares. This stage lasts from one to three days. After which depression and apathy begin to give way to anxiety. Patients experience increased shortness of breath and tachycardia (rapid heartbeat).

2. Stage of excitement. At this time, the most striking symptom of the disease is the appearance of hydrophobia, i.e. hydrophobia. When trying to drink liquid, the patient experiences a pronounced spasm of the auxiliary respiratory muscles and pharyngeal muscles.

The intensity of this symptom quickly increases and after some time a convulsive spasm occurs even at the mention of water. In addition, an attack of convulsions can be triggered by a breeze, a slight draft (aerophobia), a loud sound (acousticophobia) or bright light (photophobia).

Tachycardia increases, increased sweating and drooling (sialorrhea) appear. At the height of an attack of excitement, patients become aggressive and furious. They may lash out at people around them and cause injury. Their consciousness at this moment is darkened, they experience frightening visual and auditory hallucinations.

During an attack, death may occur as a result of cardiac and respiratory arrest. If death does not occur, the duration of the excitation stage is three days.

But actually it is not! Unfortunately, all these are signs of death in the very near future. Body temperature rises steadily and reaches 41 - 42 degrees C. The duration of this stage does not exceed 24 hours.

Death occurs from paralysis of the respiratory and vascular-motor centers.

Thus, the total duration of the clinical stage of rabies does not exceed 5–7 days.

Diagnostics

The diagnosis of “Rabies” is made in most cases by doctors based on the characteristic clinical picture and medical history. Not so long ago, even in developed countries, intravital laboratory diagnosis of the disease was impossible. The final diagnosis was established only after the death of the patient based on the results of the autopsy (detection of Negri bodies in the brain).

Only in 2008, an international team of scientists from the Pasteur Institute, led by Dr. Laurent Dacheux, proposed a unique method for intravital diagnosis of rabies. It is based on the detection of L-polymerase inherent in the rabies virus in a skin biopsy using a reverse transcriptase nested polymerase reaction.

To conduct the study, small sections of skin (biopsy samples) are taken from the posterior-superior surface of the neck. This diagnostic method has shown high sensitivity and specificity.

Moreover, a positive and reliable result can be obtained from the very first day of the disease until death from it.

Currently, experts recommend PCR diagnosis of rabies for all patients with encephalitis (inflammation of the brain), the cause of which is unknown.

Treatment of rabies

Once clinical symptoms of rabies appear, there is no effective treatment for patients. In this case, symptomatic therapy is carried out, aimed at eliminating signs of the disease and alleviating the condition of patients. In cases of severe agitation and convulsions, administration of muscle relaxants and transfer of the patient to long-term artificial ventilation are indicated.

Therefore, in the event of a bite from an unknown, sick or suspicious animal, emergency vaccination should be started as soon as possible. Moreover, it is effective only if it is started within 14 days from the moment of the bite.

Vaccinations can be carried out according to conditional (the bite was inflicted by a domestic animal that has no signs of disease and which can be monitored for ten days) and unconditional (lack of information about the animal, bite from a clearly unhealthy animal) indications.

In cases where it can be assumed that the patient has a short incubation period (bites were inflicted on the face or neck, extensive injuries), active-passive immunization is indicated. To do this, victims are given not only the rabies vaccine, but also rabies immunoglobulin.

After vaccination, immunity to rabies is formed, which lasts for twelve months.

Rabies prevention measures

 Considering the danger of this disease, great attention should be paid to its prevention. Measures to prevent rabies primarily include active control of sources of infection. These include:

1. — Control of infection of wild animal populations;
2. — Carrying out routine vaccination of domestic animals against rabies;
3. — Careful adherence to the rules for keeping pets;
4. — Vaccination of people exposed to the rabies virus, such as laboratory workers.

Rabies prevention measures also include rules for wound treatment. It should be washed well with laundry soap under running water. After this, its edges are treated with iodine.

A sterile dressing is applied. If the wound does not pose a threat to life, then excision of its edges and suturing is carried out no earlier than three days from the bite.

Vaccination against rabies is mandatory.

Source: http://promedicinu.ru/diseases/bieshienstvo

Rabies

Rabies is an infectious zoonosis of viral etiology, characterized by predominantly severe damage to the central nervous system, which can lead to death. A person becomes infected with rabies through an animal bite. Spreading along nerve fibers, the rabies virus first increases their excitability and then causes the development of paralysis. Penetrating into the tissues of the spinal cord and brain, the virus causes severe disturbances in the functioning of the central nervous system, clinically manifested by various phobias, attacks of aggressive agitation, and hallucinatory syndrome. Rabies remains an incurable disease. For this reason, it is difficult to overestimate the importance of preventive rabies vaccination given to the patient in the event of an animal bite.

Rabies is an infectious zoonosis of viral etiology, characterized by predominantly severe damage to the central nervous system, which can lead to death. A person becomes infected with rabies through an animal bite.

Rabies is caused by an RNA-containing rhabdovirus, which is bullet-shaped and has two specific antigens: soluble AgS and surface AgV&.

During the replication process, the virus promotes the appearance of specific inclusions in neurons - eosinophilic Babes-Negri bodies.

The rabies virus is quite resistant to cooling and freezing, but is easily inactivated by boiling, exposure to ultraviolet radiation, and disinfection with various chemical reagents (Lysol, chloramine, carboxylic acid, sublimate, etc.).

The reservoir and source of rabies are carnivores (dogs, wolves, cats, some rodents, horses and livestock). Animals excrete the virus in saliva, the contagious period begins 8-10 days before the development of clinical signs. Sick people are not a significant source of infection.

Rabies is transmitted parenterally, usually when a person is bitten by a sick animal (saliva containing the pathogen enters the wound and the virus penetrates the vascular bed). Currently, there is evidence of the possibility of aerogenic, alimentary and transplacental routes of infection.

Humans have limited natural susceptibility to rabies; the likelihood of developing infection if infected depends on the location of the bite and the depth of the injury and ranges from 23% of cases for bites of the extremities (proximal parts) to 90% for bites to the face and neck.

In a third of cases, infection occurs through the bite of wild animals; in other cases, domestic animals and livestock are responsible for human rabies.

If you seek medical help in a timely manner and carry out preventive measures, rabies will not develop in infected individuals.

The rabies virus enters the body through damaged skin and spreads along the fibers of nerve cells, to which it has a pronounced tropism. In addition, the virus can spread throughout the body through the blood and lymph.

The main role in the pathogenesis of the disease is played by the ability of the virus to bind acetylcholine receptors of nerve cells and increase reflex excitability, and subsequently cause paralysis. Penetration of the virus into the cells of the brain and spinal cord leads to gross organic and functional disorders of the central nervous system.

Patients develop hemorrhages and swelling of the brain, necrosis and degeneration of its tissue.

Pathological degeneration of cells leads to functional disorders of organs and systems due to impaired innervation. From the central nervous system, the virus spreads to other organs and tissues (lungs, kidneys, liver and endocrine glands, etc.).

Its entry into the salivary glands leads to the release of the pathogen in saliva.

The incubation period for rabies can range from a couple of weeks when the bite is localized on the face or neck to several months (1-3) when the pathogen is introduced into the extremities. In rare cases, the incubation period lasted up to a year.

Rabies occurs in a succession of three periods. In the initial period (depression), there is a gradual change in the patient’s behavior. In rare cases, depression is preceded by general malaise, low-grade fever, pain in the area of ​​infection (usually a wound that has already healed at the onset of the disease).

Sometimes (extremely rarely) the site of entry of the pathogen becomes inflamed again. Typically, during this period, the clinic is limited to manifestations of the central nervous system (headaches, sleep disorders, loss of appetite) and the psyche (apathy, depression, irritability, depression and attacks of fear).

Sometimes patients may feel chest discomfort (tightness) and suffer from indigestion (usually constipation).

The height of the disease (excitement stage) occurs 2-3 days after the first signs of depression appear, and is characterized by the development of various phobias: fear of water, air, sounds and light. Hydrophobia - fear of water - prevents patients from drinking.

Characteristic behavior is when a glass of water is offered, the patient happily takes it, but an attempt to drink the liquid causes an attack of paralyzing fear, a pause in breathing, and the patient throws the glass. However, rabies is not always accompanied by hydrophobia, which can make diagnosis difficult.

Aerophobia is characterized by attacks of suffocation due to air movement; with acoustophobia and photophobia, such a reaction is observed to noise and bright light.

Attacks of suffocation are short-lived (a few seconds), they are accompanied by spasms and convulsions of the facial muscles, the pupils are dilated, patients are excited, experience panic, scream, throw their heads back. There is trembling of the hands. Breathing during paroxysms is intermittent, whistling, and inhalations are noisy.

The muscles of the shoulder girdle are involved in breathing. During this period, patients are in an aggressive, excited state, scream a lot, and are prone to unsystematic aggressive activity (they rush around, they can hit or bite). Hypersalivation is characteristic.

As the disease progresses, attacks of agitation become more frequent. There is weight loss, excessive sweating, and hallucinations (auditory, visual and olfactory). The duration of the excitation period is 2-3 days, less often it extends to 6 days.

The terminal stage of the disease is paralytic. During this period, patients become apathetic, their movements are limited, and sensitivity is reduced.

Due to the subsidence of phobic paroxysms, a false impression arises that the patient has become better, but at this time the body temperature quickly rises, tachycardia and arterial hypotension develop, and paralysis of the limbs and, subsequently, of the cranial nerves occurs.

Damage to the respiratory and vasomotor centers causes cardiac and respiratory arrest and death. The paralytic period can last from one to three days.

Diagnosis is mainly carried out on the basis of the clinical picture and epidemiological history data. Diagnostic methods that are intravital in nature also include bioassays on laboratory animals (newborn mice).

When they are infected with a virus isolated from saliva, cerebrospinal fluid or tear fluid, mice die after 6-7 days.

Histological analysis of the brain tissue of a deceased patient makes it possible to definitively confirm the diagnosis if Babes-Negri bodies are detected in the cells.

Currently, rabies is an incurable disease; therapeutic measures are palliative in nature and aimed at alleviating the patient’s condition.

Patients are hospitalized in a darkened, soundproofed room, they are prescribed symptomatic drugs: sleeping pills and anticonvulsants, painkillers, tranquilizers.

Nutrition and rehydration measures are carried out parenterally.

Now there is active testing of new treatment regimens using specific immunoglobulins, immunomodulators, cerebral hypothermia and intensive care techniques. However, rabies is still a fatal disease: death occurs in 100% of cases of clinical symptoms.

Rabies prevention is primarily aimed at reducing morbidity among animals and limiting the likelihood of stray and wild animals biting humans.

A year later, revaccination is carried out and in the future, if the risk of infection remains high, repeat immunization is recommended every three years.

In the event of an animal bite, a set of measures must be taken to prevent rabies: the wound is washed with medical alcohol, treated with antiseptics, an aseptic bandage is applied, after which you should immediately contact a trauma center (or a surgeon or paramedic at the FAP). A course of preventive rabies vaccination (dry inactivated vaccine) and passive immunization (rabies immunoglobulin) is carried out as soon as possible. The schedule of preventive injections depends on the location of the bite, the depth of the wound and the degree of contamination with saliva.

Source: https://www.KrasotaiMedicina.ru/diseases/infectious/rabies