World Rabies Day, you need to know about rabies with a fatality rate of 100%!

About Rabies Day

World Rabies Day began in 2007 as the most significant event
on the global rabies calendar initiated and coordinated by the Global Rabies Control Alliance (GARC).

28 September 2022 is the 16th World Rabies Day and the theme of this year's World Rabies Day campaign is "One Health, Zero Deaths"
.

rabies

Rabies is a highly lethal infectious disease caused by rabies virus (RABV), once infected almost 100% of the people die, so far there is no drug that can cure rabies, the only safe and effective way is pre-exposure immunization or post-exposure prophylaxis before the onset of the disease, including wound rinsing, disinfection treatment, rabies vaccination, and the selection of rabies immunoglobulin preparations
according to the severity of the wound.

Rabies, also known as "water phobia" and "mad dog disease", is a zoonotic infectious disease caused by rabies virus, which is clinically manifested as a characteristic fear of water, fear of wind, fear of light, fear of restlessness, pharyngeal muscle spasms, progressive paralysis and other symptoms
.

Biological properties of the rabies virus

Rabies viruses belong to the rabies virus genus of the family Bullet Viruses of the order Bulbophyllum macroviridae
.

What animals can infect rabies

Dogs are the main source of rabies infection in China, followed by cats, and the two together account for more than 95% of the source of infection; Wild carnivores also have the risk of rabies transmission: weasel, red fox, raccoon, and wolf are important sources of wildlife infection in China; Bats can also transmit rabies, but are rare
in our country.

Livestock such as cattle, sheep, horses, pigs and rodents such as rabbits and rats have a low
risk of bites.

Birds, fish, insects, lizards, turtles, snakes, etc.

Pathogenesis of rabies (Deep reading video)

Animals infected with rabies virus have the virus in their saliva, lick your paws, and the virus
may also be on your paws.

If you are accidentally scratched or bitten by an animal infected with rabies, the virus will enter the human body through the broken mucous membranes and skin to complete the transmission
.

If there is a wound on the body, it is best to stay away from cats, dogs and dogs, once the wound is exposed to the virus, the virus can enter the human body through the broken skin!

As soon as the rabies virus enters the human body, it is addicted to two things: one is replication, and the other is to go to the central nervous system composed of brain and spinal cord to do things
.

When this product first enters the wound, it will honestly stay in the muscle cells near the wound and quietly replicate
a small amount of Mimi.

After a few days of replication, the rabies virus will migrate
along the nerves in the direction of the central nervous system.

Stop at a place in the spinal cord called the dorsal root ganglion and take a short break while starting to replicate
wildly.

The rabies virus then travels with a large population along the spinal cord to the brain
.

The brain seems to be the paradise world of the rabies virus, and the rabies virus here gives birth to a baby, a baby, a copy
.

Brain nerve cells are tortured by this large number of viruses, injured and dead
.

After the rabies virus enters the human body, the immune system then opens the pursuit of the rabies virus, because the rabies virus moves along the nerve throughout the process, the nerve can become a battlefield, under the fire of the immune system, nerve cells are killed and injured
.

By the time the rabies virus travels to the spinal cord and brain, the numbers are already large
.

In this way, the spinal cord and brain have withstood the fiercest shelling of the immune system, and the degree of damage has been the most severe
.

The spinal cord and the brain are the decision-making centers of all human movements and thoughts, and when they go wrong, everything is messed
up.

Because of problems with the nervous system, the human body is prone to extreme states, both extremely hyperactive and extremely depressed
.

Common states of extreme hyperactivity include fear, anxiety, agitation, irritability, nervousness, or insomnia; Muscle spasms throughout the body, sweating, drooling, increased heart rate, or increased
blood pressure.

Common extreme depressions include paralysis, eye movements, jaw dropping, or expressionlessness
.

As the disease progresses, the nervous system collapses under the dual torment of the virus and the immune system
.

Patients will gradually develop a weakened respiratory heartbeat, decreased blood pressure, and dilated pupils until they are comatose, have respiratory arrest, and eventually die
.

Clinical manifestations of different stages of rabies

From infection to morbidity, rabies will go through four stages: incubation period, prodromal phase, acute neurological symptom stage, and paralysis period, and different stages will have different clinical manifestations
.
But not every patient goes through all stages
.

01 Incubation period

The period from infection to the onset of illness without any symptoms is mostly 1 to 3 months, and
rarely within a week or more.

02 Precursor period

Usually 2-10 days, usually with atypical symptoms such as malaise, anorexia, fatigue, headache and fever, unwarranted fear, anxiety, agitation, irritability, nervousness, insomnia, or depression
.
Some patients experience specific neuropathic pain or paresthesias at the site of injury, such as itching, numbness, or the sensation
of ants crawling by.

03 Acute neurological symptom phase (excitatory phase)

Generally lasting 1 to 3 days, patients will develop typical clinical symptoms of rabies, divided into manic and paralyzing types
.
Manic type manifests as fever with hyperactivity, disorientation, hallucinations, spasmodic seizures, eccentricity, and neck rigidity
.
Prominent manifestations include extreme fear, water phobia, fear of wind, severe choking, difficulty swallowing, difficulty breathing, difficulty urinating, and sweating and salivating; Patients with paralytic type do not have the typical excitatory phase and hydrophobia
.

04 Paralysis period

Generally lasts 6-18 hours
.
After the acute neurological symptom period, the patient gradually enters a quiet state, at which time the spasm stops, the patient gradually becomes quiet, and flaccid paralysis occurs, especially limb paralysis
.
The patient's breathing becomes weaker or irregular; Gradual decrease in blood pressure, loss of reflexes, and dilation of the
pupils.

Most patients go into a coma before death, and respiratory arrest usually occurs
shortly after coma.
Patients often die
of respiratory and heart failure 7 to 10 days after the first clinical onset of clinical symptoms.

What to do after being bitten by a dog

There is evidence that more than 99% of patients survive
even in the absence of rabies passive immunization preparations, with effective wound cleaning plus immediate rabies vaccination and completion of post-exposure prophylaxis procedures.

1.
Wound rinsing and cleaning

If the wound is mild, all bites can be washed alternately with soapy water (or other weakly alkaline cleaning agent) and flowing water of a certain pressure for about 15 minutes; The wound is then rinsed with normal saline to avoid residual soapy water or other cleaning agents
at the wound.

2.
Disinfection treatment

After thorough rinsing, rubbing or cleaning the inside of the wound with dilute iodophor or other medical preparations with the ability to inactivate the virus, it is possible to inactivate the rabies virus
that remains locally in the wound.

Classification and management of rabies exposure levels

Judged by rabies exposure rating:

Level 1 exposure

Touch/feed the animal, the skin is intact and not injured
.

No processing is required

Secondary exposure

Bare skin is lightly scratched or bruised by light bites, and the skin is broken but no bleeding
.

Treat the wound immediately and get vaccinated

Tertiary exposure

Single/multiple penetrating skin bites or scratches accompanied by bleeding broken skin being licked; Contact with bats; Mucosal passive object fluid contamination
.

The wound is treated immediately and a passive immune preparation is injected, followed by vaccination

Rabies vaccination

The rabies vaccine immunization program mainly has two kinds of "2-1-1" 4-needle method and 5-needle method, and the two immunization effects are the same
.

4-dose method: 2 doses on 0 days after rabies virus exposure, 1 dose each on days 7 and 21
.

5-dose method: 1 dose each 0, 3, 7, 14, and 28 days after rabies
virus exposure.

Experts remind: If the vaccine is not given on time, such as 1 day or a few days late, the next injection will be postponed accordingly, and the interval between vaccinations will remain unchanged
.

Rabies post-exposure disposal procedures

Other things to know about rabies

1.
If I am bitten by a dog, can I suck the bite with my mouth?

A: After being bitten by a dog or cat, you cannot use your mouth to suck
on the wound.

2.
Rabies incubation period

A: The incubation period of rabies is generally 1-3 months, which can be as short as one week and as long as one year
.
Onset of disease over a year is very rare
.

3.
Is it okay if the skin is not broken?

A: In principle, if you are bitten, you should be vaccinated, and the probability of infection will be relatively small
without biting through the skin.
But whether the skin is broken, can not only rely on the naked eye to judge, it is best to wipe it with alcohol immediately, if you feel the sting, indicating that the skin is broken, it is best to go to the hospital for vaccination
.
It should be reminded that if the skin itself has a wound, after being licked by cats and dogs, it is also possible to be infected, and it is best to go to the hospital for vaccination
.

4.
Is face injury more dangerous?

A: If it is a face or other area with a dense distribution of nerves, and it is bitten by an animal with rabies, the incubation period is shorter and the onset of the disease is faster
.
So when you can't be sure whether your cat or dog is healthy, don't rub them with your
face.
If you really encounter a mad dog bite, try to protect your head and face
.

5.
After being vaccinated, do you still have to be hit if you are bitten again?

A: After the whole process of vaccination against rabies, that is, 4 injections or 5 injections (according to the procedure of your own vaccination, whether it is 4 stitches or 5 stitches),

Within 6 months of full immunization: rabies vaccination
is generally not required.

6 months to one year after full immunization: 1 dose
each on the 0th and 3rd days of re-exposure.

Within 1 to 3 years after full immunization: 1 dose
each on the 0th, 3rd and 7th days of re-exposure.

3 years: If you are bitten again, you need to follow the complete immunization process
.

6.
What do I need to pay attention to after vaccination?

A: After receiving the rabies vaccine, you should pay attention to avoid eating spicy and irritating foods in your diet, and do not exercise vigorously and do not stay up late to prevent excessive fatigue
.

7.
If the vaccine is not finished, is there a preventive effect?

A: As long as you have been vaccinated against rabies, you can play a certain preventive effect, but it is not as good as
the protection effect produced by the whole vaccination.

8.
Can pregnant women get rabies vaccine?

A: Because of the high mortality rate of rabies, the rabies vaccine is almost no contraindications, the earlier the vaccination, the better the effect, try to use the same brand of vaccine, all the population can be shot
.
The Guidelines state that the rabies vaccine for pregnant women is safe and does not affect
the fetus.
Even during pregnancy, if bitten by a suspected sick cat or dog, rabies vaccine and immunopassive preparations should be given
.

9.
Can I get rabies vaccination in advance?

A: People who have regular contact with animals, such as veterinarians, or who are going to the field in the near future, can get rabies vaccine in advance for prevention
.

10.
Do only dogs carry the rabies virus?

A: It's not just dogs that carry the rabies virus; Animals that are susceptible to rabies virus mainly include wild animals such as dogs, cats, foxes, weasels and bats, while birds, fish, insects, lizards, turtles and snakes do not infect and transmit rabies viruses
.

In addition, domestic hamsters, rabbits and other pets do not carry rabies virus, and do not need to be vaccinated against rabies
after being bitten.
Rabies vaccination
is recommended if bitten by a wild hamster rabbit.

Misconceptions about rabies

How to correctly understand the misunderstandings of rabies, eliminate these misunderstandings, and correctly understand rabies can help control the spread
of rabies.

Only dogs can carry the rabies virus?

Wrong! Dogs are the main source of rabies infection in China, accounting for about 95%, followed by cats
.
Weasel, red fox, raccoon and wolf are important wild rabies hosts and sources of
infection in China.

Rabies virus incubation period of 20 years?

Wrong! Most have an incubation period of 1-3 months, but some are less than 1 week and more than 1 year
.
The scientifically proven maximum incubation period is 6 years
.

Only being bitten gets sick?

Wrong! Dogs suspected of carrying rabies virus are likely to become infected
by scratching, biting, licking/mucous membranes, or bare wounds.

Is the rabies vaccine only effective if it is injected within 24 hours of being bitten?

Wrong! There is no such thing as
24 hours, 72 hours.
As long as the disease has not yet occurred, the vaccine has a role, the sooner the better, as soon as possible to deal with
.

Will you get rabies after being scratched and bitten by a dog?

Wrong! There is no definite answer to this question, and it needs to be looked at in different situations:

If it is determined that it is a healthy dog that does not carry the virus, there is no need to worry;

If it is not possible to determine whether the dog carries the rabies virus, it should be considered whether it is infected;

If it is general feeding and contact, there is no skin damage, no treatment is required;

If skin damage occurs when bitten by rabid dogs or suspected dogs, precautions must be taken in a timely manner