Hello.
A little over a year ago, I had to deal with such an unpleasant thing as a suspicion of rabies infection. read yesterday reminded me of that case - especially the lack of mention of rabies in it, although it is an extremely widespread (especially in Russia, Asia, Africa and America) and a very insidious virus. Unfortunately, the risks associated with it are not always given due importance.
So what is rabies? This incurable a viral disease that is transmitted through the saliva or blood of infected animals and humans. In the vast majority of cases, the bite of an animal that carries the virus leads to infection.
What can the average resident of Russia say offhand about rabies? Well, there is such a disease. In connection with it, rabid dogs are most often remembered. The older generation will most likely add that in the event of a bite from such a dog, you will have to make 40 injections in the stomach and forget about alcohol for several months. That, perhaps, is all.
Surprisingly, not everyone knows that rabies is a 100% fatal disease. If the virus enters your body in one way or another, the “countdown” starts: gradually multiplying and spreading, the virus moves along the nerve fibers to the spinal cord and brain. His “journey” can last from several days or weeks to several months - the closer the bite to the head, the less time you have. All this time you will feel completely normal, but if you let the virus get to its target, you are doomed. When this happens, you will not yet feel the symptoms of the disease, but you will already become its carrier: the virus will appear in the body's secretions. After that, rabies becomes possible to detect by analysis, but it is too late to treat it at this stage. As the virus multiplies in the brain, the first harmless first symptoms begin to appear, which develop into rapidly progressive inflammation of the brain and paralysis within a few days. The outcome is always the same - death.
Treating rabies is literally a race against death. The disease will not develop only if, before the virus enters the brain, the rabies vaccine has time to be applied and given time to act. This vaccine is an inactivated (dead) rabies virus that is injected into the body to "teach" the immune system to fight the active virus. Unfortunately, this "learning" takes time to develop antibodies, while the virus continues to make its way to your brain. It is believed that it is not too late to apply the vaccine up to 14 days after the bite - but it is better to do this as soon as possible, preferably on the very first day. If you asked for help in a timely manner and you were given a vaccine, the body will form an immune response and destroy the virus “on the march”. If you hesitated and the virus managed to penetrate the brain before the formation of an immune response, you can look after yourself a place in the cemetery. The further development of the disease will no longer be stopped.
As you can see, this disease is extremely serious - and all the more strange are the myths that exist in Russia on this topic.
Myth number 1: Only dogs carry rabies. Sometimes cats and (more rarely) foxes are also named as possible peddlers.
The sad reality is that the carriers of rabies, in addition to those named, can be many other animals (more precisely, mammals and some birds) - raccoons, cattle, rats, bats, roosters, jackals, and even squirrels or hedgehogs.
Myth number 2: a rabid animal is easy to distinguish by inappropriate behavior (the animal moves strangely, it saliva flows, it rushes at people).
Unfortunately, this is not always true. The incubation period of rabies is quite long, and the saliva of the carrier of the infection becomes contagious 3-5 days before the onset of the first symptoms. In addition, rabies can occur in a "silent" form, and the animal often loses fear and goes out to people without outwardly showing any threatening symptoms. Therefore, when bitten by any wild or simply unknown animal (even if it looked healthy), the only correct action is to consult a doctor as soon as possible, preferably on the very first day, to administer an anti-rabies vaccine.
Myth number 3: if the bite wound is small, it is enough to simply wash it with soap and disinfect.
Perhaps the most dangerous misconception. The rabies virus, indeed, does not tolerate contact with alkaline solutions - but in order to penetrate into the tissues of the body, any damage to the skin is enough for it. There is no way to know if he managed to do this before washing the wound.
Myth number 4: the doctor will definitely prescribe you 40 painful injections in the stomach, and you will have to go to these injections every day.
It really was so, but in the last century. Current rabies vaccines require 4 to 6 shots in the upper arm, a few days apart, plus an optional second shot at the site of the bite.
In addition, a doctor (infectious disease specialist or rabiologist) may decide on the inappropriateness of vaccination, based on the circumstances of the bite and the local epidemiological situation (it is estimated what kind of animal it was, whether it was domestic or wild, where and how everything happened, whether cases of rabies, etc.).
Myth number 5: The rabies vaccine has many side effects and can even kill you.
There are indeed side effects of this type of vaccine - this is the main reason why rabies is most often vaccinated not prophylactically, but only in case of a risk of infection. These "side effects" are quite unpleasant, but most often they are not very long, and enduring them is not such a big price to pay to stay alive. It is impossible to die from the vaccinations themselves, but if, after being bitten by a suspicious animal, they are not given or the re-vaccination is skipped, then it is very possible to die from rabies.
Myth number 6: if you catch or kill an animal that has bitten you, then you do not need to be vaccinated, because doctors can do an analysis and find out if it was sick with rabies.
This is only half true. If the animal is caught and does not show signs of rabies, it can be quarantined, but this will not save you from vaccination. Doctors can decide to stop it only if the animal does not get sick and does not die within 10 days - but here such a trap as atypical rabies may lie in wait for you. This is when a sick animal lives much longer than those same 10 days - and all this time it is a carrier of the virus, without showing external symptoms of the disease. Comments are superfluous. However, it should be noted that according to statistics, atypical rabies is extremely rare - but it’s still better to complete the vaccination course that has been started than to get into those very statistics and prove later in the next world that a tragic coincidence has occurred.
In the case when the animal is killed on the spot or caught and euthanized - such an analysis is possible through the study of brain sections, but how long it will be done (and whether it will be) depends very much on where it all happened and where you turned for help. . In most cases, it is safer to start a vaccination course immediately and stop if rabies is not confirmed by a laboratory test.
If the animal that bit you escaped, this is a clear indication for vaccination, and only a doctor should assess the degree of risk here. Of course, going through a course of vaccinations may well turn out to be a reinsurance - after all, you have no way to know for sure whether an animal has been infected with rabies. But if the vaccination is not done, and the animal was still a carrier of the virus, then you are guaranteed a painful death in a few weeks or months.
Myth number 7: If you are bitten by an animal that has a rabies vaccination, vaccination is not required.
This is true, but not always. The vaccination must be, firstly, documented (fixed in the vaccination certificate), and secondly, it must not be expired or delivered less than a month before the incident. In addition, even if everything is fine according to the documents, but the animal behaves inappropriately, you should consult a doctor and follow his recommendations.
Myth number 8: You can get rabies if you touch a sick animal, or if it scratches or licks you.
This is not entirely true. The rabies virus is not able to exist in the external environment, so it cannot be on the skin / hair of an animal or on the claws (for example, of a cat). Here in saliva, he feels great - but he is not able to penetrate through intact skin. In the latter case, however, you should immediately wash with soap and disinfect the salivated area of the skin, after which you should still consult a doctor and let him decide on the need for further action.
Myth number 9: during and after vaccination against rabies do not drink alcohol, otherwise it will neutralize the effect of the vaccine.
There is no scientific basis for claims that alcohol blocks the production of antibodies during rabies vaccination. Such a horror story is distributed exclusively in the countries of the former USSR. Tellingly, outside the former socialist camp, doctors have not heard of such prohibitions, and there are no alcohol-related contraindications in the instructions for rabies vaccines.
The roots of this horror story go back to the last century, when the previous generation vaccines were used, which were really pricked in the stomach for 30-40 days in a row. Skipping the next injection, both then and now, is fraught with nullifying the effect of vaccination, and drunkenness is one of the common reasons for not going to the doctor.
Myth number 10: Rabies is curable. The Americans cured the sick girl according to the Milwaukee protocol after the onset of symptoms of the disease.
This is very debatable. Indeed, such an extremely complex and expensive (about $ 800000) method of treating rabies at the symptomatic stage exists, but a few cases of its successful use have been confirmed worldwide. In addition, science still cannot explain how exactly they differ from the many more cases where treatment according to this protocol did not bring results. Therefore, one should not rely on the Milwaukee Protocol - the probability of success there fluctuates at the level of 5%. The only officially recognized and effective way to avoid rabies in the event of a risk of infection is still only timely vaccination.
In conclusion, I will tell an instructive story. I live in Germany, and we, like in many neighboring countries, have long had no "local" rabies in animals (and, accordingly, cases of human infection) thanks to the efforts of the government and health organizations. But the “imported” sometimes seeps through. The last case was about 8 years ago: a man was admitted to the hospital with complaints of high fever, spasms when swallowing and problems with coordination of movements. In the process of taking an anamnesis, he mentioned that 3 months before the onset of the disease, he returned from a trip to Africa. He was immediately tested for rabies and the result was positive. The patient later managed to tell that he was bitten by a dog during the trip, but he did not attach any importance to this and did not go anywhere. This man soon died in an isolated ward. And all the local epidemiological services up to the Ministry of Health by that time were already on their ears - still, the first case of rabies in the country for God knows how many years ... They did a titanic job, within 3 days they found and vaccinated everyone with whom the deceased had contact after returning from that ill-fated trip.
Do not neglect the bites of animals, even domestic ones, if they are not vaccinated - especially in countries where rabies is common. Only a doctor can make an informed decision about the need for vaccination in each case. By letting it take its course, you are putting your life and the lives of your loved ones at risk.
Source: habr.com