Rabies: incubation period in humans, symptoms and diagnosis. Rabies: incubation period in humans, symptoms and diagnosis

The rabies virus enters the human body after being bitten by diseased wild or domestic animals. Infection occurs when the saliva of the host comes into contact with damaged skin or mucous membranes. The incubation period for rabies virus is 2 weeks to 2 months. In some cases, this period is extended to one year. When communicating with a sick person, elementary caution should be observed, since after infection, his saliva also contains the rabies virus.

The danger is bites (multiple and deep), as well as any damage to the neck, hands, head and face. Moreover, with direct contact with the carrier, the rabies virus can enter the blood even through small fresh scratches, open wounds, abrasions, mucous membranes of the eyes and oral cavity. With bites to the head and face, the risk of getting the virus is 90%, damage to the hands - 63%, legs - 23%. However, these statistics are of no value to ordinary people. Remember that any bite should be regarded as a potential source of death. dangerous disease. At the same time, it doesn’t matter at all who exactly bit you, because, having caught rabies, the cutest dog can turn into an evil, uncontrollable creature.

Rabies - symptoms of the disease

After entering the human body, the rabies virus begins to multiply rapidly. During this process, the symptoms of rabies go through 3 distinct phases:

prodromal - the first signs of rabies appear at the bite sites: itching, pain, swelling and redness of the scar. In addition, a person begins to feel a general malaise, headache, lack of air. He has a fever and has trouble swallowing food. Perhaps the appearance of symptoms indicating a disorder of the central nervous system (nightmares, insomnia, unreasonable fear);
encephalitic - the period of excitation occurs 2-3 days after the onset of the first symptoms. This phase is characterized by the development of painful spasms of the muscles of the body, provoked by the most different factors(noise, bright light, stale air). Patients become aggressive. They scream, tear their clothes, break furniture and other interior items. Between attacks, there may be auditory and visual hallucinations, incoherent delirium. In this state, a person is very dangerous, because he has an abnormal "mad" strength. Along with the above symptoms, rabies in humans leads to severe tachycardia, excessive sweating and excessive salivation. A characteristic feature is foam from the mouth;
the final phase - the rabies virus causes paralysis of the limbs and damage to the cranial nerves, but psychomotor agitation weakens. The patient becomes calmer, can eat and drink on his own, suffer less from convulsions and spasms. But this is just a semblance of normalization of the state, because after 10-20 hours a person will inevitably die from cardiac arrest or paralysis of the respiratory center. Death comes suddenly, without agony.

One important fact should be especially noted: rabies, the symptoms of which indicate the onset of the third phase, does not leave the victim a single chance for life. Do not forget that the rabies virus is deadly, and if left untreated, it is 100% likely to lead to death. For this reason, it is necessary to consult a doctor not when the first signs of rabies appear, but immediately after bites and other injuries associated with animal attacks. This is especially important against the background of the fact that in some cases, patients develop the so-called silent rabies, which does not have pronounced symptoms of arousal. With such a development of signs of rabies, a person does not feel any special changes. general condition and thinks everything worked out. The fallacy of inaction becomes clear only after the first paralysis, when it is no longer possible to save the patient's life.

How is rabies treated in humans?

Once again, we note that any animal bite should be considered as a potential source of infection with the rabies virus. Accordingly, the victim must consult a doctor and undergo a course of treatment. Antiviral vaccinations against rabies are given at trauma centers. In our country, the drug KOKAV is used for this. The vaccine is administered intramuscularly at 0, 3, 7, 14, 30 and 90 days after the bite. If the injury was caused by accident, such as while playing with a well-known pet, the course of treatment can be stopped after 10-15 days if the animal does not show signs of rabies.

Multiple injuries and bites, even in the absence of signs of rabies, require the use of rabies immunoglobulin. It is used simultaneously with vaccination in the first hours after injury. It is also very important to properly treat the wound. She's being washed warm water and disinfectant. The edges of the wound are wiped with alcohol or 5% tincture of iodine. In addition, tetanus toxoid is administered to the patient.

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So what is this disease, what does it threaten and how to treat it?

What it is?

Rabies is a viral disease that occurs after the bite of an infected animal. nervous system and usually ends with fatal. The rabies virus (Neuroryctes rabid) belongs to the group of myxoviruses of the Lyssavirus genus of the Rhabdoviridae family. It is found in saliva, as well as in tears and urine.

The virus is not persistent external environment- dies when heated to 56 0 C in 15 minutes, when boiled in 2 minutes. Sensitive to ultraviolet and direct sunbeams, to ethanol and to many disinfectants. However, resistant to low temperatures, to phenol, antibiotics.

After entering the body, the rabies virus spreads along the nerve endings, affecting almost the entire nervous system. Edema, hemorrhages, degenerative and necrotic changes in the nerve cells of the brain and spinal cord.

Sources of infection

The source of the rabies virus is both wild and domestic animals. Wild animals include wolves, foxes, jackals, raccoons, badgers, skunks, the bats, rodents, and for domestic animals - dogs, cats, horses, pigs, small and large cattle. However, the greatest danger to humans is posed by foxes and stray dogs outside the city in the spring and summer.

Animals are considered infectious 3-10 days before the onset of signs of the disease and then during the entire period of the disease. Often animals with rabies can be distinguished by profuse salivation and lacrimation, as well as by observing signs of rabies. Human infection occurs when bitten by a "rabid" animal. And also when the saliva of a sick animal gets on damaged skin or mucous membranes.

IN last years airborne, alimentary (through food and water) and transplacental (through the placenta during pregnancy) routes of transmission of the virus are described. A lot of discussion is caused by several cases of human infection with rabies as a result of organ transplants.

What is happening?

The incubation period (the period from the bite to the onset of the disease) averages 30-50 days, although it can last 10-90 days, in rare cases - more than 1 year. Moreover, the further the bite from the head, the more incubation period. Of particular danger are bites to the head and hands. The longest incubation period is for a leg bite. There are 3 stages of the disease: I - initial, II - excitation, III - paralytic.

The first stage begins with general malaise, headache, slight increase body temperature, muscle pain, dry mouth, loss of appetite, sore throat, dry cough, there may be nausea and vomiting. Appear at the bite site discomfort- burning, redness, pulling pains, itching, hypersensitivity. The patient is depressed, closed, refuses to eat, he has an inexplicable fear, melancholy, anxiety, depression, less often - increased irritability. Insomnia, nightmares, olfactory and visual hallucinations are also characteristic.

After 1-3 days, a patient with rabies enters the second stage - excitation. There is anxiety, anxiety, and, most characteristic of this stage, attacks of hydrophobia. When trying to drink, and soon even at the sight and sound of running water, there is a feeling of horror and spasms of the muscles of the pharynx and larynx. Breathing becomes noisy, accompanied by pain and convulsions. At this stage of the disease, a person becomes irritable, excitable, very aggressive, "mad". During attacks, patients scream and rush about, they can break furniture, showing superhuman strength, and throw themselves at people. There is increased sweating and salivation, it is difficult for the patient to swallow saliva and he constantly spits it out. This period usually lasts 2-3 days.

Then comes the third stage of the disease, the beginning of which is characterized by sedation - fear disappears, attacks of hydrophobia, there is hope for recovery. After that, the body temperature rises above 40-42 ° C, paralysis of the limbs, impaired consciousness, convulsions occur. Death occurs from respiratory paralysis or cardiac arrest. Thus, the duration of the disease rarely exceeds a week.

How to treat?

There is no cure for rabies as such. If the disease is already in the first stage, there will most likely be no other outcome than a lethal one. Although there are isolated cases of cure for rabies in the world. But for now, it's exotic. However, there is a way to prevent the disease by killing it in the bud. This is the method specific prevention- the introduction of the rabies vaccine, no later than the 14th day from the moment of the bite. The best prevention- this is the introduction of a specific immunoglobulin and / or active immunization (vaccination).

The vaccine is administered intramuscularly, 1 ml 5 times: on the day of infection, then on the 3rd, 7th, 14th and 28th day. With this scheme, good immunity is created, but WHO also recommends a 6th injection 90 days after the first. best place inoculation is the deltoid muscle or thigh. In the event that a person is bitten, but before the bite was vaccinated according to the full scheme, and he has a sufficient level of antibodies, he is vaccinated according to a special scheme without the use of immunoglobulin. Therapy may be discontinued if the animal is found to remain healthy during the 10-day observation period or if the animal has not been found to have rabies virus. Some individuals who are at risk (veterinarians, dog handlers, hunters) need to be vaccinated in advance. Vaccinations are also carried out according to a specially established scheme with the first revaccination after 12 months. and then every 5 years.

What to do if you are bitten by an animal?

The first thing to do is to immediately wash the bite with soap. It is necessary to wash intensively, for 10 minutes. deep wounds rinsing is recommended soapy water e.g. with a syringe or catheter. Wounds do not need to be cauterized or stitched. After that, you should immediately contact the nearest emergency room, because the success of rabies vaccination highly depends on how quickly you seek help from a doctor. It is advisable to inform the doctor in the emergency room of the following information - a description of the animal, its appearance and behaviour, presence of a collar, circumstances of the bite. Followed by a course of vaccinations prescribed by a doctor. Forty injections in the stomach have not been done for a long time, you will be given a vaccine and will be allowed to go home. And so five or six times.

If the owner of a dog or cat cannot provide vaccination certificates, then there are two ways to determine whether the animal is sick with rabies. In the first case, the animal is killed to obtain a sample of its brain tissue. In the second case, the animal is placed in quarantine when veterinary clinic for 10 days. If during this time the animal does not show symptoms of rabies, then it is considered healthy.

The bitten person can be left in the hospital if his condition is especially serious, as well as persons with diseases of the nervous system or allergic diseases; people who are revaccinated, vaccinated with other vaccines within the last two months and pregnant. At the time of vaccination and 6 months after it, you must refrain from drinking alcohol. In addition, if you are undergoing a course of vaccination against rabies, you should not overwork, overcool or, conversely, overheat. During vaccinations, it is necessary to carefully monitor the state of health. And in case of any complaints of a deterioration in the condition, it is necessary to consult a doctor, and temporarily stop vaccinations. Only after an examination by a neuropathologist and a therapist is the issue of continuing vaccinations decided.

Prevention

There are two Russian rabies vaccines - "cultural anti-rabies vaccine" (CAV) (concentration 0.5 IU / ml) and "concentrated cultural anti-rabies vaccine" (CoCAV) (concentration 2.5 IU / ml). The CAV vaccine has another name - Rabivak-Vnukovo-32 or simply Rabivak. CAV is administered in large volumes and more times, so if you have a choice, choose KoKAV.

On Russian market the French vaccine Verorab (Aventis Pasteur) containing an inactivated virus (Wistar strain, Rabies PM / Wi38-1503-3M) - 2.5 IU and the German Rabipur (Ciron Behring) consisting of an inactivated (killed) rabies virus ( strain Flury LEP).

There is also a French inoculation called Imogam Rage. This is an immunoglobulin that is administered once, simultaneously with the vaccine, and is indicated for persons suspected of being infected with the rabies virus, especially in case of significant damage (in accordance with WHO recommendations - single or multiple bites or scratches with violation of the integrity of the skin).

The side effects of all vaccines are about the same and include local reactions in the form of soreness, swelling and induration, an increase lymph nodes general malaise, weakness, headache, disturbed sleep and appetite, fever, and sometimes there is an allergy to the components of the vaccine.

Rabies- This viral disease, caused by the Rabies virus rabies virus, is observed in warm-blooded animals and in humans. It is transmitted with saliva when an animal bites. There is a severe progressive lesion of the central nervous system (the virus moves through the damaged skin to the nerve endings, then to the spinal cord and brain). The disease is fatal to humans when symptoms develop, which can only be prevented by urgent vaccination.

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Peculiarities

Rabies is a life-threatening condition that causes tens of thousands of deaths each year. Dogs are the most common source of the virus.

According to the World Health Organization, up to 59,000 people die from rabies every year. Ninety-nine percent of them were bitten mad dog. However, the availability of vaccines for both animals and humans has resulted in a dramatic decline in rabies cases.

Rabies is caused by a virus that attacks the central nervous system, especially causing inflammation in the brain. Domestic dogs, cats, rabbits, and wild animals such as skunks, raccoons, and bats can transfer the virus to humans through bites and scratches. The key to fighting the virus is a quick response.

Signs and symptoms of rabies

In humans, the main symptom of rabies is hydrophobia (fear of water), which manifests itself when trying to drink, then at the sight of water and at the mention of it. There are also convulsive contractions of the swallowing muscles, a feeling of fear, convulsions, shortness of breath. Seizures arise from sound, light stimuli; the patient comes and begins to crush, break, throw himself at people; after this "violent" attack, a "quiet" one begins - a sign of the onset of ascending paralysis. This is followed by respiratory arrest and death of the patient.

The period between the bite and the onset of symptoms is called the incubation period. As a general rule, it usually takes 4 to 12 weeks for symptoms of rabies to show up when a person is infected. However, incubation periods can also vary from a few days to six years.

The onset of rabies begins with flu-like symptoms, including:

Increase in body temperature;
muscle weakness;
Tingling.

You can also feel a burning sensation at the site of the bite.

In addition to these main symptoms, there are also: a temperature of 37 ° C, a depressed state, bad dream, insomnia, anxiety, the bite site hurts (even if the wound has healed). As the virus continues to attack the central nervous system, two different types diseases.

excited rabies

Infected individuals who develop agitated rabies will be hyperactive and excitable and may exhibit erratic behavior. Other symptoms include:

Insomnia;
Anxiety;
Confusion;
Agitation;
hallucinations;
excessive salivation;
problems with swallowing;
Fear of water.

Paralytic rabies (silent rabies)

This form of rabies takes longer, but the effects are just as severe. Infected people slowly become paralyzed, eventually falling into a coma and dying. According to the World Health Organization, 30% of rabies cases are paralytic.

How do people get rabies?

Rabies viruses (the feral virus, the "mad dog" virus) are rapidly destroyed in the external environment.

Animals with rabies transmit the virus to other animals and humans through saliva after being bitten or scratched. However, any contact with mucous membranes or an open wound can also spread the virus. Transmission of this virus is considered exclusively from animal to animal and animal to human. While human-to-human transmission of the virus is extremely rare, a few cases have been reported following corneal transplants.

When a person has been bitten, the virus spreads through the nerves to the brain. The virus multiplies rapidly in the brain. This activity causes severe inflammation brain and spinal cord, after which the person's condition rapidly deteriorates and the person dies. Importantly, bites or scratches to the head and neck are thought to accelerate brain and spinal cord involvement due to the location of the initial injury. If you have been bitten on the neck, seek help as soon as possible.

Animals that can spread rabies

The main symptom of an animal's disease is a change in its behavior: a domestic, kind animal becomes aggressive, and a wild animal willingly makes contact.

Both wild and domestic animals can spread the rabies virus. The following animals are the main sources of rabies infection in humans:

Dogs;
The bats;
Ferrets;
cats;
cows;
Goats;
Horses;
rabbits;
Beavers;
coyotes;
Monkey;
Raccoons;
Skunks.

Who is at risk of rabies?

For most people, the risk of contracting rabies is relatively low. However, there is a certain group of people who may have more high risk rabies infection. These include:

Living in an area inhabited by bats;
Travel to developing countries;
living in countryside where there is more exposure to wildlife and little or no access to vaccines and preventive therapy immunoglobulin;
Frequent camping and exposure to wildlife;
Under the age of 15 years (rabies is most common in this age group);

While dogs are responsible for the majority of rabies cases worldwide, bats are responsible for the majority of rabies deaths in the Americas.

How do doctors diagnose rabies?

There is no test to discover early stages rabies infection. Once symptoms appear, a blood or tissue test will help your doctor determine if you have a disease. If you have been bitten by a wild animal, doctors usually give you a preventive rabies vaccine to stop the infection before symptoms appear.

Usually, laboratory diagnostics is not carried out, but there is a method for detecting the antigen of the rabies virus in prints from the surface of the eye.

Can rabies be cured?

After being infected with the rabies virus, a person may have a series of injections to prevent infection. Rabies immunoglobulin, which provides an immediate dose of rabies antibodies to fight infection, helps prevent the virus from entering. Then getting the rabies vaccine is the key to preventing the disease. The rabies vaccine is given in a series of five injections over 14 days.

Animal control will probably try to find the animal that bit you so it can be tested for rabies. If the animal is not rabid, you can avoid injections. However, if the animal cannot be found, the safest course of action is to take preventive measures.

Getting the rabies vaccine as soon as possible after being bitten by animals The best way prevent infection. Doctors will treat the wound by washing it for at least 15 minutes with soap and water, detergent or iodine. They will then give you immunoglobin and start a series of injections for the rabies vaccine. This protocol is known as "post-exposure prophylaxis".

Side effects of rabies treatment

Rabies vaccine and immunoglobulin can very rarely cause some side effects, including:

Pain, swelling, or itching at the injection site;
Headache;
Nausea;
Abdominal pain;
Muscle pain;
Dizziness.

How to prevent rabies

Rabies is a preventable disease. There are a few simple steps you can take to avoid getting rabies:

Get rabies vaccinations before traveling to developing countries, working closely with animals or working in a rabies virus laboratory.
Vaccinate your pets.
Report stray animals to animal control.
Avoid contact with wild animals.
Keep bats out of living quarters or other structures near your home.

You must report any signs of an infected animal to local departments control or animal health.

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IN modern society There are diseases from which no one is immune. A pleasant stay in the forest can break the bites poisonous snakes, A sweet smell favorite ice cream to provoke wasp stings.

However, there is a special disease that is unlike any other, provoked by the Neuroiyctes rabid virus. It is important to know the signs of rabies in humans and animals in order to be able to protect yourself and loved ones, and prevent the malaise from developing. After all, even our beloved Murkas and Shariks - without proper care for them - can become sources of insidious malaise.

In this article, we will look at the symptoms viral infection, we will tell you what measures must be taken to prevent its development. Let's answer the question why a seemingly small bite of a pet, for some people, is worth the most precious thing - life. We hope that our publications will allow you to feel more confident in any situation.

How the disease is transmitted

A special rabies virus, which is found in the salivary fluid of a sick animal, provokes an insidious disease. Let's look at how the virus is transmitted, infection occurs, sources.

It happens:

when a person is bitten by animals,
when salivary fluid enters open wounds, abrasions, scratches.

However, there were cases when the disease was diagnosed in workers involved in the processing of the skins of sick foxes. Particularly dangerous are numerous bites, as well as lesions of the hands and head. The causative agent of infection tends to "leak" into the fibers of the central nervous system, multiply rapidly, spread to the periphery, and cause paralysis.

The main "hotbeds" of infection in cities and villages are numerous dogs, as well as cats and cattle. In nature, carriers of rabies are foxes and wolves, raccoon dogs and jackals, bats. Bears and hedgehogs, lynxes and moose get sick less often.

You should know: a lesion in the head causes ailment in 88%, in the wrist - in 68%, in the ankles and feet - 20%.

Often worried people ask doctors questions: Is it possible to get infected through a scratch? It is possible if it was salivated by a sick individual. Is rabies transmitted from person to person? This happens extremely rarely. IN medical publications the following exceptional cases are indicated:

transmission of the pathogen through household items used by the patient;
through food, water;
infection of the fetus during pregnancy;
when transplanting an organ taken from a sick person.

The main signs of ill health

The main problem is that although the incubation period usually lasts from 1 to 3 months, it can also be as short as 10 days or as long as one year. In this case, there may be no symptoms of infection, and complete clinical picture occurs already in the stage of agony.

Special signs of rabies in humans, manifested at the very beginning of the disease:

increased excitability,
insomnia,
redness and swelling of the healing scar,
nagging pain, burning and itching at the site of injury,
temperature increase,
problems when swallowing food.

Please note that signs of rabies in humans are a signal for immediate hospitalization. Road every minute! The development of "sores" in children is much more intense than in adults. Also during this period, a person can be overcome by causeless fear, longing, anxiety. This is the prodromal phase. The first signs are observed within 2-3 days, sometimes the phase is delayed up to 5-6 days.

Muscle spasms can start suddenly:

when trying to quench thirst (rabies),
with small breaths of the breeze (aerophobia),
in bright light (photophobia),
at loud sounds (acousticophobia).

During the peak of the attack there is an unbridled rampage, aggressive behavior, uncontrolled profuse salivation, tachycardia. The person is literally flooded with sweat, the pupils dilate significantly, the face becomes cyanotic, the pulse is accelerated. Patients can tear their clothes, bite others, spit, break furniture, behave inappropriately. characteristic feature this phase - foam from the mouth. Hallucinations, delusions, general anxiety are also possible.

The excitation is replaced by the paralytic phase of the disease. The patient seems to be more balanced, can drink liquids and eat food without the help of outsiders, he is less disturbed by spasms and convulsions. However, this is only the appearance of an improvement in the condition, the disease inevitably leads a person to death. Death occurs from complete paralysis of the respiratory center, cessation of the work of the heart muscle.

Important: immediately, if the sick animal is unknown or not? Be sure to contact the doctors! Despite the fact that there are no medicines that can stop the persistence of the virus, a timely vaccination against rabies in a person can easily prevent the development of a deadly disease.

Signs of infection in four-legged friends

To feel protected, you should know the signs of rabies in cats and dogs, and other animals. There are three forms of development of malaise:

Hidden. The previously cheerful and frisky four-legged friend suddenly becomes suspiciously calm and indifferent, very reluctantly responds to the call of the owner, does not always make contact. He loses his appetite. The eyes are often sad, watery. The animal is hammered into the farthest corner of the apartment, cats often leave home forever. Sometimes the symptoms manifest themselves in a different way - the animal becomes too intrusive, very friendly. The approximate duration of this form is 2-3 days.
Aggressive. The main characteristics are excitability, activity, aggression, violentness. The pet constantly looks around, as if he senses danger. Symptoms of the disease begin to appear - clouding of the cornea and strabismus, profuse salivation. During this period, the animal may begin to bite, swallow various items run away from home. Often there is vomiting, strong salivation, imbalance.
Paralytic. Aggressive attacks alternate with imaginary recovery. However, the disease progresses. First paralysis covers hind limbs, passes to the muscles of the body, and then to the forelimbs. Death comes from paralysis respiratory organs, hearts.

Always remember that disease in animals is incurable. An analysis in a veterinary clinic can be taken when observing alarming symptoms.

Important: Keep in mind that an infected animal is not necessarily a scary monster with red streaks of eyes. A cute dog can also be a victim of a formidable illness.

Why sometimes the disease progresses

It would seem that it is possible to give injections to a person immediately after an animal attack. Why do people keep dying from the virus? There are three main reasons why people enter treatment in extreme serious condition when the chances of recovery are zero:

Too late appeal to doctors for help.
Violation of the regimen during vaccination.
Interrupted treatment period.

Carelessness and elementary illiteracy in matters of personal health allow the disease to progress. Perceiving the injuries received from an animal as ordinary scratches, a person endangers his life. Always remember that timely rabies injections will save the life of you and your loved ones!

How to prevent disease

Doctors do not get tired of repeating - prevention is the most the best protection from all ailments. Within three days after the accident, an anti-rabies vaccination is essential for a person - side effects are rare, accounting for only 3%. Later introduced immunoglobulin has no effect.

Important: For six months after vaccination, you can not go to the sauna and bath, overwork, overheat in the hot sun, drink strong drinks. Failure to comply with the regime can provoke an imbalance immune system, further development disease, lead to death.

When sending kids on vacation to a camp or to grandmothers for fresh milk, be sure to teach them what to do with some other insect. Pay Special attention for bites unfamiliar dogs, cats.

To keep your beloved pet away negative consequences from unexpected contact with other animals - do not ignore the annual vaccination.

We wish you to be reasonably careful on vacation, do not forget that even the cutest and most affectionate little animals can be sick. It is better to admire them from afar, do not try to caress them, stroke them or pick them up. If contact with an animal does occur, seek medical attention immediately. Do not forget that the signs of rabies in humans do not appear immediately. Rabies vaccine - the only way stop the virus from spreading. Let your four-legged friends bring only joy!

Rabies is acute infection caused by a virus that enters the human body when a sick animal bites or its saliva comes into contact with the skin. Clinically characterized by severe damage to the nervous system. It is one of the most dangerous infectious diseases.

Without specific treatment- the introduction of a vaccine against rabies - the disease ends in death. How earlier man apply for medical care after a bite, the less chance of getting sick. Let's get acquainted with the causes, signs of rabies in humans, talk about the principles of its diagnosis and treatment, as well as how to avoid this dangerous disease.

What it is?

Rabies is an infectious zoonosis viral etiology, characterized by a predominantly severe lesion of the central nervous system, threatening a fatal outcome. Humans become infected with rabies when bitten by animals.

Pathogenesis

The virus is unstable in the external environment - it dies when heated to 56 ° C in 15 minutes, when boiled - in 2 minutes. Sensitive to ultraviolet and direct sunlight, to ethanol and to many disinfectants. However, it is resistant to low temperatures and phenol.

The virus replicates in nerve cells organism, forming the bodies of Babesh-Negri. Instances of the virus are carried through the axons of neurons at a rate of approximately 3 mm per hour. Reaching the spinal cord and brain, they cause meningoencephalitis. In the nervous system, the virus causes inflammatory, degenerative and necrotic changes. The death of animals and humans occurs due to asphyxia and cardiac arrest.

Symptoms of rabies in humans

The incubation period of rabies is from 10 days to 3-4 (but more often 1-3) months, in some cases up to one year, that is, the virus can exist in the body without symptoms. In immunized people, on average, it lasts 77 days, in non-immunized people - 54 days.

Isolated cases of an extremely long incubation period have been described. So, it was 4 and 6 years after immigrating to the USA for two immigrants from Laos and the Philippines; the virus strains isolated from these patients were absent from animals in the United States, but were present in the regions of origin of the immigrants. In some cases of a long incubation period, rabies developed under the influence of some external factor: falling from a tree 5 years after infection, impact electric shock after 444 days.

The duration mainly depends on the location of the injury. How longer than the virus have to get to the brain longer man will remain outwardly healthy. In medicine, cases have been described when the disease manifested itself even 4 years after the bite of an infected cow.

Rabies in humans goes through three stages of development, each of which is manifested by different symptoms.

1 stage

The initial stage of rabies (1-3 days):

The very first symptoms of rabies in humans occur at the site of the bite. By this time, the wound may be completely healed, but the person begins to “feel” the bite. There is a pulling pain with the greatest manifestation in the center of the bite, burning and itching, increased sensitivity of the skin. The scar may re-inflame and swell.
Subfebrile condition occurs - the temperature fluctuates between 37 C -37.3 C, but does not exceed them.
Weakness, headaches, vomiting and diarrhea are noted.
If the bite fell on the face, the person begins to be disturbed by visual and olfactory hallucinations- intrusive smells that are not really there, visual non-existent pictures.
Typical mental disorders are noted: the patient is overcome by causeless fear, melancholy, depression. In rare cases, anxiety is replaced by irritability. The person becomes withdrawn and apathetic to the events taking place.
Sleep and appetite are disturbed. In rare moments of sleep, the patient is overcome by terrible dreams.

2 stage

The next stage lasts from 2 to 3 days, it is called the stage of excitement. It is characterized by:

Due to damage to the nervous system, there is an increase in the excitability of the neuro-reflex system. The tone of the autonomic nervous system prevails.
A striking symptom of the progression of the disease is the development of hydrophobia. When trying to take a sip of liquid infected person spasm occurs. The respiratory and swallowing muscles are exposed to it, up to the occurrence of vomiting. As the disease progresses, a similar spasm will occur in response to the sound of running water and even the sight of it.
The patient's breathing becomes rare and convulsive.
There are facial cramps. Any external stimuli cause an acute reaction of the nervous system.
Seizures become a response even to minor healthy person irritants: bright light, wind or draft, sharp sound. This causes fear in the patient.
pupils dilate, eyeballs protrude (exophthalmos), the gaze is fixed at one point. The pulse quickens profuse sweat, saliva flows continuously, its volume increases significantly.
Mental disorders progress, the patient is overly excited, becomes violent. He carries a threat to himself and others, behaves aggressively and even violently. The infected rush at others, fight and bite, tear things, hair, beat against the walls. In fact, a person during such an attack suffers terribly from haunting eerie images and sounds. During the peak of an attack, a person may stop breathing, as well as stop the heartbeat.

When the attack passes, people behave adequately, non-aggressively, their speech is logical and correct.

3 stage

Paralysis occurs due to loss of functions of the cerebral cortex. Some groups of muscles and organs (tongue, larynx, etc.) are subjected to paralysis. Motor and sensory functions fade away, attacks of convulsions and phobias stop. The patient calms down externally.

There is a significant increase in temperature up to 40-42 C. There is a rapid heartbeat against the background of a drop in pressure. The death of the patient occurs due to paralysis of the heart or respiratory center.

So the total duration clinical manifestations 3-7 days. In some cases, the above stages and symptoms of rabies in humans can be erased, and the disease progresses very quickly to paralysis (death occurs within the first day after the first manifestations).

Diagnostics

Diagnosis is based on anamnesis data: animal bite or salivation of the skin. Then they play a part specific signs rabies: rabies, hypersensitivity to irritants (sounds, light, drafts), profuse salivation, attacks of psychomotor agitation with convulsions (even in response to the slightest movement of air).

From laboratory methods one can note the detection of rabies virus antigens in prints from the surface of the cornea. In the blood test, leukocytosis is noted due to an increase in the content of lymphocytes. After the death of the patient, at an autopsy, Babesh-Negri bodies are found in the substance of the brain.

Treatment of rabies in humans

Before 2005 it was not known effective methods treatment of rabies in case of occurrence clinical signs diseases. had to be limited symptomatic means to alleviate the painful condition. Motor excitation was removed with sedatives (sedatives), convulsions were eliminated with curare-like drugs. Respiratory disorders were compensated by tracheostomy and connection of the patient to an artificial respiration apparatus.

In 2005, there were reports that a 15-year-old girl from the United States, Gina Geese, was able to recover from being infected with the rabies virus without vaccination, when treatment was started after the appearance clinical symptoms. During the treatment, Gis was introduced into an artificial coma, and then drugs were introduced to her that stimulate the body's immune activity. The method was based on the assumption that the rabies virus does not cause irreversible damage to the central nervous system, but only causes a temporary disruption of its functions, and thus, if most of the brain functions are temporarily "turned off", the body will gradually be able to develop enough antibodies to defeat the virus. After a week in a coma and subsequent treatment, Gies was discharged from the hospital a few months later with no signs of being infected with the rabies virus.

However, rabies is incurable last stage. Probability lethal outcome when infected - 99.9%.

Features of vaccination

Since the treatment of rabies at the stage of the appearance of signs is no longer effective, prevention of the disease is required to prevent the spread of the virus, by introducing a special vaccine.

Rabies vaccination is prescribed for a person in such cases:

if he was injured by objects on which the saliva of the infected was;
if he was attacked by an apparently unhealthy animal and received open damage skin;
if he has been bitten by wild rodents;
if he has been in contact with the saliva of a patient with a pathology such as rabies, a person, and in other cases when open wound the saliva of the intended carrier could have entered;
if he has scratches on his body resulting from contact with an animal, which died shortly after they were applied for an unknown reason.

Rabies vaccinations are prescribed immediately, at regular intervals. They are carried out both on an outpatient basis and inpatient - depending on the desire of the patient and the severity of the bites.

However, it should be remembered that vaccination can cause side effects, such as redness of the injection site, fever, dyspeptic disorders, a violation of the general condition. Exist special instructions regarding vaccination against rabies and alcohol intake - to prevent the development post-vaccination complications, people are prohibited from drinking alcohol during the vaccination period and six months after it.

Prevention

Specific prophylaxis is carried out by conducting a course of combined administration of an anti-rabies vaccine and anti-rabies immunoglobulin after an animal bite or saliva. 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 with iodine or 70 ° 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.