Update: October 2018
Rabies refers to diseases against which practically
powerless nonspecific preventive measures because
the causative agent of infection is constantly present in natural foci
among the animal population. This disease has been known for a very long time and until
a certain time has always led to the death of a person.
The prevalence of the disease is low, but infections
registered in almost all countries of the world, except
a number of island and northern states (UK, Japan,
Norway and others.).
Rabies is an infectious zoonosis with acute
current caused by the virus Neuroiyctes rabid.
The disease is characterized by severe damage to the central nervous system (central
nervous system) and in the absence of timely emergency
vaccination is life threatening.
Although it stops the persistence of the virus in nature
man cannot do it, development of the disease is easily prevented
by timely and proper vaccination of a person with suspicion
on rabies. But with late access to a doctor and development
the clinical picture of the patient is doomed to death. In this article, we
consider the symptoms of rabies in humans and preventive measures
to prevent the development of the disease.
Etiology and transmission of rabies
Rabies virus is highly pathogenic
for warm-blooded birds and animals. Virus circulating in nature
supports its livelihoods, spreading among
animal and bird populations. Despite this, the sources of infection in
Most of the cases are dogs, like pets,
as well as roving, who in one way or another are infected from wild
animals. The proportion of wild animals as sources of infection is
about 25-28% of all cases of rabies. Ten percent of the time
infection comes from cats.
The rabies virus is in the saliva of an infected animal. Person
infected with osliuneniya and bite animals with rabies.
Particularly dangerous in terms of infection are the bites of the hands and
heads, as well as multiple bites. For the disease is characteristic
seasonality in spring and summer. Sick person,
as a source of infection, it is theoretically dangerous during
development of the clinical picture when he does not control his
According to the Rosselkhoznadzor, only in the first half of 2012 in Russia
950 cases of rabies were recorded, mainly in the Central Federal District – 52%,
Volga -17%, Ural 8%, South Federal District – 7% Siberian 7%. Main
foxes are considered to be distributors of rabies, in Russia for every 10
km2 accounts for up to 10 foxes, but in order for the disease not to
developed rapidly should be no more than 1 fox per 10 km2.
In recent years, the number of wolves and
raccoon dogs, which along with foxes can also actively
spread the virus. Moreover, such animals also became ill.
like lynx, hedgehogs, bears and moose, which is not peculiar.
Increased cases of attacks on humans rabid crows.
Очень важно своевременно вакцинировать домашних animals. There are
cases where domestic dogs unvaccinated for rabies travel with
the owners of nature, the cottage, attack hedgehogs or return from
forest in the blood and ruffled, and then, after some time
begin to respond inadequately to the caress and avoid the light,
hide in dark places and die soon.
Before, after the bite of a domestic dog, before conducting
prevention, the animals were observed for 10 days if the dog
did not die, the drugs were not prescribed (see symptoms of rabies in
dogs). Today, in a difficult situation with rabies and the presence of
A safe vaccine is recommended immediately after a bite.
medical care and vaccination.
The structure of cases with clinical manifestations of rabies
As stated earlier, fighting rabies in the event of a bite or
contamination of infected animals is reduced to vaccination
the patient. Therefore, to date, patients coming from an explicit
The clinical picture of rabies is uncommon. Incidence
rabies is associated with three main reasons:
- Late seeking medical care after a bite;
- Violations of the regime during the vaccination period
- Incomplete vaccination.
Unfortunately, for many people, the fateful becomes elementary.
illiteracy and carelessness in relation to their health.
Perceiving the bite of an animal, as a banal scratch, a man puts
endanger your life. Rabies is the case when
Better to be safe and consult a doctor immediately.
case of a bite and even salting with animals.
What happens to the human body after infection with rabies?
The nerve pathways cause the virus to enter the brain and spinal cord and
causes the death of nerve cells. Gradual destruction of the nervous
system causes a certain symptomatology and, in the end,
приводит к смерти the patient.
Diagnosis of rabies
Diagnosis of the disease is based on the collected history (fact
salivation or bite) and the clinical manifestations of the disease that
are typical in most cases. Blood picture
characterized by an increase in lymphocytes and the absence of eosinophils. AT
prints from the surface of the cornea can detect antigen
Signs of rabies in humans
After the virus enters the human body comes hidden or
incubation period of 1-3 months. AT редких
In cases of this shortening up to 10-12 days and lengthening
up to one year. The duration of the incubation is affected by the location of the bite.
– the longer the path to the brain, the longer the hidden
period. There were cases when a person fell ill 4 years after
bitten by a mad cow.
After the incubation period, the true disease occurs.
ATыделяют три стадии бешенства, которые сменяют друг друга: I —
initial, II – excitement, III – paralysis. So what are the symptoms
rabies appears in a person after being bitten by an infected person.
Initial stage of rabies (1-3 days)
- The very first symptoms of rabies in humans occur in place
bite. By this time, the wound may completely heal, but
the person begins to “feel” the bite. Feels nagging with
greatest manifestation in the center of the bite, burning and itching, increased
skin sensitivity The scar may again become inflamed and
- ATозникает субфебрилитет – температура колеблется в пределах 37
C -37.3 C, but does not exceed them.
- There is weakness, headaches, vomiting and diarrhea.
- If the bite is on the face area, the person begins
disturb visual and olfactory hallucinations – obsessive
smells that are not really present, visual non-existent
- There are typical mental disorders: the patient overcomes
unreasonable fear, melancholy, depression. AT редких случаях тревожность
replaced by irritability. Person становится замкнутым и
apathetic to the events.
- Sleep and appetite are disturbed. AT редкие минуты сна больного
terrible dreams prevail.
Stage of arousal (2-3 days)
- This stage is characterized by high reflex
excitability with a predominance of vegetative nervous tone
- One of the most prominent symptoms is hydrophobia or hydrophobia.
When a patient tries to take a sip, spastic spasm occurs.
swallowing muscles and respiratory muscles up to vomiting.
This symptom is characterized by progression – in the future, even sound
pouring water and its appearance causes spasm of the larynx and pharynx.
- The nature of breathing changes – it becomes short and
- ATнешние раздражители обостряют реакцию нервной system.
ATозникают судороги, искажающие лицо человека.
- A convulsive seizure can be triggered by the movement of air,
sharp sound and bright light. ATследствие этих проявлений больной
experiencing fear of previously familiar stimuli.
- Objectively observed dilated pupils and exophthalmos with
fixed look at one point. Sharply accelerated pulse.
The patient sweats heavily and suffers from copious incessant
- Mental disorders continue to progress. ATо время приступа
marked psychomotor agitation. Sick becomes
violent and dangerous for themselves and for others and commits
aggressive and violent actions (hence the name
diseases). Patients rush at others, can hit and even
bite, can cause damage to themselves – tear hair, clothes, bump
about walls and floor. AT момент приступа человека одолевают ужасающие
auditory and visual hallucinations. At the peak of an attack is possible
respiratory and cardiac arrest.
- AT период между приступами человек становится адекватным,
correctly answers questions and shows no signs
Stage of paralysis (12-24 hours)
Paralysis occurs due to loss of function of the cerebral cortex
the brain. Paralysis of certain groups of muscles and organs
(tongue, larynx, etc.). Motor and sensual fade away
functions, the attacks of cramps and phobias stop. Sick outwardly
There is a significant increase in temperature up to 40-42 C.
ATозникает учащенное сердцебиение на фоне падения давления. Death
the patient is caused by paralysis of the heart or respiratory
Thus, the total duration of clinical manifestations of 3-7
days AT некоторых случаях вышеописанные стадии и симптомы бешенства
a person can be erased and the disease progresses very quickly
before paralysis (death occurs during the first days after the first
With the development of the clinical picture, the prognosis is always unfavorable.
AT стационаре лечение сводится к облегчению состояния больного –
creating special conditions without exposure to wind, noise and light. AT
In large doses, opioid analgesics are administered to the patient and are given
supportive therapy. Translation to artificial lung ventilation
prolongs life. Но исход всегда одинаков – смерть the patient.
The first thing that should remember any man, bitten by animals –
seek medical attention as soon as possible. Algorithm
further treatment tactics, including the need for emergency
vaccination, determines only the doctor. Preventing rabies in humans
at risk (bitten or oslyuyavnyh sick animals)
carried out by active and passive anti-rabies vaccination
immunoglobulin according to the scheme.
Before going to the doctor you need to wash the wound with a large one as soon as possible.
the amount of running water. Prophylactic vaccination against
rabies is indicated for persons at risk of exposure
rabies (veterinarians, hunters, etc.).
Active immunization should be carried out immediately;
produced on day 1, day 3, 7, 14, 28, who also recommends
perform an additional injection 3 months after the sixth
injections. The vaccine is administered in 1 ml intramuscularly. This scheme happens
enough for the formation of immunity.
When is vaccine prevention indicated?
- after a bite by rodents living in the wild
- after biting, light scratching or salivation of the skin
of a person is clearly rabid animals, unknown animals or when
suspicion of having rabies
- after biting through thin clothes, as well as getting a wound
items that have been contaminated by saliva suspicious or
When is a rabies vaccine not appropriate?
- for wounds and bites by domestic rats or rodents in
areas in which over the past two years
animal rabies cases have been reported
- when biting through very dense tissue and while maintaining
- after getting wounds from non-birds of prey
- when eating milk or meat of rabid animals, but
- if the animal got sick only more than 10 days after
injured or bite, or 10 days after the bite
remained healthy (today this item is considered not
relevant and should be as soon as possible after the bite to apply for
- after contact with a person with rabies – if not
mucosal osusions or skin integrity problems have occurred
Side effects after vaccination may be as follows:
fever up to 38 ° C, headache, chills, allergic
manifestations, digestive disorders, swollen lymph nodes,
pain in the joints, at the injection site – compaction, light
Автор: врач-гигиенист, эпидемиолог