Rabies, also known as Hydrophobia, is an acute infectious disease caused by the rabies virus (RabiesVirus) invading the nervous system and is a natural epidemic of human-animal origin. Human rabies is most often contracted from the bite of an infected dog, cat or wild animal, with a death rate of nearly 100%. The disease presents with typical and unique symptoms, and can be diagnosed basically based on clinical.
This standard is proposed by the Ministry of Health of the People’s Republic of China.
This standard is drafted by Tianjin Infectious Disease Hospital.
The drafters of this standard: Zhu Limin and Yu Shuwen.
This standard is entrusted by the Ministry of Health to the technical focal point of the Chinese Academy of Preventive Medicine is responsible for the interpretation.
1.Scope
This standard specifies the diagnostic criteria and treatment principles of rabies.
This standard applies to all levels and types of medical and health care health epidemic prevention agency personnel for the diagnosis of rabies reporting and handling.
2.Diagnostic principles
The clinical diagnosis can be made mainly on the basis of the epidemiological history of the disease and the typical unique clinical manifestations.
3, diagnostic criteria
3.1 Epidemiological history
History of licking and biting by dogs, cats or other host animals.
3.2 Clinical symptoms
3.2.1 Abnormal sensation, numbness and itching, tingling or anthroposis in or around the healed bite wound. Excitement, irritability, fear, and abnormal sensitivity to external stimuli such as wind, water, light, sound, etc. appear.
3.2.2 “Hydrophobia” symptoms with sympathetic hyperexcitability (salivation, excessive sweating, rapid heart rhythm, increased blood pressure), followed by muscle paralysis or cranial nerve paralysis (aphasia, aphasia, arrhythmia).
3.3 Laboratory tests
3.3.1 Immunofluorescent antibody method for antigen detection: saliva, nasopharyngeal washings, corneal blots, skin sections taken within the first week of onset, stained with fluorescent antibodies, positive for rabies virus antigen.
3.3.2 Those who have survived for more than one week do serum neutralization test or complement binding test to detect antibodies, those with increased potency, and if they have been vaccinated, the neutralizing antibody potency needs to exceed 1:5000.
3.3.3 Post-mortem brain tissue specimens with positive virus isolation or positive fluorescence antibody staining of the print or detection of Necky’s vesicles in brain tissue.
3.4 Case classification
3.4.1 Clinically diagnosed cases: with 3.1 plus 3.2.1 or 3.2.2.
3.4.2 Confirmed cases: with any of 3.4.1 plus 3.3.
4. Treatment principles
4.1 Keep the patient in strict isolation in a single ward with quieter and darker light to avoid unnecessary stimulation.
4.2 Disinfect patient secretions and excretions strictly.
4.3 Strengthen the monitoring of respiratory, circulatory and other system complications.
4.4 Symptomatic treatment: replenish water-electrolyte and heat, correct acid-base balance imbalance; use various sedatives, such as Valium, phenobarbital, chloral hydrate and hibernation drugs in turn for those who are irritable and spastic. Give dehydrating agents with cerebral edema. Prevent respiratory muscle spasm leading to asphyxia, tracheotomy if necessary, intermittent positive pressure oxygen administration. If there is tachycardia, arrhythmia, or elevated blood pressure, use β-blockers or cardiac agents.
5. Prevention
5.1 Management of infectious sources.
5.2 Wound treatment.
5.3 Vaccination.