Rabies can be prevented but not cured

  Rabies is known to the medical community as a preventable, untreatable disease. The reason is that once rabies occurs, the mortality rate is 100% and none of the patients are spared. However, in everyday life some people do not take rabies seriously, and as a result, they lose their own lives for nothing. A survey report points out that more than 80% of rabies deaths are caused by dog bites that do not follow the rabies prevention approach to actively protect themselves. Some of these people may be ignorant of the dangers of rabies, lost their lives in a muddle; others know little about rabies, with a carefree attitude, there is a fluke mentality, thinking that “ordinary dog” bites will not be a major problem, will not get rabies, not timely to the epidemic prevention department for active and serious treatment, or rescue methods are not The results are still harmful to yourself.  More than 95% of rabies in China is caused by rabid dog bites, and the rest are caused by bites and scratches from cats or other domesticated and wild animals. The pathogen of rabies is rabies virus, which is present in large quantities in the saliva of rabid dogs. It has been found that when a person is bitten by a rabid dog, the rabies virus first multiplies around the wound and invades the peripheral nerve tissue, and then invades the central nervous system at a rate of 8 to 20 mm per day along the peripheral nerves.  After the rabies virus enters the central nervous system, the clinical symptoms of rabies gradually become apparent. The incubation period of rabies varies widely, from 10 days and a half months to several years. The length of the incubation period depends on the strength of the body’s resistance, the number of viruses entering the body and the virulence of the virus, as well as the site of the rabid dog bite, the depth of the wound, and other factors. The clinical manifestations of rabies are unique, beginning with itching, pain and numbness around the healing wound. As the disease progresses, the patient begins to experience fatigue, loss of appetite, headache, insomnia, and nausea.  Then the patient gradually becomes excited, has a sense of fear, and shows allergic reactions to stimuli such as sound and light. There is tension in the throat and often agitation and general convulsions due to water sounds, blowing wind and other stimuli. Hydrophobia is a specific symptom of rabies. Patients have throat or generalized spasms when they smell or see water. In the later stages of the disease, the patient gradually becomes quiet, fear disappears, spasms stop, muscles relax, jaws drop, mouth saliva, reflexes disappear, and pupils dilate. Death is often due to respiratory and cardiac failure, for which there is no cure.  The method of rabies prevention is rabies vaccination, and there are two methods: 1. Pre-exposure prophylaxis: That is, rabies vaccination is given before a healthy person is bitten or scratched by a rabid dog. Three doses of rabies vaccine at 0 days, 7 days, and 21 days, 1 ml per dose, will give more than 1 year of immunity. People who often work in the field, village mail carriers who travel from village to village, travelers to infected areas, and people living in areas with a high incidence of rabies are all suitable vaccination candidates.  2. Post-exposure vaccination: After being bitten or scratched by rabid dogs or other animals, local wounds should be treated immediately regardless of age or sex. Rinse the wound repeatedly with soapy water and then disinfect it several times with tincture of iodine, and then vaccinate against rabies in a timely, full and adequate amount. Generally, the bite victim should receive one rabies vaccination on day 0 (day 1, the same day), 3 (day 4, and so on), 7, 14, and 28 days, for a total of 5 doses.  The doses are the same for adults and children. For severe bites (head, face, neck, fingers, 3 bites on multiple sites or bites that lick and touch mucous membranes), in addition to the rabies vaccine as described above, double the amount should be injected on days 0 and 3, and the vaccine should be injected on day 0 with anti-rabies serum (40 IU/kg) or anti-rabies immunoglobulin (20 IU/kg) infiltrating the bite locally and intramuscularly.  For combined use of anti-rabies serum or immunoglobulin, two to three additional doses of vaccine must be given after the full vaccination is completed, i.e., one additional dose of vaccine each on day 15, 75, or 10, 20, or 90 days after the full vaccination, for a total of 9 or 10 doses of rabies vaccine.  In the past, there was a view that if a rabid dog bite did not result in a timely rabies vaccination for various reasons, and the disease did not develop after several months, there was no need to use the vaccine to prevent it. This is not true because if a rabid dog bite is definitely received, it is estimated that about 5% of rabies patients have an incubation period of more than 12 months. Therefore, the World Health Organization recommends that patients who have been bitten by rabid dogs for several months should also undergo the aforementioned life-saving immunization program.