What is rabies and why are bites or scratches from domestic dogs and cats dangerous?

— How to recognize the symptoms of rabies?

— Often the disease begins with a picture of a common viral infection, namely:

• General weakness;
• Headache;
• Heat.

The patient may notice redness in the bite area and complain of burning and pain.

These symptoms are gradually accompanied by insomnia, irritability, and fear of air and water. When a person with rabies sees water, the esophagus and respiratory muscles begin to spasm, and a large amount of saliva is released.

In the end, delusions, hallucinations, and paralysis develop. The patient dies within 7-8 days from the onset of the first signs of the disease.

What damage is considered the most dangerous?

The period from the bite to the onset of the disease (latent or incubation period) averages 30-50 days in humans, although it can last 10-90 days, in rare cases - more than 1 year. Moreover, the further the bite site is from the head, the longer the incubation period. Consequently, taking into account the localization (location) of the damage, bites to the head, face, and neck are especially dangerous. The category of severe (dangerous) injuries also includes bites on the fingers, because these parts of the body have many nerve endings. Bites to the forearm, shoulder, and torso are considered less dangerous. The incubation period lasts the longest for a bite on the legs.

— What is more dangerous: a bite or a scratch, and why?

— Both a bite, a scratch and saliva are dangerous. Remember that the rabies virus enters the body not only from a wound, but also from intact mucous membranes, but the deeper, larger and more numerous the bite wound, the more dangerous it is!

Immediate combination vaccination against rabies is required, which involves the administration of rabies immunoglobulin in addition to the rabies vaccine.

A dog bite, regardless of the size of the wound, except for vital indications, cannot be sutured for 3 days. This is because suturing the wound creates favorable conditions for the rabies virus to enter the nerve endings. After 3 days, the anatomical integrity of the wound can be restored.

Prevention

Prevention (specific and nonspecific) in this case occupies a special place. A person who has been attacked must be vaccinated. In addition, everyone whose profession is related to animals (veterinarians, hunters) is vaccinated. Nonspecific prevention consists of thoroughly treating the wound surface with a 20% solution of medical soap.

During the consultation, the doctor will answer questions and tell you what can be done if you become infected with rabies. Appointments can be made online and at the above numbers.

Related services: Ambulance call 5288

— Does the animal with rabies show any symptoms?

— Yes, a dog with rabies has certain signs that appear 12-20 days after the bite. The animal's behavior changes: it avoids people, howls, is in no mood, often angry, does not eat, does not drink water, can swallow unusual objects (a piece of wood, rags, nails). After 1-2 days he becomes aggressive, a large amount of saliva comes from his mouth, has an unsteady gait, runs away from home and often gets lost, after 2-3 days paralysis begins, and dies on the 7th or 8th day.

10 days before symptoms of the disease appear, saliva is dangerous because it already contains the rabies virus!

Rabies is an extremely dangerous viral disease characterized by severe damage to the brain and spinal cord. It often ends in death.

Rabies occurs in all mammals and is transmitted through body fluids, mainly saliva. A person, as a rule, becomes infected with it as a result of the bite of an infected animal, most often a dog, cat, rabbit, ferret, fox, wolf, raccoon, bat, etc.

At the initial stage, the disease is manifested by increased salivation and fear of water, as well as a depressed state, which is replaced by attacks of aggression and excitement.

People at risk of developing rabies should be vaccinated.

Unfortunately, the appearance of symptoms of the disease inevitably ends in death, so treatment only involves alleviating the patient’s condition.

Synonyms Russian

Rabies, hydrophobia, hydrophobia.

English synonyms

Rabies, Hydrophobia, Canine madness, Lyssa, Madnessan.

Symptoms

Rabies usually does not cause any symptoms until the last stage of the disease, when treatment is no longer possible. The incubation period (from infection to the onset of symptoms) ranges from 7 days to 1 year, with an average of 20-90 days. Signs of the disease often appear several days before the patient’s death:

• before the main symptoms appear, swelling, redness, itching may occur at the site of the bite,
• fever,
• headache, malaise,
• loss of appetite, nausea, vomiting, diarrhea,
• anxiety, sleep disturbances,
• depression,
• increased sensitivity to auditory and visual stimuli,
• a depressed state of consciousness, anxiety, and apathy are replaced by attacks of excitement, restlessness, and aggression. Attacks of excitement are accompanied by increased breathing and heart rate,
• breathing and swallowing disorders,
• hydrophobia - fear of water (when talking about it or trying to drink, the patient experiences horror, he experiences painful spasms of the pharynx and larynx),
• excessive salivation
• hallucinations,
• convulsions,
• partial paralysis

General information about the disease

Rabies is a dangerous viral disease that is characterized by severe damage to the central nervous system (brain and spinal cord). At the initial stage it is asymptomatic, symptoms appear at a later stage, when treatment is no longer possible.

The prevalence of rabies depends on the level of vaccination of domestic animals. It is most common in rural areas and occurs more often in the summer.

Rabies can affect all mammals and is transmitted through body fluids, mainly saliva. In humans, rabies infection usually occurs as a result of a bite from an infected animal, or contact with the saliva of an infected animal on damaged skin, mucous membranes of the mouth, nose, and eyes. Rabies is transmitted much less frequently by eating infected meat. The disease does not spread from person to person; infection through organ transplantation from infected donors can occur extremely rarely.

Most often, a person becomes infected from domestic animals - dogs, cats, rabbits, horses, ferrets, less often - from wild ones - foxes, raccoon dogs, wolves, raccoons, bats, etc. Wild animals, in turn, infect domestic animals with rabies.

After the virus enters the body through the skin or mucous membrane, it reaches the spinal cord and brain along nerve fibers, where it is fixed and begins to divide. Encephalitis occurs - inflammation of the brain. This leads to increased reflex excitability and the development of paralysis. The virus then spreads along the nerve fibers in the opposite direction, entering the liver, kidneys, adrenal glands, skin, heart, salivary glands, skeleton, causing disruption of the nervous system and dysfunction of various organs.

The rate of spread of the virus depends on the location of the bite (for bites of the head or hands it will be high), its depth, the number of pathogens that have entered the wound, the activity of microorganisms, and the immune status of the infected person.

The incubation period of the disease averages 20-90 days, but can vary from a week to one year. Once symptoms appear, death is usually inevitable.

Death usually occurs as a result of damage to the respiratory center, which entails respiratory arrest.

Who is at risk?

• Those who have been bitten by domestic or wild animals.
• Residents of rural areas who keep animals at home that are not vaccinated against rabies.
• Traveling to developing countries (Africa, Southeast Asia).
• Traveling into nature and coming into contact with wild animals (foxes, raccoons, bats, etc.)
• Hunters, trappers.
• Employees of zoos, nurseries, animal shelters.
• Veterinarians.
• Working with the rabies virus in the laboratory.

Diagnostics

The diagnosis of rabies is assumed when symptoms of the disease are present after an animal bite and is confirmed by examining a skin sample from the back of the head and isolating the virus from saliva, lacrimal and cerebrospinal fluid.

Laboratory research

• Complete blood count (without leukocyte formula and ESR). The white blood cell count may be elevated.
• General urine analysis. With rabies, there may be a significant increase in the number of leukocytes in the urine in the absence of bacterial inflammation.
• A blood test aimed at determining antibodies to the rabies pathogen. The analysis uses special immunofluorescence staining to detect the presence in the blood of molecules produced by the immune system in response to the rabies virus entering the body. The diagnosis is confirmed by a significant (4 or more times) increase in the number (titer) of antibodies to the rabies virus in patients who have not been vaccinated.

• Determination of the causative agent of rabies in biological fluids and body tissues. Study of biopsy samples (tissue fragments) of the skin of the back of the head, imprints of the cornea. Labeled antibodies (molecules that specifically bind to the rabies virus molecule) are added to the resulting material. Under the influence of ultraviolet radiation, a complex of viruses “glued” with antibodies gives a characteristic greenish glow, which indicates the presence of the rabies virus in the taken material. This analysis is most reliable during the first week of the disease.
• Study of the genetic material of the virus using the polymerase chain reaction (PCR). Saliva, blood, cerebrospinal fluid, and affected tissue can be used. The reliability of the results is close to 100%.
• Examination of brain tissue using electron microscopy. A section of brain tissue is taken (biopsy), which is then specially stained and examined under an electron microscope, which allows for a very high degree of magnification. In this case, in the cells of the nervous tissue affected by the rabies virus, special inclusions are released or the virus itself is detected.

Other research methods

• Electroencephalography (EEG) is a method that evaluates the electrical potentials of the brain.

Treatment

There is no specific treatment for rabies. As a rule, the disease is incurable and leads to death.

When bitten by a wild animal, the wound is washed, thoroughly examined for foreign bodies (for example, broken teeth), and debridement is performed. Then immunoglobulins – special cells of the immune system – are urgently introduced. Next, the patient is vaccinated over the course of two weeks (a total of 5 vaccines are used). This is the only way to prevent the disease.

After a bite, the pet must be observed for approximately 10 days and if symptoms of rabies appear, immediately consult a doctor to take measures to immunize the patient. The source of rabies - a sick animal - must be isolated.

Treatment of rabies is aimed at alleviating its symptoms - relieving seizures and reducing pain. For this purpose, anticonvulsant, analgesic, and sedative medications are used, respectively.

To reduce contact with potential irritants, the patient is placed in a special ward.

Loss of fluid and minerals are replenished; artificial ventilation is performed.

Prevention

• People at risk of developing rabies should be vaccinated.
• After being bitten by a wild animal, you must thoroughly wash the wound with soap and water and immediately consult a doctor to undergo a course of immunization and vaccination against rabies.
• Preventive vaccination of domestic animals.
• Pets should be kept indoors and supervised when outside. Cages and closed pens can be used for this purpose. This will help avoid infection of domestic animals from wild ones. Special attention should be paid to rabbits, guinea pigs, hamsters and other small pets, as they cannot be vaccinated against rabies. Often a domestic animal becomes infected outside the city, where it has the opportunity to come into contact with wild animals, for example cats, dogs can run into the forest and come into contact with infected rodents and foxes there.
• You should follow the rules of communication when meeting stray animals - do not touch them or pet them to avoid being bitten.
• Avoid contact with wild animals (eg foxes, raccoons). Healthy wild animals themselves avoid people, so an animal that is not afraid of people and does not try to escape should arouse suspicion.
• A bite from a pet can also be a reason to see a doctor, for example, if you don’t know whether it could be infected with rabies, and even more so if the animal died within a few days after the bite.

Recommended tests

• General blood analysis
• General urine analysis

Literature

• Dan L. Longo, Dennis L. Kasper, J. Larry Jameson, Anthony S. Fauci, Harrison's principles of internal medicine (18th ed.). New York: McGraw-Hill Medical Publishing Division, 2011.
• Manning SE, Rupprecht CE, Fishbein D, et al. Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. May 23 2008;57:1-28.
• Hemachudha T. Human rabies: clinical aspects, pathogenesis, and potential therapy. Curr Top Microbiol Immunol. 1994;187:121-43.
• Gerald L. Mandell. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases: Expert Consult Premium Edition. Churchill Livingstone, 2009.

— When does death occur and what is the reason?

— In the event of a bite or scratch from a sick animal, when the patient does not contact the rabies service in a timely manner, therefore does not vaccinate and becomes infected with rabies, then medicine is no longer powerless.

It is important that readers realize that symptomatic rabies cannot be treated. Even today, modern medicine has not found a drug that will save an already sick patient.

The only way to prevent rabies is timely vaccination.

Excitation stage

The stage is characterized by increased sensitivity to external stimuli (light, smell, touch, sound) and fear of water. For example, the patient cannot even take a sip of water - convulsive contractions begin, even to the point of vomiting. As the disease progresses, convulsions occur even from the sound of pouring water. The patient's blood pressure rises, the heart rate increases, breathing becomes frequent and shallow, profuse sweating and drooling appear.

This stage is characterized by periods of excitement when the sick person cannot control himself. He becomes aggressive, tears his clothes, attacks people, and screams in a voice that is not his own. The attack is accompanied by aggressive hallucinations.

On our website Dobrobut.com you will find more information on this topic. By calling the above numbers, you can make an appointment with a doctor who will tell you when to do a blood test for rabies and what can alleviate the condition of an already sick person.

Speckled skin

Microsporia or ringworm is one of the most common skin diseases of animals. When people become infected from them, people also get sick: small spots appear on the skin, covered with gray scales; there can be from two to a hundred of them on the human body. The causative agent of microsporia also affects the hair, so sometimes during treatment the head has to be shaved, which is very unpleasant for the patient. If you notice even a slight redness in the shape of a circle or ring, do not be lazy - go to a dermatologist. If time is lost, curing the disease will be much more difficult.

Disease on bird rights

Indoor birds (budgies, canaries and other small songbirds) can be a source of infection with psittacosis (pneumochlamydia). People who usually have constant contact with birds get it. When infected at home, family outbreaks can occur. Infection occurs by airborne droplets - when particles of bird feces are inhaled with dust while cleaning cages. The disease usually occurs 5–10 days after an infected bird appears in the house. If your feathered pet has been living with you for several months, then most likely it is healthy and infection is unlikely (if during this time there has been no contact with other birds). A sick person develops chills, headache and muscle pain, an increase in body temperature to 38-40 degrees, a dry cough and sore throat. On the fifth to seventh day, chest pain, shortness of breath, cough with bloody mucous sputum, and signs of pneumonia appear. A person suffers from insomnia and dizziness. If you do not consult a doctor in time, subsequent relapses and the disease may become chronic. The danger of the disease should not be underestimated, therefore, when the first signs of illness appear, you should immediately see a doctor.

First, vaccinations...

If you notice any of the signs described above, do not rush to make a diagnosis yourself: even doctors never make a final verdict without the results of laboratory tests. It is better to immediately contact specialists, since it is always easier to get rid of any disease in the early stages. However, you need to be prepared for the fact that treatment can last from several weeks to months. In severe cases, hospitalization cannot be avoided. The best infection prevention is knowledge. Knowing that four-legged friends can be sources of very unpleasant diseases, it is wiser to prevent infection. If you pick up a dog or cat on the street, be sure to take it to the vet. He examines the animal for diseases, “illuminates” it with a fluorescent lamp to find out if there is microsporia, and gives the necessary vaccinations. Only then can you fearlessly introduce the foundling to your household. If the animal is sick, try to cure it; if the case is severe, it is better to euthanize - it will be more humane. But under no circumstances throw you out onto the street! After all, it becomes a source of infection for other people. And please practice good personal hygiene.