Rabies


Rabies

Description rabies

Rabies is very dangerous and currently still incurable viral disease that causes acute encephalitis, namely inflammation of brain tissue. Worldwide die each year about fifty-five thousand people in its aftermath, the majority of victims are from rural areas of Africa and Asia, where there is less vaccination of domestic animals and poor accessibility to vaccinate infected.

It is a typical zoonosis, a disease transmitted by animals, most often when a person becomes infected saliva of an infected animal during close contact such as a bite or scratch, but rarely as possible, other methods of transmission. Carriers are only warm-blooded animals, almost exclusively mammals, birds are rare occurrence only. The Czech Republic is the most important carrier of a fox, then dogs, cats, bats and badgers in other areas of the world as well as cattle, raccoons, coyotesor hyenas.

Rabies is fatal in nearly hundred percent of cases, if not immediately after infection and vaccination administered immunoglobulins.

Rabies virus, lyssavirus called, after penetration into the body (most often bite) gets into the central nervous system, the brain, after penetration of the muscles along the peripheral nerves, known as axonal transport. Distance from the affected area of the brain determines the incubation period, which is usually about a few weeks or months, in exceptional cases can go up to a year or two. After reaching the brain leads to the outbreak of severe symptoms, the picture of the disease is very dramatic and has virtually no treatment options. Unfortunately, the patient dies within a few days.

Risk factors

Risk factors for the disease rabies is naturally exposed to infected animals. Slightly more people are likely to be at risk to employment, which with such animals come into contact more frequently. In our environment, and other developed areas of the world’s highest possibility of infection primarily from wild animals, while in poorer areas of Africa, Asia and sometimes even South America prevails infection of domesticated animals, whether it’s a typical dog or farm animals such as cattle . Still there is not enough livestock vaccination coverage. Most of the infected are children there.

rabies prevention

Global prevention should be a blanket vaccination especially dogs and other domestic animals, but wild animals such as foxes or raccoons with us in the US. In developed countries have already introduced vaccination, but in less developed countries, where it is often still not adequate resources, rabies still remains a serious problem. Prevention after infection is obviously accelerated seek medical care and administration of vaccines and immunoglobulins that very reliably prevent the development of any symptoms and thus saves the life of the infected.

Signs and symptoms of rabies

After the expiry of various long incubation period is first to nonspecific symptoms similar to flusymptoms in common. These include mainly headache, increased fatigue, fever, loss of appetite to nausea and muscle pain. It is also present tingling or twitching in the wound, the point of entry.

Problems with gradually escalating and soon there is an outbreak of severe and characteristic symptoms mainly related to the nervous system.

These symptoms have already developed the disease are very diverse. Present acute severe headache, irritability, aggressive movements, partial paralysis of various parts of the body, which can subside and again back or muscle spasms or seizures similar to epileptic. Develops and changes in mental and appear bizarre and irrational thoughts, uncontrollable excitement and agitation, panic attacks and depression. The patient has trouble sleeping when he gets to the stage where it is totally unable to sleep, is confused and disoriented bouts of paranoia. The exception is not uncontrolled and unwarranted fear and extreme sensitivity to bright light, certain sounds and touch, hallucinations and prosecute the patient gradually gets into delirium. It is negatively affected muscles of the whole body, especially the face and eyes, causing double vision and inability to speak. Disability respiratory muscles is extremely serious because the immobility of the diaphragm causes breathing difficulty breathing through sheer impossibility.

The typical image of a patient with rabies include “foaming at the mouth” – it is given very Increased production of tears and saliva. At the same time losing the ability to speak and swallow, this complex is typical for late-stage disease. In its result is affected by the developed hydrophobia, thus phobic fear of water. Because of the paralysis of the muscles of the neck and jaw victim can not swallow and looking at the water, which can quench their thirst gradually increasing, often getting panic attacks. Alternating with periods of mania and lethargy vyúsťující up in coma and subsequent death. In most cases, the cause of death already mentioned shortness.

The world is known to only a handful of cases of people who survived despite developing symptoms, most of them have suffered irreversible brain damage. Only two cases of young people and children are completely healed.

rabies treatment

As already mentioned, developed with rabies manifesting symptoms is virtually untreatable.Therefore, it is necessary to urgently seek medical help immediately after the bite or scratch by an unknown animal. At the hospital, the doctor typically first wound cleaned, disinfected, treated and make sure whether the victim vaccinated against tetanus. What happens next depends on the discretion of the physician. It’s hard to predict whether the animal was infected, so the doctor for vaccination reaches by several information:

The first question is whether the attack was provoked by an animal, or unprovoked. Unprovoked indicate increased aggressiveness of the animal and is therefore likely infection. Further terms of the type of animal, since not all the animals are able to transmit the rabies virus. Further, if it is a dog with dohledatelnými records to convince a physician about his vaccination history. If it is not possible to rule out rabies vaccination is administered to the patient.

At the same time WHO has created three categories of contact: the first involves touching or feeding suspect animal, the skin of the patient is unaffected. The second is a minor scratches or abrasions without bleeding, the third, most serious, is one or more larger bites and scratches and especially assault bat. For the second and the third category is a vaccine for the third category, and people with weakened immune systems to give rabies antibodies, immunoglobulins.

Vaccination

Vaccination against rabies was discovered in 1885 by Louis Pasteur and Emile Roux. The original vaccine had a basis in dried nerve tissue of infected rabbits. Currently used modern vaccines with a base in diploid cells. The first dose of vaccine is administered in the deltoid muscle as soon as possible after infection, followed by additional doses third, seventh and fourteenth day.

It serves modern inoculum, while the older, cheaper, which is based on neural tissue is used in poorer areas of the world, but even these are gradually being replaced.

Nowadays they are exploring other treatment options, such as the use of ketamine anesthetic to alleviate lyssaviruses activity or affecting the blood-brain barrier (that is a barrier between the nervous tissue and blood vessels). This barrier prevents immune system cells to penetrate into the sites affected by a virus, so opening this barrier appears to be one of the treatment options already propuknutého disease.

A specific treatment for specified only in 2005 is called. Milwaukee protocol, where doctors said the young unvaccinated infected patient with the initial symptoms of the disease into a coma with the use of several drugs to save the brain, while the immune system is tackled with the virus. This method of treatment has so far been successful only in one other case, both of cure were very young, the elderly yet been death.

What can I do myself

The simplest advice is mainly to avoid the suspect animals. It is not always possible to estimate the danger of an animal, but it is true that the infected animal is behaving abnormally often, can be either very aggressive or vice versa affectionate, often also foaming at the mouth. When meeting with a wild animal is good it does not irritating and far avoided. Title danger to children, who often want to feed unknown animals or pet, therefore, parents should check and watch.

Increased caution is needed in our country especially during March and April, when the virus infection peaks.

If already bitten, wash the wound well with soap and water for up to ten minutes and can be applied to the wound and alcohol or tincture of iodine and cover it with a clean sterile dressing. It is necessary to wait and immediately call your doctor and come to the nearest emergency room because everyone suspected of having rabies must be treated in hospital. It is also suitable in some way to ensure that the animal was trapped and examined by a veterinarian to determine whether the animal was infected, and also to monitor the situation regarding rabies in the area. If you know the owner of the animal, it is necessary to ask his name and address and request documents for animals, especially his records and vaccination card. Another technique is already in the hands of doctors, rabies is absolutely unmanageable own.

complications of the disease

Almost certain complications of the disease is, unfortunately, despite the ongoing research exploring treatment options still death. For the few survivors of the disease was the result of severe brain damage. It should therefore not underestimate rabies and adopt as soon as possible all the necessary measures to nepropukla illness at all. There are also classical possible complications after administration of the vaccine, which is similar to complications following administration of an ordinary flu vaccinations, so they are not serious enough and only include problems such as pain or redness at the injection site, in the worst case an allergic reaction, but that is easily manageable.

Other names: aggressiveness, Lyssa, rampage

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