Just over a year ago I had to deal with such an unpleasant thing as a suspicion of infection with rabies. The read article about vaccinations for travelers
read me a reminder of that incident - especially the lack of reference to rabies, although it is extremely widespread (especially in Russia, Asia, Africa and America) and a very insidious virus. Unfortunately, the associated risks are not always given due importance.
So what is rabies? It is an incurable
viral disease that is transmitted through the saliva or blood of infected animals and people. In the overwhelming majority of cases, the bite of an animal that carries a virus leads to infection.
What can the average resident of Russia offhand say about rabies? Well, there is such a disease. In connection with it, rabid dogs are most often remembered. The older generation most likely still necessarily adds that in the case of a bite of such a dog, you will have to make 40 injections in the stomach and forget about alcohol for a few months. Here, perhaps, that's all.
Let's see why this attitude to this disease is extremely dangerous.
Surprisingly, not everyone knows that rabies is a 100% deadly disease. If the virus in one way or another got into your body, the “countdown” is activated: gradually multiplying and spreading, the virus moves along the nerve fibers to the spinal cord and brain. His “journey” can last from several days or weeks to several months - the closer the bite to the head, the less time you have been allowed. All this time, you will feel completely normal, but if you allow the virus to reach its goal, you are doomed. When this happens, you will not feel the symptoms of the disease yet, but you will already become its peddler: the virus will appear in the secretions of the body. After this, it becomes possible to detect rabies by means of tests, but it is too late to treat it at this stage. As the virus multiplies in the brain, the first innocent first symptoms begin to manifest themselves and in a few days develop into rapidly progressive inflammation of the brain and paralysis. Exodus is always the same - death.
Treatment of rabies is literally a race with death. The disease will not develop only if you have time to apply the rabies vaccine before the virus enters the brain and give it time to act. This vaccine is an inactivated (dead) rabies virus, which is injected into the body to “train” the immune system against the active virus. Unfortunately, this “learning” takes time to produce antibodies, and the virus continues to wade to your brain. It is believed that the vaccine is not too late to apply within 14 days after the bite - but it is better to do so as soon as possible, preferably in the first day. If you timely asked for help and you were given a vaccine, the body will form an immune response and destroy the virus "on the march." If you are hesitant and the virus managed to penetrate into the brain before the formation of the immune response - you can look after your place in the cemetery. Further development of the disease will no longer stop.
As you can see, this disease is extremely serious - and the myths on this topic that exist in Russia look all the more strange.
Myth number 1
: Only dogs can get mad. Sometimes, cats and (less often) foxes are also referred to as possible peddlers.
The sad reality is that many other animals (more precisely, mammals and some birds) - raccoons, cattle, rats, bats, roosters, jackals, and even squirrels or hedgehogs can be carriers of rabies, besides the named ones.
Myth number 2
: a rabid animal can be easily distinguished by inappropriate behavior (the animal moves strangely, it has saliva, it throws itself at people).
Unfortunately, this is not always fair.The incubation period of rabies is long enough, and the carrier’s saliva becomes infectious 3-5 days before the first symptoms appear. In addition, rabies can occur in a "quiet" form, and the animal often loses its fear and goes to people, apparently not showing any threatening symptoms. Therefore, if you bite any wild or just unknown animal (even if it looked healthy), the only correct action is as soon as possible, preferably on the first day, to see a doctor for the introduction of a rabies vaccine.
Myth number 3
: if the bite wound is small, it is enough to wash it with soap and disinfect it.
Perhaps the most dangerous misconception. The rabies virus, indeed, does not tolerate contact with alkaline solutions - but in order to penetrate the tissues of the body, any damage to the skin will suffice. There is no way to know if he managed to do this before washing the wound.
Myth number 4
: the doctor will prescribe you 40 painful injections in the stomach, and you will have to go to these injections every day.
This was true, but in the last century. Currently applied rabies vaccines require 4 to 6 shots to the shoulder with an interval of several days, plus optionally another shot to the bite site.
In addition, the physician (infectious disease specialist or rabiologist) may decide that vaccination is not appropriate, based on the circumstances of the bite and the local epidemiological situation (it is estimated that it was for the animal, whether it was domestic or wild, where and how everything happened, whether cases of rabies and so on).
Myth number 5
: The rabies vaccine has many side effects and you can even die from it.
This type of vaccine does have side effects - this is the main reason why, in most cases, it is not prophylactic vaccination that is vaccinated against rabies, but only if there is a risk of infection. These “side effects” are rather unpleasant, but more often than not, they are not very long, and enduring them is not such a big price for staying alive. It is impossible to die from the vaccines themselves, but if you do not make them after the bite of a suspicious animal or skip a second vaccination, you may very well die of rabies.
Myth number 6
: if you catch or kill an animal that has bitten you, then you should not do vaccinations, because doctors will be able to do an analysis and find out if it hurt rabies.
This is only half true. If an animal is caught and has no signs of rabies, it can be quarantined, but it will not save you from vaccination. Doctors can make the decision to stop it only if the animal does not get sick and does not die within 10 days - but here you can be lurked by such a zapadlo as atypical rabies. This is when a sick animal lives significantly
longer than those same 10 days - and all this time it has been carrying the virus, without showing external symptoms of the disease. Comments are superfluous. However, it should be noted that atypical rabies is extremely rare according to statistics - but it is still better to bring the initiated vaccination course to the end than to get into the same statistics and prove later on that the tragic coincidence occurred.
In the case when the animal is killed on the spot or caught and put to sleep - such an analysis is possible through the study of brain slices, but how long it will be done (and whether) will very much depend on where everything happened and where you turned for help. . In most cases, it is safer to immediately begin a course of vaccination and stop it if rabies is not confirmed by laboratory research.
If the animal that bit you has escaped - this is a definite indication for vaccination, and only the doctor should assess the risk. Of course, passing the course of vaccinations may well be a reinsurance - because you have nowhere to find out for sure whether the animal was infected with rabies.But if the vaccination is not done, and the animal was still a carrier of the virus, then you are guaranteed a painful death in a few weeks or months.
Myth number 7
: if you have been bitten by an animal that has a rabies vaccine, vaccination is not required.
This is true, but not always. The vaccination should be, firstly, documented (recorded in the vaccination certificate), and secondly - should not be overdue or delivered less than a month before the incident. In addition, even if the documents are good, but the animal behaves inadequately - you should consult a doctor and follow his recommendations.
Myth number 8
: rabies can become infected if you touch a sick animal, or if it scratches or licked you.
This is not quite true. The rabies virus is not able to exist in the external environment, therefore it cannot be on the skin/coat of an animal or on claws (for example, feline). Here in saliva he feels fine - but he cannot penetrate through intact skin. In the latter case, however, you should immediately wash with soap and disinfect the slaked skin area, after which you should consult a doctor and let him decide on the need for further action.
Myth number 9
: you shouldn’t drink alcohol during and after rabies vaccination, otherwise it will neutralize the effect of the vaccine.
There are no scientific grounds for allegations of blocking the production of antibodies during rabies vaccination by alcohol. This horror story is distributed exclusively in the countries of the former USSR. Tellingly, the doctors did not hear about such prohibitions outside the former social camp, and there are no any contraindications related to alcohol in the instructions for rabies vaccines.
The roots of this horror story goes back to the last century, when vaccines of the previous generation were used, which were really pricked in the stomach for 30-40 days in a row. Skipping the next injection both at that time and now is fraught with nullifying the effect of vaccination, and drunkenness is one of the common reasons for not visiting a doctor.
Myth number 10
: Rabies is treatable. Americans cured a sick girl according to the Milwauke Protocol after the onset of symptoms of the disease.
This is very controversial. Indeed, such an extremely complex and expensive (about $ 800,000) method of treating rabies at the stage of symptoms exists, but the number of cases of its successful application has been confirmed all over the world. In addition, science still can not explain exactly how they differ from a much larger number of cases when the treatment under this protocol did not produce results. Therefore, one should not hope for the Milwaukee Protocol - the probability of success there fluctuates at the level of 5%. The only officially recognized and effective way to avoid rabies in the event of a risk of infection is still only timely vaccination.
In conclusion, I will tell an instructive story. I live in Germany, and in our country, as in many neighboring countries, there is no longer “local” rabies in animals (and, accordingly, cases of human infection) due to the efforts of the government and health organizations. But the “imported” sometimes leaks out. The last case was 8 years ago: a man was admitted to the hospital with complaints of high fever, spasms when swallowing and problems with coordination of movements. In the process of collecting history, he mentioned that 3 months before the onset of the disease he returned from a trip to Africa. He was immediately tested for rabies - and the result was positive. The patient later managed to tell him that he was bitten by a dog during the trip, but he did not attach any importance to this and did not address it anywhere. This man soon died in an isolated ward.And by that time all local epidemiological services up to the Ministry of Health had already stood on their ears - still, the first case of rabies in the country for what the hell knows how many years ... from that ill-fated trip.
Do not neglect the bites of animals, even pets, if they are not vaccinated - especially in countries where rabies is common. Only a doctor can make a competent decision about the need for vaccination in each particular case. By letting it drift, you put your family and your loved ones at risk.