How a dog can get rabies: all possible ways. Rabies in humans - symptoms, first signs. Can a deadly disease be cured? How not to get rabies

Rabies is an acute infectious (viral nature) disease of humans and animals, characterized by damage to the brain substance: when infected, an inflammatory process (encephalitis) develops.

Despite the fact that rabies is one of the oldest infections, there is still no tendency to reduce it, as well as effective treatments have not been developed. Rabies remains a deadly disease.

The symptoms of the disease are specific, but a rather long time can pass between infection and the first manifestations of the disease. In this article we will talk about the treatment and prevention of rabies in humans, because it is very important to know how to protect yourself and your children from a dangerous disease.

The widespread occurrence of rabies among many species of warm-blooded animals poses a risk of infection to humans, including children. Most often, infection occurs, but it is possible to get the disease from wild animals.

Cause of the disease

The source of infection is sick animals. Wild animals (foxes, wolves, bats) and domestic animals (cats, horses, dogs, pigs, cattle) also get rabies. In this regard, a distinction is made between urban and forest types of rabies.

Rare cases of virus infection from a sick person have also been registered.

A person receives the virus when bitten by sick animals or when salivating the skin and mucous membranes. At present, the possibility of infection by airborne droplets has been proven.

In this way, people can become infected by breathing air in caves with a lot of bats. The rabies virus can be obtained through food (). It is impossible to exclude the contact route of infection through things that have come into contact with the saliva of a sick animal.

The most susceptible to the disease are children from 5-7 years to 14-15 (more often boys): it is at this age that children fearlessly contact animals, strive for such contact, including with stray cats and dogs.

The group of high occupational risk of infection includes hunters, foresters, veterinarians, stray animal traps. They can also become infected from dead animals. Often cases of infection are recorded through any microtrauma of the hands when skinning, butchering the carcass of a sick animal.

The seasonality of the disease is noted: from May to September. During this period, people (including children) spend more time outside than in winter. Rural residents are more likely to get sick, as they have more opportunities for contact with different animals.

Natural foci of rabies are everywhere! Wild animals with rabies often run into nearby settlements where they can attack people.

Animals are contagious already 10 days before they show signs of rabies, but the greatest danger of infection occurs during the period of manifestation of the disease.

Not every bite from an infected animal results in rabies. Approximately 30% of the bites of sick dogs and about 45% of wolf attacks are infectious to humans. The risk of infection is higher with bites in the face and head, neck, perineum, fingers of the upper and lower extremities. Deep and lacerated wounds are very dangerous.

Infection can occur even in cases where there is no bite as such, there is just a scratch mark from the teeth, or only salivation of the skin and mucous membranes. The virus enters the body through the skin and mucous membranes.

Symptoms

The incubation period for rabies is long, from 1 to 6 months. With extensive wounds and massive infection, the incubation period can be reduced to 9 days. With bites of the face, head and neck, the latent period is short, with bites of the lower extremities it is longer. Cases of the development of rabies a year or more after being bitten are described.

In the rabies clinic, 3 periods of the disease are distinguished:

• premonitory;
• excitation period;
• period of paralysis.

AT prodromal period diseases, aching pains appear in the area of ​​saliva or bite, even if the wound has already healed. There may be reddening of the scar, itching and burning.

The child's temperature rises within 38 ° C, worries, vomiting may occur. The child refuses food, his sleep is disturbed (insomnia appears). If the baby still falls asleep, then he sees frightening dreams.

The child during this period is closed, indifferent to what is happening, the mood is depressed, anxious. The facial expression is sad. A teenager is worried about an unfounded feeling of fear, heaviness in the chest, accompanied by breathing.

The duration of the prodromal period is 2-3 days (may be extended up to 7 days). Subsequently, mental disorders intensify, depression and indifference are replaced by anxiety.

AT excitation period the most characteristic symptom of rabies disease appears: hydrophobia (or hydrophobia). When the patient tries to swallow any liquid, even saliva, there is a muscle spasm of the larynx and pharynx.

The sight and even the sound of running water, and even talking about water, cause a feeling of fear and the development of such a spasm. When trying to give a drink to a patient, he pushes the cup away, arches, and throws his head back.

At the same time, the patient's face turns blue, expresses fear: the eyes are somewhat bulging, the pupil is dilated, the gaze is fixed at one point, breathing is difficult, sweating increases. Attacks of convulsive muscle contraction, although short-lived (lasting a few seconds), but they often recur.

An attack can provoke not only the type of liquid, but also a stream of air, a loud knock or sound, a bright light. Therefore, the patient develops not only hydrophobia (hydrophobia), but also aerophobia, acousticophobia, photophobia.

In addition to increased sweating, there is a profuse formation and secretion of saliva. There is psychomotor agitation and manifestations of aggression and rage. Patients can bite, they spit, they can hit, tear their clothes.

It is this inappropriate violent and aggressive behavior that is implied when people say: "behaves like a madman."

During an attack, confusion is noted, frightening visual and auditory hallucinations appear. Between attacks, consciousness may clear up.

Vomiting, sweating and salivation, the inability to take fluids lead to dehydration (this is especially pronounced in children) and weight loss. The temperature may remain elevated.

The excitation period lasts 2 or 3 days, rarely up to 5 days. At the height of any of the attacks, respiratory and cardiac arrest may occur, that is, death.

In rare cases, the patient can survive until the third stage of the disease - period of paralysis. Attacks in this stage stop, the patient can already drink and swallow food. Eliminates hydrophobia. Consciousness during this period is clear.

But this is an imaginary improvement. Body temperature rises above 40°C. Pulse is quickened. Excitement is replaced by lethargy. Depression and apathy are on the rise.

Then the function of the pelvic organs is disturbed, paralysis of the limbs and cranial nerves develop. Death occurs as a result of paralysis of the centers of respiration and cardiac activity.

In addition to the typical form, there is also atypical form rabies. With this form, there is no clear manifestation of periods of the disease; convulsive attacks of rabies and a period of excitement may not develop. Clinical manifestations of the disease are reduced to a depressive, drowsy state, followed by the development of paralysis.

Rabies child in early age has some distinctive features:

• the disease develops after a short incubation period;
• hydrophobia is not noted;
• the excitation period is sometimes absent;
• the death of a baby can occur on the very first day of the development of the disease.

In children older than 2-3 years, the clinical manifestations of rabies are the same as in adults.

Diagnostics

Rabies is diagnosed clinically. Even in highly developed countries, it is difficult to confirm the diagnosis in vivo. As a rule, it is confirmed after the death of the patient.

The main symptoms for clinical diagnosis are:

• the fact of biting or saliva of the patient's skin by an animal;
• pain at the site of the bite after the wound has healed;
• hydrophobia;
• photophobia;
• aerophobia;
• acousticophobia;
• psychomotor agitation;
• swallowing and breathing disorders;
• mental disorders;
• paralysis.

Due to the lack of intravital laboratory diagnostics, atypical forms of the disease in the absence of arousal and hydrophobia are practically not diagnosed. Diagnosis of rabies in children is especially difficult, because it is not always possible to establish the fact of contact of a child with a sick animal.

In 2008, French scientists managed to develop and offer for life-time diagnostics a study of a biopsy of the skin area of ​​the neck (on the border with hair growth) using the ELISA method.

The method is highly specific (98%) and highly sensitive (100%) from the first day of the disease. The study allows you to detect the antigen of the virus in the nerve endings near the hair follicle.

If it is possible to carry out the method of fluorescent antibodies, the imprints of the cornea are examined to detect the antigen of the virus.

When deciding on the need for immunoprophylaxis, it is necessary to diagnose rabies in the animal that inflicted the bite. This study is carried out as soon as possible after the bite of the patient (if the corpse of the animal is available for sampling of biological tissues). In this case, the virus can be detected in the cells of the brain and cornea of ​​the eyes or sections of the skin of animals using serological reactions and the method of fluorescent antibodies.

Treatment

Treatment of a patient with rabies is carried out only in a hospital. The conditions of the patient should exclude exposure to bright light (room with darkened windows), loud noise stimuli and air currents.

An effective therapy for rabies has not been developed. Anti-rabies immunoglobulin, anti-rabies serum and large doses have a weak therapeutic effect.

Symptomatic treatment is carried out:

• painkillers to reduce pain;
• anticonvulsants;
• sleeping pills for sleep disorders;
• the introduction of solutions to normalize the water-salt balance;
• drugs to stimulate the heart and respiratory system;
• treatment in a pressure chamber (hyperbaric oxygenation);
• cerebral hypothermia (ice pack on the head);
• connection of an artificial respiration apparatus (according to indications).

The outcome of the disease is unfavorable, patients die. Single worldwide cases of recovery of children are described.

Prevention

In our country, specific and non-specific prevention of rabies is carried out.

Non-specific prophylaxis provides for the following measures:

• capture and isolation of stray animals;
• identification of rabid animals by the veterinary service with their subsequent euthanasia;
• extermination of predatory animals near settlements;
• quarantine measures and laboratory diagnostics in the focus of infection;
• sanitary and educational work among the population.

Specific prophylaxis is carried out by conducting a course of combined administration of an anti-rabies vaccine and anti-rabies immunoglobulin after a bite or saliva by an animal. After a bite, you should treat the wound and consult a surgeon.

Wound treatment is carried out as follows:

• wash the wound abundantly with boiled soapy water or hydrogen peroxide;
• treat the wound or 70 ° with alcohol;
• suturing the wound, as well as excision of its edges, is contraindicated;
• anti-rabies immunoglobulin is injected around the wound and into the wound itself;
• after 24 hours, anti-rabies serum is introduced.

The first two points of treatment should be carried out at home, even before visiting a doctor; the rest is performed by a surgeon.

Given the detrimental effect of high temperature on the virus, in the field, you can use the old method of treating wounds after an animal bite: cauterization of the bite wound with a red-hot iron.

To destroy the virus, you can put a crystal of permanganate or carbolic acid in the wound.

In the case of a pet bite, the doctor specifies under what circumstances the bite was received, whether it was provoked by the patient's behavior, whether the animal was vaccinated against rabies and where the animal is now. If the bitten animal is healthy (there is a certificate of vaccination), then vaccination is not carried out.

If the animal disappears after the bite, or if the patient is bitten by a wild animal, vaccination with an anti-rabies vaccine and anti-rabies immunoglobulin is carried out.

The vaccination scheme is selected for the patient (especially the child) by the doctor individually: depending on the depth and location of the bite, the duration of the bite, on which animal caused the bite and whether it is possible to observe it.

If, after 10 days of observation of a pet that has bitten a person, it remains healthy, then the administration of the vaccine is canceled after 3 injections already received (if salivation or a shallow single bite has occurred).

But if the bite was inflicted in dangerous places (listed above), as well as in the absence of the opportunity to observe or examine the animal, continue to administer the vaccine until the end of the prescribed regimen.

• salivation of mucous membranes;
• bites (of any depth and quantity) to the dangerous places listed above;
• deep single or multiple bites inflicted by pets;
• any damage or saliva by wild animals or rodents.

The rabies vaccine is injected intramuscularly into the shoulder area, and for children under 5 years old - into the area of ​​the upper third of the anterolateral surface of the thigh. The vaccine should not be injected into the buttocks. The vaccine has a preventive effect even in the case of multiple severe bites.

Persons from the occupational risk group are given primary prophylaxis with the rabies vaccine. Prophylactic administration of the vaccine is also recommended for young children, given that they may not tell about the contact with the animal.

Preliminary prevention can also be carried out for children when planning vacations in the countryside or at a health summer camp.

The vaccine is administered 1 ml intramuscularly 3 times: 7 and 28 days after the first injection. Persons at risk of infection are revaccinated every 3 years. Adults and children after vaccination should avoid overheating, avoid overwork. During vaccination and within six months after it, it is necessary to categorically exclude the use of any types and doses. Otherwise, there may be complications from the CNS.

Summary for parents

Given that rabies is almost impossible to cure, all measures must be taken to prevent infection of the child. Children should be taught from an early age the dangers of contact with stray cats and dogs. Small children should not be left unattended to prevent attacks and animal bites.

• Rabies is a vaccine-preventable viral disease that occurs in more than 150 countries and territories.
• In the vast majority of human deaths from rabies, the source of infection is dogs, which account for up to 99% of all cases of rabies transmission to humans.
• Rabies eradication can be achieved through dog vaccination and bite prevention.
• This infection kills tens of thousands of people every year, mostly in Asia and Africa.
• 40% of people bitten by animals suspected of having rabies are children under 15 years of age.
• Immediate, thorough washing of the wound with soap and water after contact with a suspected rabid animal is critical and can save lives.
• WHO, the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO), and the Global Alliance for Rabies Control (GARB) have established the United Against Rabies partnership to develop a common strategy to reduce zero human deaths from rabies by 2030.

Rabies is an infectious viral disease that is almost always fatal after the onset of clinical symptoms. Nearly 99% of rabies virus transmission to humans comes from domestic dogs. At the same time, rabies can affect both domestic and wild animals. It is transmitted to humans through bites or scratches, usually through saliva.

Rabies is present on every continent except Antarctica, with 95% of human deaths occurring in regions of Asia and Africa.

Rabies is one of the neglected tropical diseases that predominantly affects poor and vulnerable populations living in remote rural areas. Although there are effective rabies vaccines and immunoglobulins available for humans, they are not always available and not always available to those in need. In general, rabies deaths are rarely reported in official records. The victims are often children between the ages of 5 and 14. Given that the average cost of a course of rabies post-exposure prophylaxis (PEP) can be US$40 in Africa and US$49 in Asia, such treatment can represent a catastrophic financial burden for affected families whose daily income averages US$1-2 per person. person.

Each year, more than 15 million people worldwide are vaccinated after being bitten. This is estimated to prevent hundreds of thousands of rabies deaths each year.

Prevention

Elimination of rabies in dogs

Rabies is a vaccine-preventable disease. Vaccination of dogs is the most cost-effective strategy for the prevention of rabies in humans. Vaccination of dogs leads to a reduction in rabies-related mortality and reduces the need for PEP as a component of medical care for dog bite patients.

Rabies awareness and dog bite prevention

Education about dog behavior and prevention of bites in both children and adults is a critical extension of a rabies vaccination program and can reduce both the incidence of rabies in humans and the financial burden associated with treating dog bites. Raising awareness of rabies prevention and control in communities includes education and dissemination of information about responsible pet ownership, dog bite prevention, and immediate response after a bite. Participation and ownership of the program at the community level promotes greater outreach and learning of the basics.

Preventive immunization of people

There are vaccines intended for humans for preventive immunization prior to animal contact. They are recommended for people involved in certain high-risk activities, such as laboratory workers who work with live rabies viruses and other rabies-causing viruses (lyssaviruses), and those who are professionally or non-professionally involved in activities that may directly contact with bats, predators or other mammals that can act as carriers of the infection.

Preventive immunization is also recommended for people traveling to remote areas affected by rabies who plan to spend a lot of time in nature, doing caving or mountaineering. People traveling on long trips or moving permanently to areas with a high risk of rabies should be vaccinated if there is limited local access to anti-rabies medicines. Finally, consideration should be given to immunizing children living in or visiting remote high-risk areas. When playing with animals, children may get more severe bites or may not report bites.

Symptoms

The incubation period for rabies is usually 2-3 months, but can vary from 1 week to 1 year depending on factors such as the site of entry of the rabies virus and the viral load. The initial symptoms of rabies include fever and pain, as well as unusual or unexplained tingling, prickling, or burning sensations (paresthesia) at the site of the wound. As the virus spreads through the central nervous system, progressive lethal inflammation of the brain and spinal cord develops.

There are two forms of this disease:

• People with violent rabies show signs of hyperactivity, agitated behavior, hydrophobia (fear of water), and sometimes aerophobia (fear of drafts or fresh air). Death occurs within a few days as a result of cardiorespiratory arrest.
• Paralytic rabies accounts for about 20% of all human cases. This form of rabies is less dramatic and usually longer than the violent form. Muscles are gradually paralyzed, starting at the site of a bite or scratch. A coma slowly develops and eventually death occurs. Paralytic rabies is often misdiagnosed, contributing to underreporting of the disease.

Diagnostics

Currently available diagnostic tools are not suitable for detecting rabies infection before the onset of clinical symptoms of the disease, and until specific signs of rabies develop, such as hydrophobia or aerophobia, clinical diagnosis can be difficult. Intravital and post-mortem confirmation of rabies in humans can be carried out using various diagnostic methods aimed at detecting the whole virus, viral antigens or nucleic acids in infected tissues (brain, skin, urine or saliva).

Transmission

Infection in humans usually results from a deep bite or scratch inflicted on an animal that is infected with rabies, with 99% of transmission to humans occurring from rabid dogs. Africa and Asia have the heaviest human burden of rabies and account for 95% of the world's rabies deaths.

In the Americas, bats are now the main source of infection for the majority of human rabies deaths, as transmission from dogs in this region has largely been interrupted. In addition, bat rabies is emerging as a new public health threat in Australia and Western Europe. Human deaths from contact with foxes, raccoons, skunks, jackals, mongooses and other wild predatory animals that carry rabies are very rare. There is no evidence to support the transmission of rabies through rodent bites.

Transmission can also occur if infectious material (usually saliva) comes into direct contact with mucous membranes or fresh wounds on the skin of a person. Human-to-human transmission through a bite is theoretically possible, but has never been confirmed.

Infection with rabies by inhalation of aerosols containing the virus, or by transplantation of infected organs, is very rare. Human transmission of rabies through ingestion of raw meat or other animal tissue has never been confirmed.

Post-exposure prophylaxis (PEP)

Post-exposure prophylaxis (PEP) is the immediate care of a person who has been bitten after contact that carries the risk of rabies infection. This prevents the virus from entering the central nervous system, which inevitably leads to death. The PEP is as follows:

• copious irrigation and local treatment of the wound as soon as possible after contact;
• a course of immunization with a powerful and effective rabies vaccine that meets WHO standards;
• if indicated, the introduction of anti-rabies immunoglobulin (AIH).

Effective medical care, provided soon after an exposure that suggests a risk of rabies infection, can prevent the onset of symptoms and death.

Copious washing of the wound

Recommended first aid procedures include immediately and thoroughly washing the wound with soap and water, detergent, povidone-iodine, or other substances that kill the rabies virus for at least 15 minutes.

Depending on the severity of contact with an animal suspected of being infected with rabies, it is recommended to perform PEP according to the following scheme (see table):

• a mammal that has bitten a human is known to be a carrier or carrier of rabies
• contact occurs in a geographical area where rabies is still present
• the animal looks ill or exhibits abnormal behavior
• the wound or mucosa was contaminated with the saliva of the animal
• the bite was not provoked
• the animal is not vaccinated.

The availability of a vaccine in a suspect animal should not be the deciding factor in deciding whether to start PEP if the animal's immunization is in doubt. This may apply to situations where dog vaccination programs are not well regulated or monitored due to lack of resources or low priority.

WHO continues to strengthen human rabies prevention through elimination of rabies in dogs, strategies to prevent dog bites, and through the increased use of intradermal PEP, which reduces the volume and hence the cost of cell-cultured vaccine by 60-80%.

Comprehensive management of bites

If possible, inform the veterinary service, identify the bitten animal and place it in quarantine for observation (this applies to healthy dogs and cats). Alternatively, the animal may be euthanized for immediate laboratory analysis. Prophylaxis should be continued during the 10-day observation period or until laboratory results are available. Prophylactic treatment may be interrupted if it is confirmed that the animal has not been infected with rabies. If an animal suspected of having rabies cannot be captured and tested, a full course of prophylaxis should be completed.

WHO activities

Rabies is included in the WHO roadmap for neglected tropical diseases. Because it is a zoonotic disease, strong intersectoral coordination is needed at the national, regional and global levels.

Activities at the global level

The United Against Rabies Partnership is a global effort to achieve zero human deaths from rabies by 2030

In 2015, WHO, the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) and the Global Alliance against Rabies (GARB) adopted a common strategy to achieve zero human deaths from rabies by 2030 and created the United Against Rabies partnership.

This initiative is the first example of a collaborative effort between the human and animal health sectors to advocate for and prioritize investments in rabies control and to coordinate global efforts to eliminate rabies. "Global strategic plan to achieve zero human rabies deaths by 2030: Zero cases by 2030" will guide and support countries in the development and implementation of their national rabies elimination plans based on the One Health concept and through intersectoral collaboration.

Monitoring and surveillance of the disease should be a central component of any rabies control program. The designation of a disease as a disease to be notified is critical to the establishment of an efficient reporting system. Such a system should include mechanisms for the transmission of data from the community level to the national level, as well as to the OIE and WHO. This will provide feedback on the effectiveness of the program and allow action to be taken to overcome weaknesses.

The availability of stockpiles of rabies vaccine for both dogs and humans is having a catalytic effect on rabies eradication efforts. WHO is working with partners to forecast global demand for human and canine vaccines and rabies immunoglobulin to assess global production potential and explore bulk procurement opportunities for countries through WHO/UNICEF mechanisms (vaccines and AIH for humans) and OIE /WHO (vaccines for animals).

In 2016, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) established a working group on rabies vaccines and immunoglobulins. The working group is currently reviewing the scientific evidence, relevant programmatic aspects and costs associated with their use. In particular, it will address issues such as intradermal vaccine administration, shortened vaccination schedules, and potential exposure to new biological agents. Recommendations resulting from this work will be considered by SAGE in October 2017 to update the WHO position on rabies immunization.

WHO supported research in rabies-endemic countries

With WHO support, selected countries in Africa and Asia are conducting prospective and retrospective studies to collect data on dog bites and rabies cases, AEDs and follow-up, vaccine needs, and program options.

Preliminary results from studies in Cambodia, Kenya and Viet Nam confirm that:

• children under 15 years of age are at increased risk of exposure to the rabies virus, and such exposure occurs mainly through dog bites;
• factors contributing to treatment adherence are both the availability of biologics and the cost of AEDs; and
• reporting at the health system level underestimates detected cases of rabies in humans and dogs compared to community-based systems.

Once the data collection is completed, more information will be available to support the need for investment in rabies control programs - this is critical to global and regional strategies to achieve zero human deaths from rabies by 2030. In addition, the GAVI Alliance will take this data into account in its Vaccine Investment Strategy to include rabies vaccines in its portfolio. A decision is expected at the end of 2018.

Regional and national examples

Since 1983, countries in the Region of the Americas have reduced the incidence of rabies by more than 95% in humans and by 98% in dogs. This success has been driven primarily by effective policies and programs focusing on regionally regulated dog vaccination campaigns, public awareness, and the widespread dissemination and availability of AEDs.

Many countries in the WHO South-East Asia Region have initiated rabies eradication campaigns in line with the goal of eliminating the disease in the region by 2020. Bangladesh launched its rabies eradication program in 2010, and through bite management, mass vaccination of dogs and increasing access to free vaccines from 2010-2013. Mortality from rabies among humans has decreased by 50% in the country.

In addition, much progress has been made in the Philippines, South Africa and the United Republic of Tanzania, where WHO pilot projects under a Bill & Melinda Gates Foundation project have recently shown that human cases of rabies can be reduced through a combination of interventions such as mass vaccination of dogs, facilitating access to PEP, enhanced surveillance and raising public awareness.

The following principles play a key role in sustaining rabies control programs and expanding them to nearby areas: start small, boost local rabies programs with comprehensive incentives, demonstrate the success and cost-effectiveness of programs, and ensure government and affected communities are involved.

One of the most dangerous infectious and viral diseases for all types of warm-blooded animals is rabies. With this disease, the peripheral, central nervous system is affected, systemic failures in the work of other internal organs are noted. The infection inevitably leads to death.

belongs to the category of zooanthroponoses, therefore it poses a danger to human health and life. How can a dog get rabies? What are the first symptoms of the disease in animals? Can pets be protected from rabies?

A deadly infection is provoked by a specific filterable neurotropic RNA-containing virus of the rhabdovirus family, which is resistant to high temperatures and chemical disinfectants. The causative agent is widespread in the environment, so outbreaks of infection are recorded in all countries of the world. Inactivated at low temperatures.

Important! The rhabdovirus infects the central nervous system of domestic, wild animals, and humans. The disease is incurable and always fatal. Hydrophobia is registered all over the world, in our country.

The spreaders of the deadly infection are carnivorous predators. Wolves, foxes, raccoons, jackals, hedgehogs, coyotes, rodents carry rhabdoviruses, release the pathogen into the environment.

How infection occurs, ways of infection

Dogs can become infected with a deadly infection, regardless of breed, age. As a rule, infection occurs by contact, only through bites. The highest concentration of the virus is found in saliva of infected individuals. The pathogen penetrates through mucous membranes, damaged epidermis, microcracks, wounds, and other flaws on the skin. The ingress of saliva through a scratch, open wounds can also provoke infection. Especially dangerous are lacerations in the muzzle, neck, withers.

Important! Without a bite, in an aerogenic, alimentary way, it is impossible to become infected with hydrophobia. Therefore, infection is possible if the domestic dog had contact with stray relatives, was bitten by predatory animals.

In outwardly healthy, but already infected dogs, the pathogen appears in saliva about seven to ten days before the onset of characteristic symptoms, while if the pet has strong immunity, symptoms will appear later, two to three weeks after infection.

After a bite, the rhabdovirus remains in the wound for several days, after which it moves along neurotropic centrifugal pathways at a speed of 3 mm/h to the neurons of the brain, spinal cord, and cellular structures of the salivary glands, where it replicates and multiplies.

The rate of infection depends on:

• age;
• bite sites;
• localization, concentration of rhabdovirus in the body;
• serotype;
• immune potential.

Young pet dogs have been shown to show symptoms more quickly after infection than older pets.

Symptoms, manifestations of infection

The main target of the rhabdovirus is the cellular structures of the brain and spinal cord. having penetrated into a favorable environment for itself, the pathogen destroys neurons, nerve tissues, mucous membranes, which leads to malfunctions in the functioning of the central nervous system, irreversible processes in the body.

Important! In dogs, rabies occurs in violent, quiet, abortive, atypical forms. The rhabdovirus affects not only the nervous, but also the immune, endocrine systems.

The duration of the incubation period, if the dog is infected with a deadly virus, ranges from several days to several weeks. The infection is characterized by fulminant, acute, subacute, rarely chronic course. In the chronic form, animals are latent bacteria carriers for a long period of time.

Rampant Form

With this form of infection, development occurs in several successive stages. Allocate:

• prodromal;
• manic;
• paralytic.

At the beginning of the development of the infectious process, attentive owners may notice changes in the behavior of a pet. Dogs become inactive, reluctant to carry out elementary commands, refuse to go for a walk, take part in active games. Animals try to hide in secluded places in the house, apartment. The duration of the prodromal stage of rabies is two to four days.

After the infection has passed into the manic stage, the symptoms appear more intensely, clearly. Dogs that had a good disposition show aggression, rush at people, their relatives, and pets. Aggression is replaced by oppression, bouts of affection.

Typical symptoms for this stage include:

• inadequate response to external stimuli;
• fear of water, loud noises, bright light;
• panic attacks;
• obvious bouts of nervous breakdown;
• refusal of water, food;
• dilated pupils;
• salivation;
• sudden weight loss;
• violation of respiratory function, heart rhythm;
• deterioration of the coat.

Domestic dogs are severely malnourished, often run away from home, running tens of kilometers without stopping, and begin to eat inedible objects. The timbre of the voice changes. The barking becomes intermittent, hoarse. Body temperature is normal or slightly lower. The duration of the excitation stage does not exceed five days.

When the infection passes into the paralytic stage, which lasts for three to four days, the disease is manifested by fever, tremors, and muscle spasms. The lower jaw droops. Saliva flows profusely from the mouth. The swallowing reflex is completely absent. The slightest noise of water, sharp sounds cause panic. At the end of the disease, paralysis of the respiratory center, pharynx, larynx, limbs, and body is noted. The dog falls into a coma, dies due to respiratory failure.

Silent, atypical form

If the infection in the dog proceeds in a silent form, the manic stage does not appear. The pet looks depressed, apathetic. The dog does not react to external stimuli, does not show aggression, does not respond to the owner's commands, its nickname. Death occurs due to paralysis of the respiratory center.

The atypical form is manifested by nervous disorders of varying degrees of intensity, disorders of the digestive functions. Dogs develop gastritis, gastroenteritis, bloody diarrhea. Animals are tormented by debilitating vomiting, bouts of nausea. Dogs quickly lose weight, appear malnourished, become unmanageable, and die, usually within a few weeks.

The only self-healing form of infection can be called an abortive form of hydrophobia. The pain starts suddenly and goes away just as suddenly. This phenomenon has not been fully studied.

Treatment, diagnosis

When diagnosing rabies, there are no particular difficulties. A comprehensive examination of animals, a series of laboratory, biological studies, tests on laboratory animals are carried out. The dog takes the cerebrospinal fluid for analysis. When making a diagnosis, the epizootological situation and anamnesis data are taken into account.

The fastest method for diagnosing rabies is ELISA (enzyme-linked immunosorbent assay). A differential diagnosis is mandatory, since the symptoms of this infection are similar to Aujeszky's disease, a nervous form of canine distemper, and meningoencephalitis.

Important! If the pet had contact with predatory animals, stray relatives, we recommend taking the dog to a veterinary clinic.

The animal will be quarantined in a separate box. Veterinarians will be constantly monitoring him for two weeks. During this period, no one is allowed near the animal, including the owners. If the diagnosis is confirmed, the dog is euthanized.

Unfortunately, rabies is an incurable disease of a viral-infectious nature. There is no curative therapy, so owners must do everything possible to protect their faithful friend from infection with the rabies virus.

Prevention of hydrophobia

The only reliable way to protect your beloved dog from rabies is timely preventive vaccination. Dogs can be vaccinated from the age of four months or after the change of milk teeth. For immunization, complex polyvaccines or special anti-rabies monovaccines (Nobivak Rabies) of domestic and foreign production are used.

A vaccinated dog receives specific immune protection along with the vaccine, and becomes less susceptible to a deadly infection. Protective antibodies are produced in the body of animals about a month after vaccination.

Depending on the drug (vaccine) administered, revaccination is carried out in a year. In some cases, immune protection lasts up to three years. The optimal drug, vaccination schedule for your pet will be selected by a veterinarian.

You should not allow the dog to come into contact with homeless relatives, stray cats, rodents on walks. If you often travel to nature, to the forest, to hunt with a faithful pet, we recommend that you annually take rabies antibody titer test.

Carefully monitor the behavior, habits, physiological state of your pet. If there is a suspicion of infection with the rabies virus, in case of deterioration in the general condition, immediately take the dog to the veterinary clinic.

Over the past 3 years, 60 cases of human rabies infection have been recorded in Russia. The largest number of such cases is registered in the Central, Volga, North Caucasian and Southern federal districts, as well as in the Republic of Tatarstan and the Chelyabinsk region. In the Nizhny Novgorod region, quarantine has been declared in 50 settlements today. These municipalities are recognized as unfavorable in terms of the spread of rabies, and among the diseased there are both wild and domestic animals.

In September 2015, quarantine was announced in 6 Moscow veterinary clinics due to the occurrence of rabies in domestic animals. If rabies has been found in pets, this is the most dangerous, as they are likely to come into contact with humans.

Rabies - is it a fatal disease?

The rabies virus infects the central nervous system of animals and humans. Rising along the nerve pathways, it reaches the brain and causes inflammation (specific encephalitis). Until 2005, rabies was considered a fatal infection for humans. Only a few cases of curing people from this terrible infectious disease are known. However, a timely vaccination or certain measures, which will be discussed later, can save the patient's life.

The main carriers of the rabies virus (Rabies virus):

1. Wild animals (wolves, foxes, wild cats, lynxes, bats, hedgehogs, rodents)
2. Farm animals
3. Pets

Statistics on the incidence of rabies in Russia by types of animal carriers for 1997 - 2007

The diagrams show that the main sources of rabies are wild animals. Recently, due to the spread of rabies among wild animals, the virus penetrates simultaneously into several biological species. For example, from a wolf it is transmitted to a fox or a marten. Therefore, in the forest you need to be especially careful and attentive. We have previously written about .

Approximately half of all cases of rabies infection are domestic and farm animals in contact with wild ones. The most dangerous wild animals in terms of rabies infection are foxes (first diagram). Moreover, you can meet rabid foxes both in the forest and in the city. When infected with rabies, foxes can manifest themselves in two ways. Some can behave aggressively and attack people. Others, on the contrary, reach out to people and show affection, like domestic cats. This behavior is not typical for a healthy fox.

If you meet such a fox, you must immediately leave the forest or zone in which it is located. Under no circumstances should you take them.

How can a person get rabies?

A person becomes infected with rabies usually when an animal attacks him and then bites him. When analyzing the bulletin on rabies, it was revealed that it is the street type of rabies that occurs on the territory of our country. 99% of people who died of rabies (WHO) were infected by street stray dogs. It is also possible to become infected with rabies when saliva of an animal comes into contact with damaged human skin. But such cases are quite rare. Rabies cannot be contracted through urine, by eating berries in the forest, or by smelling flowers.

The second source of human infection is forest foxes, we wrote about them above. In addition, pets bitten by rabid wild animals can infect humans.

Symptoms of rabies in animals

After a dog or cat is infected with rabies, it usually takes about 15 days before the animal begins to behave aggressively.

The most common symptoms in dogs are:

1. Begins to gnaw on the bite or lick it.
2. The dog's pupils dilate, while it begins to behave aggressively and even runs away from home.
3. Keeping his appetite, the dog can swallow inedible things.
4. The animal may have strong salivation with foam and vomiting (doctors attribute this to the main symptom of rabies).
5. Hydrophobia (may not appear).

After the manifestation of these signs, as a rule, on the third day, paralysis of all muscles and death of the animal occurs.

In cats salivation and strong excitement are most often observed.

In cows limbs are paralyzed and death occurs.

Symptoms of rabies in humans

With rabies, the incubation period ranges from 8 days to 1 year. Most often, the disease does not manifest itself in any way within 40 days.

The duration of the incubation period and the course of the disease directly depend on the site of the bite on the body, the age of the victim, the depth of the wound and the penetration of the virus, and the rapid application of the vaccine.

It is believed that the smallest incubation period in humans is when bitten by a wolf. As for the bite site, the most dangerous are the defeat of the head, face and hands during the attack of the animal, since the rabies virus infects the nerve fibers and human cells, then moving along the spinal cord to the brain.

The death of a person occurs due to suffocation and cardiac arrest.

Symptoms of rabies in humans:

1. The primary symptoms of rabies include: subfebrile body temperature (above 37, but below 38 degrees), malaise, convulsions during breathing and a desire to swallow food, headache, nausea, lack of air. The bite site turns red, there is increased salivation.
2. Appear nervous excitement, irritability, anxiety, headache, insomnia, depression, poor appetite. All this lasts about 1-3 days.
3. Then a characteristic symptom of rabies appears - "foam from the mouth", excitement is accompanied by muscle cramps, which can occur even from bright light. Patients can become aggressive, scream, tear their clothes, use force, break furniture. Body temperature rises to 39-41 degrees, tachycardia, increased lacrimation, salivation, sweating are observed.
4. In the future, hydrophobia and severe spasms of breathing appear. Most often at this point, the pupils dilate, convulsions can distort the face.
5. Then the face turns blue. In the last stage of the disease, hallucinations with changes in mood and fits of anger are possible, which are very dangerous. During a rage, a sick person can even bite others.

It is worth knowing that there is quiet frenzy" when a person's disease can be almost asymptomatic, he does not show arousal. It is most commonly transmitted by human bites from bats native to South America.

What to do if you are bitten by a rabid animal or a stray dog?

1. At the first symptoms of rabies, it is almost impossible to save a person. Therefore, if you have been bitten by a forest or stray animal, as well as an unvaccinated pet, you should immediately seek medical help.
2. If a rabid animal is a pet, then you need to tie and isolate it.
3. Before the arrival of the ambulance, wash the wound with water and laundry soap and cause profuse bleeding from the wound, so there is a chance that the virus will come out of it with blood (virus penetration is 3 mm per hour)
4. You can not sew up the wound, treat it with alcohol, iodine or other antiseptic.
5. Do not drink alcohol after being bitten.
6. Animals that have bitten people should be examined by a veterinarian.
7. If the animal is aggressive and there is no way to tie it up, then it is necessary, without touching it, to call the sanitary service through the rescue phone 112.

Rabies Prevention

In the prevention of rabies, a very important role is played by the owner's compliance with the rules for keeping pets. The very first thing to do when you decide to take an animal into your home is to find out if it has been vaccinated against rabies. Preventive vaccination using anti-rabies vaccines for pets is mandatory in our country and in any even a small city or village they are required to do it free of charge at state veterinary clinics. The rabies vaccine is given at an early age. Re-vaccinations should be done every year.

If you suspect rabies in a pet, you should immediately take it to a veterinary facility for examination and research. If the animal is not vaccinated, then it should not be allowed to participate in exhibitions and livestock farms, as well as go hunting with it in the forest.

If you want to sell, buy or transport dogs, you must issue a veterinary certificate indicating that the animal was vaccinated against rabies no more than 11 months and no less than 30 days before the trip.

If your pet has been bitten by wild animals or stray dogs, you must immediately report this to the veterinary services for examination by a doctor.

The material was prepared with the participation of a veterinary assistant

Text: Maria Pletneva

Hello! We went to nature with a child, they grilled kebabs there. A 5-year-old child ran and played, touched trees with his hands and played with branches that he picked up from the ground, and immediately after that, until I saw him, he took a piece of barbecue with these dirty hands and ate it, naturally, before eating it, he sides touched this piece with dirty hands. And there were a lot of wild cats running around. I have a question: if one of the cats was infected with rabies and his drool was somewhere on the branches, and the child touched them with his hands and then ate with these hands, and the child has a lot of fresh scratches on his hands and there is a fresh scratch on his lip, Is it possible to get rabies this way and do I need to be vaccinated against rabies? Thanks in advance for your reply.

Hope, Krasnodar

Hello! No risk, no need to do anything. Sincerely, Alexandrov P.A.

Clarifying question 24.11.2013 Hope, Russia, Krasnodar

Hello! Tell me more, please, why you can get rabies by biting and salivating damaged skin, and if some object was salubbed and then touched with damaged skin, you can’t get infected? If I understood correctly.

Clarifying question 25.11.2013 Hope, Russia, Krasnodar

Hello! Tell me more, please, how does the described case differ from salivation of the skin, in which it is possible to become infected with rabies, because in the described case, saliva can also get on the skin?

So rabies is not transmitted.

Clarifying question 10.07.2014 Nechiporenko Marina, Belgorod

Hello! Tell me, please, is it possible to get rabies if the kitten's saliva got into the mouth and on the face? The fact is that today the kitten (and he has not been vaccinated yet, but he is already catching mice) was playing with himself and after that saliva foamed on his muzzle. My husband put the kitten in my arms, and he, in turn, shook his head at the very moment when I was talking to my husband, and saliva flew into my mouth. Now I'm afraid that I might get rabies this way. Please answer, what is the probability of infection?

ANSWERED: 07/11/2014

the general hysteria about rabies is the "merit" of not very smart leaders. I recommend not to worry about this. the child must be taught the rules of hygiene.

Vaccination is probably not needed in this case.

ANSWERED: 10/17/2015

The probability of infection of the animal is not high (it is quite possible that she died for some reason. It was necessary to apply immediately after contact with the animal, and it would be even more correct not to allow contact)

Clarifying question 23.12.2015 elena, lugansk

Clarifying question 23.12.2015 elena, lugansk

Tell me, is it possible to get rabies if a child scratched his neck with the leg of a chair that stood in the room where the dog was bathed (after it was bitten by stray dogs) and perhaps it rubbed against the chair?

Clarifying question 23.12.2015 elena, lugansk

Is it possible to become infected with rabies if a child scratched his neck with the leg of a chair that stood in a room where 8 hours ago they brought in a pet dog that had been slobbered and bitten by stray dogs and bathed it? (so the saliva of other dogs could get on this chair) The situation with rabies in this region is unfavorable, due to military operations and the lack of hunting!

Hello! impossible Sincerely, Alexandrov P.A.

Clarifying question 24.09.2017 Evgeny Fedotov, Moscow

Hello, but after all, the WHO documents say that you can become infected by contact with saliva, that is, even if I touched the damaged area of ​​\u200b\u200bthe skin to (possibly) saliva from a foreign object, is infection possible or not? Thanks in advance.

ANSWERED: 09/26/2017

Hello, kind person! You were told that there is no risk in your case. There are no activities to speak of.

Clarifying question 25.07.2018 Andrey, Rostov-on-Don

The dog tried to bite me, but she couldn’t as I removed my leg, but she sang to scratch me with her fang through her pants, but without damaging her pants, is it possible to get rabies this way

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