Now there are more and more people keeping pets, and owners and pets are often intimate. However, I would like to remind everyone that during the playfulness, if the cute pets accidentally leave a "mark of love" on you, you must remember t...
Now there are more and more people keeping pets, and owners and pets are often intimate. However, I would like to remind everyone that during the playfulness, if the cute pets accidentally leave a "mark of love" on you, you must remember to get vaccinated with rabies vaccine or rabies immunoglobulin, and do not take chances to prevent the occurrence of rabies.
3 rabies were earned in one week
Recently, Wuhan Medical Treatment Center received three "rabies" patients in a row within one week. Among them, the youngest boy, only 1 year and 9 months, died of ineffective rescue on the afternoon of May 16.
On March 4, Ding Ding (pseudonym), who was drinking wedding wine with her grandparents, was bitten on the forehead by a dog that suddenly jumped out. After bleeding, she immediately underwent a simple wound treatment. She then went to the disease control department for rabies vaccination and received 3 shots as required.
On May 14, the child developed symptoms such as nausea, vomiting, and mental depression. On the 15th, the parents found that the child sweated a lot and saliva. On the 16th, they began to have a frightened and irritable face. The local hospital diagnosed rabies and suggested to be transferred to the hospital. Finally, they came to the Wuhan Medical Treatment Center. He came to the hospital at around 2 pm on the 16th, and developed respiratory distress and cardiac arrest at 3 20 pm. After more than two hours of rescue, Ding Ding, 1 year old and 9 months old, died at around 5 pm on the 16th.
Zou Hai (pseudonym), 43, from Suizhou, is a caring person who specializes in adopting stray cats and stray dogs. On April 14, a stray dog he adopted bit his right finger and bleeded. But he believed in his rich experience and did not deal with it. On the afternoon of May 11, I began to experience headaches, increased saliva, and constant spitting, accompanied by nausea, vomiting, fear of light, and mental depression. On May 13, a local hospital in Suizhou was diagnosed with "rabies" and was finally transferred to the Wuhan Medical Treatment Center on May 14.
Hao Huizhen (pseudonym), 56 years old, from Henan. Due to "rabies", ECMO membrane lungs are being used for supportive treatment. On March 31, the little finger of his right hand was bitten and bleeding by a dog. The village health center performed a simple wound rinsing and disinfection on it, but did not take any other treatment. On May 11, the situation was abnormal and he was also transferred to the Wuhan Medical Treatment Center.
Wen Danning, director of the Infectious Diseases Department, felt deeply saddened by the death of young children, but also expressed her powerlessness. She introduced that rabies, also known as waterphobia, is an acute zoonotic infectious disease caused by rabies virus that mainly invades the central nervous system. So far, the mortality rate has reached 100%. Animals with rabies virus are the source of infection for this disease. The main source of infection for rabies in my country is diseased dogs, followed by domestic animals such as cats, pigs, cattle, and horses. Director Wen explained that people are generally susceptible to rabies virus, and veterinarians and animal breeders are particularly susceptible to it. The incidence rate after being bitten by sick dogs is 15% to 20%. Whether the disease occurs after being bitten by a sick animal is mainly related to the bite site (the chance of being bitten after being bitten at the head, face, neck, and finger), the severity of the bite (the incidence rate of those with deep wounds and large ones), local treatment (the chance of being quickly and thoroughly cleaned after bite is less), people injected with rabies vaccine and immunoglobulin (the incidence rate of those who are injected with sufficient rabies vaccine and immunoglobulin in a timely, full-time, and sufficient rabies vaccine and immunoglobulin), and people in the bite (the chance of being low if those with low immune function or defective) are also related to the situation.
Rabies vaccination is the most effective prevention method.
The mortality rate of rabies is almost 100%, so you should seek medical treatment immediately after being injured by a pet. Vaccination with rabies is the most effective prevention method.
The basis for post-exposure prevention and treatment of rabies in my country is the wound treatment steps that WHO is still recommending. Different levels of damage have different treatment methods.
Class I contact: that is, the skin that has been licked by animals can be simply rinsed with clean water or not treated.
Class II and above: refers to skin damage caused by mild damage but no bleeding, penetrating skin bites or scratches, or direct contact between animal saliva and mucosa, and PEP is required. After cleaning the wound with the same method for more than 15 minutes, and receive a rabies vaccine. When a Class II contact is determined to be a Class II contact and is immune-deficient, or a Class II exposure is located on the head and face and the injured animal is not sure of its health, the wound should be treated immediately and a rabies passive immune preparation (i.e., rabies immunoglobulin) should be injected.
Those who are judged as Class III exposure should be treated immediately and rabies passive immunization preparations should be injected, followed by rabies vaccination. The clinical manifestations of rabies
The length of incubation period varies, most of which are within 3 months. The length of incubation period is related to factors such as age (shorter children), wound site (early onset of head and face bites), wound depth, number of invading viruses and virility. Others such as incomplete expansion of the disease, trauma, cold, and overwork may cause the disease to occur early. The typical clinical manifestations can be divided into the following 3 periods:
prodromal period or invasion period
Before the excited state appears, most patients have low fever, loss of appetite, nausea, headache, fatigue, and periarthritis, which is similar to "cold"; then they develop fear and anxiety, are more sensitive to sound, light, wind, pain, etc., and have a sensation of throat tightness. The most diagnostic early symptoms are abnormal sensations in the wound and its surroundings, including numbness, itching, pain and ant walking. This is caused by the stimulation of neurons when the virus reproduces and lasts for 2 to 4 days. The patients in the excitatory period gradually enter a state of high excitement, which are prominently manifested as extreme fear, fear of water, fear of wind, pharyngeal muscle spasm, difficulty breathing, difficulty in urination and defecation, and sweating and salivation. The spasm of the paralysis period stops, and the patient gradually becomes quiet, but he suffers from slow paralysis, especially limb paralysis. Eye muscles, facial muscles and chewing muscles can also be affected, manifested as strabismus, disordered eye movement, jaw drop, inability to close the mouth, and lack of expression on the face.
The entire course of rabies is usually no more than 6 days, and occasionally more than 10 days are seen.. In addition, there are also "paralytic" or "quiet" that are mainly manifested as paralysis, also known as dumb rabies. This type of patients do not have excitation periods or water fear, but start with high fever, headache, vomiting, and pain in the bite, and then experience limb weakness, abdominal distension, ataxia, muscle paralysis, incontinence, etc. The disease lasted for 10 days and eventually died of respiratory muscle paralysis and medulla oblongata. Rabies caused by vampire bat bites are often this type of disease. Treatment of rabies, single rooms are strictly isolated, and special personnel are cared for and rest quietly to prevent all stimulation, light, wind, etc., and high nutritional therapy is performed intubation of large venous cannulation. Medical staff must wear masks and gloves and isolation clothes. Patients' secretions, excrements and contaminants must be strictly disinfected.
Actively deal with symptomatic treatment and prevent and treat various complications
(1) Those with water fear in the nervous system should be fasted and drinkable, and try to minimize various stimuli. Spraining seizures can be given phenytoin, diazepam, etc. For cerebral edema, dehydrating agents such as mannitol and furure can be given, and if it is ineffective, lateral ventricular drainage can be given.
(2) People with excessive antidiuretic hormones with pituitary dysfunction should limit water intake. People with diabetes insipidus should be given intravenous fluid and vasopressin for posterior pituitary lobes.
(3) Those with difficulty in inhalation of respiratory system are given tracheostomy, those with cyanosis, hypoxia, and lung abscessation are given oxygen and artificial respiration, and those with pneumonia are given physical therapy and antibacterial drugs. For those with pneumothorax, lung reextraction surgery is performed. Pay attention to prevent aspiration pneumonia.
(4) Most cardiac rhythm disorders in the cardiovascular system are supraventricular. Those related to hypoxemia should be given oxygen, and those related to viral myocarditis should be treated as myocarditis. For those with hypotension, vasoconstrictor and volume expansion rehydration. For those with heart failure, use cardiotropic agents such as digoxin. If arterial or venous thrombosis is formed, venous cannula can be exchanged; if there is a occlusion of the superior vena cava, venous cannula should be removed. People with cardiac arrest perform resuscitation.
(5) Other anemia patients have blood transfusions, and those with gastrointestinal bleeding have blood transfusions and fluid replenishment. Use cold mattresses for high fever, and use hot blankets for low body temperature. If the blood volume is too low or too high, adjustments should be made in time.
"Citizens who like to raise cats and dogs must remember to manage and immunize cats and dogs." Director Wen reminded that if they are bitten and scratched by cats and dogs, use 20% soapy water or 0.1% benzalkonium bromide (Xinjieer) to thoroughly rinse the wound for at least half an hour, striving to remove the saliva and squeeze out the dirty blood. After thorough rinsing, apply the wound with 2% iodine or 75% alcohol. The wound is generally not sutured or bandaged to allow blood drainage. If there is anti-rabies immunoglobulin or immune serum, local infiltration injection should be performed at the bottom or around the wound. In addition, attention should be paid to preventing tetanus and bacterial infections.
