Rabies for animals and humans is an almost incurable disease. Therefore, people who are constantly in contact with animals or who have been bitten need the introduction of an anti-rabies vaccine. Physicians know that it is impossible to delay. As soon as the first symptoms begin to appear, it will be extremely difficult to save a person. The patient is protected in every possible way from irritants, they must be placed in an isolated room and only symptomatic treatment is carried out, because there are no specific drugs for this disease. Doctors use antivirals, anticonvulsants, sleeping pills and doses of morphine in large quantities.
Cure possible
There are several cases where rabies has been defeated. However, there are only three confirmed cases in the world and five more that have not been officially recorded. For treatment, the so-called Milwaukee protocol was used, when the patient is introduced into an artificial coma and differentantiviral drugs.
The first patient to survive being bitten by a rabid animal was a girl named Giana Geese. Her therapy did not use the rabies vaccine, but the Milwaukee protocol was used. However, this method is very dangerous and in itself can lead to death or severe brain damage. To avoid such consequences, an anti-rabies culture concentrated vaccine was invented. It is a medical device that induces the production of one's own immunity against the virus that causes rabies.
Therapy before and after
Before the invention of the vaccine, a person who had been bitten by a wild animal was given 20-30 injections under the skin in the abdomen. However, now this technique is no longer used or is used extremely rarely, as it is considered obsolete.
At the moment, doctors have a concentrated anti-rabies vaccine in their arsenal, which must be used after contact with an infected animal or animal that causes suspicion. It is important to give an injection on the first day after the bite. It should be noted that standard therapy is not canceled after vaccination, but the injection will reduce the number of other injections and significantly reduce their dosage. It is noted that the vaccine is well tolerated by all patients, including young children. But sometimes it may bother a little itching, redness and rashes at the injection site.
Composition of the drug
The culture-inactivated rabies vaccine is produced inlyophilizate format, which is used to prepare liquid for injection. It is a white hygroscopic mass. The medicine contains the rabies virus antigen, which is effective against the disease (Vnukovo-32 strain).
The solution is supplied in small ampoules containing 1 ml of the product. For greater efficiency, the composition contains the following auxiliary substances:
- human albumin;
- gelatin;
- sucrose.
The kit also comes with a solvent bottle containing water for injection.
Vaccination effectiveness
The drug is designed to prevent infection of humans from animals. As medical practice and doctors' reviews show, the effectiveness of the injection allows in 96% of cases to avoid death and prevent the development of the disease. However, the maximum effect should be expected with immediate administration or when using the drug within two weeks after contact with a potentially dangerous animal. This is dangerous, because symptoms may appear much later, but there is also a point in introducing the vaccine after a couple of months.
Indications for an injection
Anti-rabies vaccines for humans were invented specifically to prevent the development of such a formidable disease as rabies in humans. They are used without fail if a person has been bitten by an unknown animal or slobbered by a suspicious animal. Also, the injection is done for prophylactic purposes.certain categories of persons:
- veterinarians;
- people who work in animal virus laboratories;
- persons who are engaged in the maintenance of neglected animals, their capture and supervision;
- to avid hunters;
- taxidermists;
- flayer workers;
- foresters;
- to everyone who works with the study of the rabies virus.
The drug is allowed to be administered to adults and children. The difference lies in the method of administration. If adults receive an injection in the superficial muscle of the shoulder, then children are given an injection in the upper thigh. It is forbidden to inject the vaccine into the gluteal muscle.
Instruction prescribes
The introduction of the anti-rabies vaccine is indicated as soon as a person has been bitten by an infected animal or with signs of having a rabies virus. To do this, the doctor takes an ampoule of medicine and mixes it with water intended for injection. It should be remembered that the prepared solution cannot be stored, because the duration of the dissolution of antibodies should not exceed one minute.
If there is no damage to the skin, no traces of saliva and no direct contact with a potentially dangerous animal, then vaccination and additional treatment is not required.
Vaccine treatment and prevention schemes differ depending on the presence of damage and the fate of the animal.
On contact with saliva
If a person was not bitten, but the saliva of an animal got on the skin, then the following scheme is assumedrabies prevention:
- It is necessary to introduce 1 ml of the drug on the first day, then injections are made on the 3rd, 7th, 14th, 30th, 90th day.
- However, the further fate of the animal is important here. If it is possible to monitor him, then take into account his state of he alth. When on the 10th day the animal has no signs of rabies, then human therapy is also stopped. It turns out that a person will receive only three injections.
If there are scratches
If, after contact with a suspicious animal, scratches or minor bites remain on the body, then the scheme is assumed to be similar to the previous one. It is advisable to seek medical attention on the first day of the incident, followed by repeated injections on days 3, 7, 14, 30 and 90. Also, carefully monitor the condition of the animal and stop therapy if after 10 days the animal does not show signs of rabies. However, if the scratches occurred in the area of the head, neck, genitals and hands, then the scheme is used, which is discussed below.
Deep Biting Therapy
If a person is badly bitten, or there are scratches and saliva in potentially dangerous places (genitals, neck, head, fingers and toes), then the rabies vaccine should be immediately introduced. The instruction also prescribes additional complex therapy with immunoglobulin. The scheme remains the same and repeated injections are required after the period of time described above. Heterologous rabies immunoglobulin will be needed if:
- there are singledeep bites;
- there are scratches and salivation of the mucous membranes, neck and head;
- it is impossible to track the further he alth of the animal;
- bitten by bats or rodents.
In these cases, only after the introduction of immunoglobulin, the rabies vaccine is used. The instructions indicate that the injections are placed in different places. Usually the entire dose of immunoglobulin is distributed around the bite. If this is not possible, due to the specific location of the wound, then the remainder is injected into the upper part of the shoulder, gluteal muscle, or thigh. However, the locations should not coincide with the area where the vaccine itself is administered.
The rabies vaccine is used equally for adult patients and children. The instructions for use indicate that the dosage in both cases is the same and does not depend on age.
Contraindications for vaccine administration
If an injection is necessary for vital indications, when it is known for sure that an animal infected with the rabies virus has bitten, then no contraindications are taken into account. The vaccine can save a patient's life, and its absence almost always leads to death. But, if the prophylactic administration of antibodies to the virus is supposed, then there are certain contraindications:
- pregnancy and lactation;
- individual reaction to injection components;
- diseases that occur in an acute form;
- chronic diseases in the acute stage;
- previously identified negative allergic reactions that threaten the life and he alth of the patient (edemaQuincke);
- heart failure;
- antibiotic intolerance.
Adverse reactions
The inactivated dry rabies vaccine is generally well tolerated by patients of all ages. It is noted that after the injection there are no consequences. However, sometimes negative reactions, both local and general, are recorded.
Local manifestations:
- swelling of tissues at the injection site;
- itching and redness;
- skin hypermia;
- swollen lymph nodes near the injection site.
Also, patients note that the following general negative symptoms may be disturbing:
- headache;
- short-term temperature increase;
- increased weakness;
- rarely have neurological symptoms.
Is it possible to replace
The anti-rabies cultural vaccine has no complete analogues. But there are drugs with a similar principle of action. This means that the composition of the medicines is somewhat different, but the action is based on the suppression of the rabies virus by introducing antibodies to it. The following drugs can be distinguished:
- "Rabivak-Vnukovo - 32";
- "Kokav";
- "Rabipur".
How the vaccine works
Anti-rabies vaccine promotes the appearance of antibodies against the rabies virus in the human body two weeks after the first injection. The maximum concentration of the substance is reached 30-40 days after the injection. However, the period is too long and the time for activationimmunity may be deficient if the area of the bite involves the neck, genitals, arms and legs. Therefore, it is so important to administer immunoglobulin before the vaccine.
It is worth highlighting that 14 days after the start of therapy with the vaccine, the patient acquires strong immunity to the disease, then its effect lasts only one year.
Important points
Sometimes the rabies vaccine can cause neurological complications, so the patient should be under close medical supervision for half an hour after the injection. If such complications occur, then urgent hospitalization and symptomatic therapy is required, including:
- antihistamines;
- hyposensitizing drugs.
Vaccination must be carried out in a medical office equipped with everything necessary. Otherwise, it is important to provide staff with anti-shock drugs. Mandatory issuance of a certificate to a person, which indicates:
- vaccination date;
- series and type of vaccine;
- conducted course;
- vaccination symptoms.
After seeking medical attention after contact with a suspicious animal, the following types of procedures are mandatory:
- treatment of abrasions, wounds, scratches and other injuries;
- administering the vaccine;
- patient monitoring;
- accounting for the condition of the animal.
These procedures should be carried out as soon as possible, ideally - on the first day. But, if a person asked for help after a certain period of time,then the quality and quantity of procedures remain unchanged.
Prohibited activities
Dry rabies vaccine may not be effective if glucocorticosteroids or immunosuppressants are taken concomitantly. Therefore, it is important to always tell your doctor about all medications you use.
Not possible during the entire course of therapy and six months after vaccination:
- drink alcohol;
- to overcool and overheat;
- overwork.
If the ampoules have expired or their integrity has been violated, then they cannot be used. It is also necessary to dispose of the medicine that has changed its color.
Vaccine reviews
Patients who were injected with the vaccine noted that it was well tolerated and protected from the possibility of contracting the virus. Doctors say that it is better to suffer some deterioration in he alth, but not to catch the virus. Usually the reaction occurs after the first injection. It happens that the temperature rises, but not higher than 37.5 degrees. Patients complain of general malaise, headache. For some, it is important that you can not drink alcohol for six months. But the vaccine puts a lot of stress on the liver, so this measure is justified.
Doctors and most patients agree that although the injection is somewhat dangerous and can cause complications, it saves lives, and this is the most important thing. Well, if you can track the fate of the animal, and if it is he althy, then after three injections it is allowed to stop therapy.
Vaccination is especially difficult for children, because the dosage and administration schedule are not reduced. Their temperature rises, physical activity decreases, swelling and redness occur at the injection site. But the injection can protect against a dangerous virus that children cannot otherwise be protected from.
