Humanity lives on the planet in the neighborhood with many forms of life, including microscopic ones. First of all, these are viruses and bacteria. Paradoxically, such tiny organisms have a huge impact on the human population.
Rabies in brief
During the existence of the human species, many things have changed: climatic conditions, landscape, social formations, advances in science, technology and medicine. It is thanks to the latter that people no longer die from the epidemic pandemics that raged just a few centuries ago. But there remained a number of diseases stubbornly untreatable, despite all the efforts made. Among them, rabies is especially prominent.
This disease has been known for a very long time. He changed many names, but the formidable essence of the disease remained unchanged - it is deadly. It is caused by the rabies virus (rabies), which is carried by infected animals. The saliva that got into the wound during the bite is filled with a viral component, and if you do not immediately go to the trauma center, the disease will very soon go into the active stage.
The name of the disease has the word "demon" in its composition - it was a sick person who was considered possessed in ancient times. Symptoms of the disease occur on the tenth day. Sometimes the incubation period lasts up to several months and in very rare cases is calculated in years. The essence of the disease is as follows: the virus affects the spinal cord and brain, causing light and hydrophobia, aerophobia, hallucinations, paralysis and other severe disorders. In other words, a person is not able to drink a single sip of water, at the sight of which the patient immediately begins convulsions, and at the slightest movement of air, the patient experiences sharp muscle spasms. Death occurs due to paralysis of the respiratory muscles and the heart muscle.
Two ways of protection
Since the disease is extremely dangerous and almost 100% fatal, people have been trying to find ways to treat it, or at least prevent it, for centuries. At the end of the nineteenth century, the famous microbiologist Louis Pasteur, through many laboratory experiments on animals, invented a vaccine that helped stop the deadly journey of rabies around the planet.
Over time, scientists have found another way to help prevent the disease before the first symptoms appear. This is anti-rabies immunoglobulin. At the moment, these drugs are the only obstacle to rabies. It should be noted that the rabies vaccine is not able to destroy the virus, like the second drug. Their principle of action is based on other mechanisms.
Distinguishing features of rabies drugs
So, what are the fundamental differences between these medicines?
The action of the rabies vaccine is based on the following scheme. After the introduction of the drug, viral antigens enter the body. This is a kind of neutralized analogue of a live virus, containing all the necessary information about it. It is required that the immune system for a certain time (about 2 weeks) has developed ways to adequately protect the body. This occurs through the formation of specific proteins - antibodies. These substances remember everything related to the antigens of the specified virus, and when an aggressive agent enters the body, they immediately destroy it. Most vaccines work this way. Accordingly, active immunity is developed. This is what the rabies vaccine is used for.
Anti-rabies immunoglobulin works a little differently. With its help, not dead viral antigens enter the body, but donor antibodies. The fact is that while active immunity is being developed, the body is absolutely defenseless against the invasion of harmful microbes. Therefore, the patient is injected with anti-rabies immunoglobulin - a drug based on donated human or animal blood (most often a horse). Thus, a large number of antibodies and antigens enter the body (the medication also contains them), which help to develop passive immunity. Basically, the drug is used as part of a combined course of immunization.
The difference between the medicines describedis that the vaccine gives a more stable and long-lasting immunity, but after a while, and with the help of immunoglobulin, an immediate, but short-term protection of the body against the virus is produced.
Anti-rabies immunoglobulin: types
Depending on the origin of antibodies, the drug is divided into two types:
- Heterological.
- Homologous.
The first type is called "Anti-rabies immunoglobulin from horse blood serum". The second is a medicine based on human donated blood. It should be noted that in order to increase the amount of antibodies in the biological material, blood is taken from a person previously vaccinated with the rabies vaccine. This type of drug is considered more effective and safer than an animal product. The dosage of the homologous species required for immunization is half that.
Four names of such a drug as anti-rabies immunoglobulin have been registered. The product has more than one manufacturer: two medicines are manufactured in Russia (Biopharma, FGBI ARRIAH), the rest are made in China (FC Sichuan Yuanda Shuyan), Israel (Kamada Ltd.) and Ukraine (Biolek ). Taking into account the special danger of the disease and the specifics of the use of such drugs, they are sold directly - from pharmacies to medical institutions.
"Rebinolin" - anti-rabies immunoglobulin
The first type of this medicationbased on human biomaterial. It is positioned by scientists as more effective. When considering its properties and nuances of application, you should pay attention to the following points:
- Dosage form. Rabies immunoglobulin (the instructions clearly indicate this fact) is a transparent or slightly yellowish substance containing a slight precipitate. This drug is in the form of a solution for injection into the body intramuscularly or subcutaneously.
- Impact on the body. At least three days after administration, the maximum concentration of antibodies is reached, aimed at the destruction of the rabies virus. These proteins are excreted from the body within a month.
- Indications. It is prescribed for contact with infected animals, suggesting bites and saliva on the affected skin. The drug is administered in combination with an anti-rabies vaccine to mutually enhance the effect.
- Unwanted manifestations. Since a foreign agent enters the body, the reaction can be very acute. In addition to redness, swelling and hyperthermia (sometimes only subfebrile condition is observed), cases of sudden reactions were recorded: Quincke's edema, urticaria or anaphylactic shock. Intermittent vomiting and hypotension have also been reported.
- Interaction with other medicines. Incompatible with vaccines containing live viral cultures. Can be used in conjunction with antibiotics and tetanus toxoid.
- Special instructions. During pregnancy and lactation, the use of the drug is possible, since long-termthe study of the effect of immunoglobulins on the human body allows us to assert that the drug will not have a harmful effect on the fetus and expectant mother.
Anti-rabies immunoglobulin from human blood serum is an effective tool to prevent rabies. It should be emphasized that this drug has no contraindications, since it is prescribed in terms of life criteria. Moreover, the sooner the victim turns for help, the more stable the result will be.
How to use the drug
Before applying anti-rabies immunoglobulin, the instructions for use involve the following algorithm:
- Thorough washing of wounds with running water, soap and antiseptics.
- Before the drug is administered, the integrity of the ampoule, the appearance of the drug and the expiration date are checked.
- Anti-rabies immunoglobulin (homologic) is administered at this dosage: 20 IU per kilogram of body weight.
- Better if almost the entire dose is injected directly into the wound or nearby affected tissue. If this action is impossible, an intramuscular injection is performed in full.
- For children, the drug is injected into the thigh area, for adults - into the buttock.
A remedy called "Rebinolin" of Israeli origin. The shelf life of the drug, subject to the storage regimen, is 2 years. Freezing immunoglobulin is strictly prohibited. Permissible temperaturestorage - from 2 to 8 ⁰С.
Comprehensive approach
As a general rule, immunoglobulin of any kind is administered along with the rabies vaccine. In this regard, there are several points that you should definitely pay attention to:
- The introduction of anti-rabies immunoglobulin is carried out strictly before the use of the vaccine (a break between drugs is 30 minutes).
- To use the funds, different parts of the body are selected, located as far as possible from each other. For example, immunoglobulin goes to the left buttock, and the vaccine goes to the deltoid muscle on the right.
- Syringes for drugs should be different.
- No medication given intravenously.
- It is strongly discouraged to increase the dosage of anti-rabies immunoglobulin.
Drug based on animal biomaterial
"Rabies immunoglobulin from horse blood serum" (liquid) is classified as a heterologous species. It is considered slightly less safe for the reason that the specific proteins it contains can cause an unpredictable reaction in the body. At the same time, the use of a drug based on human biomaterial is relatively well tolerated by patients. In this regard, before using heterologous immunoglobulin, an intradermal test in the forearm is mandatory.
If after 20 minutes there is no serious swelling or redness, then diluted immunoglobulin (solution 1 to 100) is administered subcutaneously. And only ifafter half an hour the test is still negative, use the rest of the drug. And not immediately, but according to the following scheme: a part of the heated dose of anti-rabies immunoglobulin is injected into the wound area, after 15 minutes the next portion is injected into the tissues around the wound. If the anatomical features of the bite site do not allow the use of the entire ampoule in the affected area, then the rest is used for intramuscular injection. The whole procedure takes about an hour.
If heterologous anti-rabies immunoglobulin is used for immunization, the instructions say that if there is a positive test, antihistamines are prescribed before the drug is administered, and an adrenaline solution is used to avoid shock.
Another difference between this type and the previous one is the dosage. A horse serum-based product is used at a double dose (40 IU per kilogram of body weight).
Rabies vaccine
At the moment, 5 drugs of domestic production and one of Indian production are registered in the Russian Federation. This vaccine is produced in transparent ampoules complete with distilled water and contains inactivated rabies virus. After dilution, it appears as a pink or colorless liquid. When using this tool, there are important nuances:
- When administered, the necessary rules of antiseptics must be observed, and the vaccination room must be equipped with anti-shock agents and emergency medicines. After breeding, storage is allowedrabies vaccine no more than 5 minutes.
- Half an hour after the homologous immunoglobulin was administered, the vaccine is allowed.
- The drug is injected into the thigh (children under 5 years old) or into the deltoid muscle of the shoulder girdle. The use of the drug in the buttocks is strictly prohibited.
- The patient must be under the supervision of medical staff for at least half an hour after manipulation.
Types of immunizations
There are two types of immunization: prophylactic and curative. The first is activated if a person is engaged in potentially dangerous activities where there is a high risk of contracting rabies. These are hunters, rangers, workers of bacteriological laboratories, veterinarians. The second type is applied immediately after contact with a sick animal. Both options have a specific execution algorithm. In addition to schemas, there is another difference between these types. If in the first case a chronic disease in the acute stage or pregnancy may become a contraindication, then the second type of immunization is carried out according to vital indications.
Vaccination schedules
The generally accepted vaccination schedule is as follows:
- If the nature of the contact involves minor skin damage - scratches, small bites, abrasions, as well as saliva by pets, and all of these wounds are located in the torso and limbs, then the person is vaccinated immediately after the damage has been treated. Single dose of anti-rabiesvaccine is 1 ml. Immunization is carried out on the day of contact, and then on the 3rd, 7th, 14th, 30th and 90th day. The schedule may be changed if the animal under observation has not died or has not been diagnosed with rabies virus. In this case, they are limited to three times the introduction of the vaccine.
- Wounds of the head, neck, hands, genitals, ankles and fingers caused by domestic animals, as well as injuries or saliva from wild animals, rodents and bats, require immediate comprehensive measures. On the day of contact, before the introduction of the rabies vaccine, a mandatory injection of immunoglobulin is used, carried out according to the above rules. Next, immunization is carried out according to the standard scheme.
For he alth reasons
This phrase is often heard in doctors' offices or on the territory of hospital wards, so everyone is used to it. But unfortunately, people sometimes tend to forget how valuable human life is. Every day to see the smile of your child, to hear the mother's voice in the receiver, to watch the flight of birds - all this is so ordinary that it is taken for granted. And only when trouble knocks on the house, people remember it. Take care of yourself and your loved ones, and in case of potential danger, do not delay seeking help.
