Q：

Newspapers often report that people bitten by dogs develop rabies and die. My neighbors also have cats and other pets. What should I do if I am bitten by these small animals?

Animals are human friends. Many families keep some pets because they like small animals. When children tease their pets, they may be bitten by them. Although sometimes the bite wound is very small, it can cause serious problems. Therefore, parents should not ignore it and learn to deal with it urgently.

Most clinical manifestations of rabies are fear of wind, water, pharyngeal muscle spasm, progressive paralysis and other symptoms. Its typical symptom is fear of water, that is, when drinking water, or even hearing the sound of water, the patient will have swallowing muscle spasm and can’t swallow the water. Even if the patient is thirsty, he can’t drink water, so it is also called fear of water.

The disease has a long incubation period, ranging from a few days to several years, and the mortality is very high, almost 100%. We must pay attention to it and carry out scientific emergency treatment.

A：

According to the course of disease, the clinical manifestations of rabies can be divided into five stages: incubation period, prodromal period, acute neurological symptom period (excitation period), paralysis period, coma and death. The development of the disease is a continuous process.

01 incubation period

The period from infection to no symptoms before onset is mostly 1-3 months, rarely within 1 week or more than 1 year.

02 prodromal period

It usually lasts for 2-10 days (usually 2-4 days), with atypical symptoms such as discomfort, anorexia, fatigue, headache and fever, and unprovoked symptoms such as fear, anxiety, excitement, irritability, nervousness, insomnia or depression.

03 acute neurological symptoms

Generally lasting for 1-3 days, it can be divided into manic type and paralytic type. Manic cases are characterized by extreme fear, fear of water, fear of wind, pharyngeal muscle spasm, dyspnea, dysuria and salivation; Paralytic cases have no typical excitatory period and hydrophobia, but the main symptoms are high fever, headache, vomiting and pain at the bite, followed by limb weakness, abdominal distension, ataxia, urinary and fecal incontinence and so on.

04 paralysis period

It usually lasts for 6-18 hours. After the period of acute neurological symptoms, the patients gradually enter a quiet state. At this time, the spasm stops, the cases gradually become quiet, and flaccid paralysis occurs, especially limb soft paralysis.

05 death

Dying patients enter a coma, and respiratory arrest usually occurs shortly after coma.

Family emergency treatment

If the bitten wound is bleeding, parents should press in time to stop bleeding, then wash the wound with soapy water or clear water, and go to the hospital for further treatment immediately after treatment, such as preventing secondary infection, vaccinating against tetanus, etc. According to the bite of different animals, doctors will make different treatment. At present, being bitten by dogs or cats is more common.

● thoroughly wash and rinse all bites and scratches alternately with 20% soapy water (or other weakly alkaline detergent) and flowing water under a certain pressure for at least 15 minutes. Then wash the wound with normal saline (or water instead), expand the wound as much as possible and fully expose it. Finally, suck up the residual liquid at the wound with sterile absorbent cotton to avoid residual soapy water or detergent at the wound.

● cover the wound with clean gauze. Do not bandage the wound unless the wound is very large and needs to stop bleeding. Because rabies virus is anaerobic, it will grow in large quantities in the absence of oxygen. After simple treatment, you should go to the hospital for further treatment as soon as possible.

● get rabies vaccine and rabies immunoglobulin immediately. It is recommended to observe whether the wound has infection after 48 hours. If there are signs of infection, antibiotics should be used in time.

B

① Vaccination before exposure: one dose shall be inoculated on 0, 7 and 21 (28) days respectively. For people in close contact with animals for a long time, after completing the basic immunization, one dose shall be strengthened after one year without injury to animals, and then one dose shall be strengthened every 3-5 years.

② Post exposure immunization: 0.5 ml each time on the day of bite (day 0), the third day, the seventh day, the fourteenth day and the twenty eighth day. If the first injection is delayed, the next four injections are delayed accordingly.

In 2010, the former Ministry of Health recommended a new vaccination program, namely the “2-1-1” immunization program. The vaccination was reduced from the past five times to three times. Two doses were vaccinated on the same day, and one dose was vaccinated on the seventh day and the twenty-first day respectively, which can effectively prevent rabies. The vaccination cycle is shortened by 7 days, and antibodies are produced rapidly. It is more suitable for patients with late medical treatment and serious bites.

So far, there is no effective way to cure rabies, and the correct prevention is the key. While we know rabies, we should understand rabies and protect ourselves and our baby with knowledge at the critical moment.

The article comes from the official account: Dr. zhangsilaiyishi.

Q：

Newspapers often report that people bitten by dogs develop rabies and die. My neighbors also have cats and other pets. What should I do if I am bitten by these small animals?

Animals are human friends. Many families keep some pets because they like small animals. When children tease their pets, they may be bitten by them. Although sometimes the bite wound is very small, it can cause serious problems. Therefore, parents should not ignore it and learn to deal with it urgently.

Most clinical manifestations of rabies are fear of wind, water, pharyngeal muscle spasm, progressive paralysis and other symptoms. Its typical symptom is fear of water, that is, when drinking water, or even hearing the sound of water, the patient will have swallowing muscle spasm and can’t swallow the water. Even if the patient is thirsty, he can’t drink water, so it is also called fear of water.

The disease has a long incubation period, ranging from a few days to several years, and the mortality is very high, almost 100%. We must pay attention to it and carry out scientific emergency treatment.

A：

According to the course of disease, the clinical manifestations of rabies can be divided into five stages: incubation period, prodromal period, acute neurological symptom period (excitation period), paralysis period, coma and death. The development of the disease is a continuous process.

01 incubation period

The period from infection to no symptoms before onset is mostly 1-3 months, rarely within 1 week or more than 1 year.

02 prodromal period

It usually lasts for 2-10 days (usually 2-4 days), with atypical symptoms such as discomfort, anorexia, fatigue, headache and fever, and unprovoked symptoms such as fear, anxiety, excitement, irritability, nervousness, insomnia or depression.

03 acute neurological symptoms

Generally lasting for 1-3 days, it can be divided into manic type and paralytic type. Manic cases are characterized by extreme fear, fear of water, fear of wind, pharyngeal muscle spasm, dyspnea, dysuria and salivation; Paralytic cases have no typical excitatory period and hydrophobia, but the main symptoms are high fever, headache, vomiting and pain at the bite, followed by limb weakness, abdominal distension, ataxia, urinary and fecal incontinence and so on.

04 paralysis period

It usually lasts for 6-18 hours. After the period of acute neurological symptoms, the patients gradually enter a quiet state. At this time, the spasm stops, the cases gradually become quiet, and flaccid paralysis occurs, especially limb soft paralysis.

05 death

Dying patients enter a coma, and respiratory arrest usually occurs shortly after coma.

Family emergency treatment

If the bitten wound is bleeding, parents should press in time to stop bleeding, then wash the wound with soapy water or clear water, and go to the hospital for further treatment immediately after treatment, such as preventing secondary infection, vaccinating against tetanus, etc. According to the bite of different animals, doctors will make different treatment. At present, being bitten by dogs or cats is more common.

● thoroughly wash and rinse all bites and scratches alternately with 20% soapy water (or other weakly alkaline detergent) and flowing water under a certain pressure for at least 15 minutes. Then wash the wound with normal saline (or water instead), expand the wound as much as possible and fully expose it. Finally, suck up the residual liquid at the wound with sterile absorbent cotton to avoid residual soapy water or detergent at the wound.

● cover the wound with clean gauze. Do not bandage the wound unless the wound is very large and needs to stop bleeding. Because rabies virus is anaerobic, it will grow in large quantities in the absence of oxygen. After simple treatment, you should go to the hospital for further treatment as soon as possible.

● get rabies vaccine and rabies immunoglobulin immediately. It is recommended to observe whether the wound has infection after 48 hours. If there are signs of infection, antibiotics should be used in time.

B

① Vaccination before exposure: one dose shall be inoculated on 0, 7 and 21 (28) days respectively. For people in close contact with animals for a long time, after completing the basic immunization, one dose shall be strengthened after one year without injury to animals, and then one dose shall be strengthened every 3-5 years.

② Post exposure immunization: 0.5 ml each time on the day of bite (day 0), the third day, the seventh day, the fourteenth day and the twenty eighth day. If the first injection is delayed, the next four injections are delayed accordingly.

In 2010, the former Ministry of Health recommended a new vaccination program, namely the “2-1-1” immunization program. The vaccination was reduced from the past five times to three times. Two doses were vaccinated on the same day, and one dose was vaccinated on the seventh day and the twenty-first day respectively, which can effectively prevent rabies. The vaccination cycle is shortened by 7 days, and antibodies are produced rapidly. It is more suitable for patients with late medical treatment and serious bites.

So far, there is no effective way to cure rabies, and the correct prevention is the key. While we know rabies, we should understand rabies and protect ourselves and our baby with knowledge at the critical moment.

The article comes from the official account: Dr. zhangsilaiyishi.