Rabies is an incurable disease. After the appearance of the clinic, it is not possible to save the patient. There is no specific therapy. The patient is simply placed in a separate ward protected from external stimuli and only symptomatic treatment is carried out (hypnotics, anticonvulsants, morphine in large doses).

Today in the world there are only 3 reliable cases of people recovering from rabies (laboratory confirmed) and another 5 not laboratory confirmed. In the first three cases, treatment was based on a combination of antiviral drugs, sedatives, and injectable anesthetics to create an induced coma. This technique was called the Milwaukee Protocol and was first used in the United States in 2004 to treat 15-year-old American Jeanna Giese.

Postexposure vaccination

Primary rabies care is provided by a surgeon (traumatologist) of the rabies care center (according to the order of the Ministry of Health No. 297 of 7.10.1997). The rabies vaccine is given on the first day of visiting a trauma center.

You can forget about courses of 20-30 injections under the skin of the abdomen. Since 1993, a concentrated purified cultural rabies vaccine (COCAV) has been used in practice, which has made it possible to shorten the course of vaccination and reduce a single vaccination dose.

The usual dose is 1.0 ml intramuscularly: for adults and adolescents, the rabies vaccine is injected into the deltoid muscle, and for children - into the outer thigh. Cannot be injected into the gluteus maximus!

The vaccination schedule includes five intramuscular injections: on the day of treatment (day 0), on the 3rd, 7th, 14th and 30th days from the start of the course. Some patients are given an additional sixth injection on day 90.

The rabies vaccine prevents the onset of the disease in 96-98% of cases. But vaccination is effective only at the beginning of the course no later than the 14th day from the moment of the bite. Nevertheless, a course of immunization is prescribed even several months after contact with an animal that is sick or suspected of rabies.

Antibodies appear 2 weeks after the start of vaccinations, reaching a maximum in 30-40 days. In this regard, where one can think of a short incubation period (bites to the head, neck, hands and fingers, multiple bites), rabies immunoglobulin is administered (see below).

Immunity becomes effective approximately 2 weeks after the end of the vaccination course. The duration of post-vaccination immunity is 1 year.

Only a full course of vaccination can prevent imminent death. Paradoxically, in the presence of effective means (rabies vaccine, immunoglobulin), people continue to die. As a rule, many victims either do not know or do not attach importance to the danger, not seeking medical attention or refusing the proposed vaccination (approximately 75% of all deaths from rabies). About 12.5% ​​of deaths occur due to the fault of medical workers who incorrectly assess the indications for prescribing a course of vaccinations. And another 12.5% ​​of deaths occur in patients who independently interrupt the course of anti-rabies immunization or violate the prescribed regimen.

It should be remembered that during the entire course of vaccination and within 6 months after its completion (total 7-9 months) are strictly contraindicated: reception alcoholic beverages, physical exhaustion, overheating in the sun or in a bath / sauna, hypothermia. All of these factors weaken the effect of the vaccine, reduce antibody production, and compromise immunity. In the case of vaccination while taking corticosteroids and immunosuppressants, the determination of the level of antibodies is mandatory. In the absence of antibodies, an additional course of treatment is carried out.

The rabies vaccine is well tolerated. Side effects are observed in only 0.02-0.03% of cases in the form of mild allergic reactions (rash).

There are no contraindications for postexposure vaccination, since the disease is fatal. Therefore, despite the presence of pregnancy or acute pathology, the victims must be vaccinated.

WHO experts, depending on the depth of skin damage and the number of bites, distinguish three categories of contact. In my opinion, tactical situations should be modified as follows.

1. Infection is unlikely

Rabies vaccine is not given when the possibility of infection is excluded:

• touching and drooling of intact skin by animals;
• a bite through dense thick tissue without its through damage;
• injury by the beak or claws of a bird (in animals, unlike birds, saliva may remain on their paws);
• eating milk or meat from rabid animals;
• a bite from a pet vaccinated against rabies for 1 year and does not have any manifestations suspicious of rabies.

The last point applies only to non-dangerous bite locations. With a dangerous localization (face, neck, hands, fingers) or multiple bites, a course of 3 vaccinations is indicated, because there are known cases of rabies transmission by animals, even those vaccinated against this disease.

After a bite, it is necessary to establish observation of the animal. And if within 10 days he develops signs of rabies, it is necessary to begin a course of vaccination, even if the attacking animal was vaccinated.

2. Infection is possible

Rabies vaccine is given when an unvaccinated pet or wild animal has bitten, scratched, or splashed saliva on already damaged skin.

If the bitten animal is known (domestic), then its further fate should be traced within 10 days. During this time, a person manages to receive 3 preventive vaccines. Rabies vaccinations are discontinued if the animal remains healthy after 10 days or it died (for example, was shot), and the study of the animal's brain did not reveal the corresponding morphological picture of rabies.

The full course of vaccination is carried out:

• when it is impossible to control the condition of the animal (escaped earlier 10 days);
• if there was contact with a wild animal. Wild animals (foxes, wolves, bats, etc.) are considered initially infected with rabies.

Moreover, if the person received earlier full course vaccination against rabies, from the end of which no more than 1 year has passed, then three injections of 1 ml are prescribed on the 0th, 3rd and 7th day. If 1 year or more has passed or an incomplete course of vaccination has been carried out, then a full course is now prescribed.

Rabies immunoglobulin

Immunoglobulin therapy is started within 24 hours after possible infection (but no later than 3 days after contact and before the third dose of the vaccine is administered on the 7th day). The usual dose of homologous (human) immunoglobulin is 20 IU / kg, single dose.

In this case, one half of the dose is used to inject the tissues around the bitten wound (irrigation of the wound is possible), the second half is injected intramuscularly into the antero-outer surface of the upper third of the thigh (immunoglobulin can be injected into the gluteus muscle).

Do not use the same syringe for the administration of immunoglobulin and vaccine! Indications for combining rabies vaccine with immunoglobulin administration:

• deep bite (with bleeding),
• a few bites,
• dangerous localization of bites (head, neck, hands and fingers).

To compose the answers, we used normative documents Russian Federation and international recommendations.

Rabies prevention is not a topic for a correspondence consultation. The best solution- an appeal to a full-time specialist.

The basic requirements for the complex of organizational and sanitary-anti-epidemic (preventive) measures aimed at preventing the onset and spread of rabies diseases among the population of the Russian Federation are regulated in the Sanitary-Epidemiological Rules of SP 3.1.7. 2627 -10 "Prevention of rabies among humans":

When a person seeks medical help for an attack and bite of an animal or salivation of damaged skin or external mucous membranes, medical workers are obliged to determine the volume and provide medical assistance, prescribe and begin a course of preventive vaccinations, inform the victim about the need to undergo preventive vaccinations and possible consequences in case of violation of the course of vaccinations.

An animal with which a case suspicious of human rabies is associated must be isolated for 10 days or killed (in case of aggressive behavior). Material from the deceased animal must be delivered to a specialized laboratory by veterinary specialists.

Persons at risk of infection are referred to a trauma doctor who determines the scope of medical care and treatment, including post-exposure prophylaxis.

What is post-exposure prophylaxis against rabies in humans?

Post-exposure (after contact) prophylaxis consists of local wound care, administration of rabies immunoglobulin (if indicated) and immediate vaccination.

How and to whom is post-exposure prophylaxis of rabies carried out in humans?

Sanitary and Epidemiological Rules of the Joint Venture 3.1.7. 2627 -10 "Prevention of rabies among humans"

Section VIII. Post-exposure prophylaxis of rabies in humans

8.1. Specific antirabies treatment (postexposure prophylaxis) for bites from suspected rabies is started pending results laboratory research animals.

8.2. Post-exposure prophylaxis is carried out by registered in established order immunobiological preparations in accordance with the instructions for their use.

8.3. With a positive result of laboratory diagnostics of an animal examined for rabies, the initiated course of specific anti-rabies treatment continues, with a negative result, the course of vaccination is terminated.

8.4. If the animal has clinical manifestations suspicious of rabies, the course of antirabies treatment continues, despite negative result laboratory diagnostics.

8.5. If the animal under observation did not fall ill (did not die) within 10 days from the moment of injury (salivation) to a person, then the course of anti-rabies treatment is terminated.

8.6. In cases of various violations of the course of anti-rabies vaccinations (non-observance of the terms of vaccination, violation of the sequence of administration of the drug, etc.), the immune status of the vaccinated should be determined in order to further adjust the specific treatment.

8.7. Determination of the immune status is mandatory in individuals whose specific treatment is carried out while taking corticosteroids and immunosuppressants, as well as HIV-infected

8.8. At the end of the course of preventive and curative-prophylactic immunization, each victim must be issued a certificate of vaccination against rabies.

8.9. Rabies treatment includes topical wound care as soon as possible after a bite or injury, and the administration of a rabies vaccine. If indicated, a combined course of treatment is carried out: rabies immunoglobulin (RIG) for the purpose of passive immunization and rabies vaccine in accordance with the instructions for the use of rabies drugs.

What rabies vaccines and immunoglobulins are registered in the Russian Federation?

Doses and immunization schedules are the same for children and adults. The course of treatment with the vaccine is prescribed regardless of the period of the victim's request for help, even several months after contact with a patient suspected of rabies or an unknown animal (except for rabies immunoglobulin).

As a standard, the following scheme of post-exposure anti-rabies prophylaxis is used in the Russian Federation:

Day 0 is the day of the first vaccination (sometimes rabies immunoglobulin is administered in addition to the vaccine) - Day 3 - Day 7 - Day 14 - Day 30 - Day 90.

When is it possible to prematurely terminate the course of anti-rabies vaccinations?

Clause 8.5.

"If the animal under observation did not fall ill (did not die) within 10 days from the moment of injury (salivation) to a person, then the course of anti-rabies treatment is terminated."

What to do if the rabies immunization schedule is violated (the follow-up vaccination was not introduced or was not introduced on time)? Can vaccinations be given at other times that do not coincide with those indicated in the instructions?

The efficacy of the rabies vaccine has been investigated only when used within the terms indicated in the instructions. Violation of the timing of the introduction of the next anti-rabies vaccinations can lead to ineffectiveness of the vaccination course if the animal was rabies.

Sanitary and Epidemiological Rules of the Joint Venture 3.1.7. 2627 -10 "Prevention of rabies among humans" paragraph 8.6:

"In cases of various violations of the course of anti-rabies vaccinations (failure to comply with the terms of vaccination, violations of the sequence of administration of the drug, etc.), the immune status of the vaccinated should be determined in order to further adjust the specific treatment."

Is it possible to continue the rabies vaccination course in different cities if I have to travel?

If the situation with the trip is completely insurmountable, then you need to consult in person with the doctor of the medical facility where you are vaccinated against rabies (or with a specialized rabies doctor, see below), and decide how and where it is possible to continue vaccination on the trip.

If a person previously received a full course of rabies vaccinations and after a while was bitten again, is it necessary to repeat the vaccinations and how exactly?

The procedure for vaccination in such cases is indicated in the instructions for the COCAV vaccine:

“..For persons who have previously received a full course of preventive or prophylactic vaccinations, from the end of which no more than 1 year has passed, three injections of the vaccine, 1.0 ml each, at 0, 3 and 7 days are prescribed; if a year or more has passed, or an incomplete course of immunization was carried out, then - in accordance with the given "Scheme of therapeutic and prophylactic vaccinations with COCAV and anti-rabies immunoglobulin (RIG)".

Where can I get rabies medical care and advice on rabies and its prevention in humans?

Sanitary and Epidemiological Rules of the Joint Venture 3.1.7. 2627 -10 "Prevention of rabies among humans" clause 9.9.

“In each municipality a center (office) for rabies care should be organized on a functional basis on the basis of one of the health care facilities that include a trauma center or a trauma department to provide rabies care to people who have suffered from animal bites. Specialists of the centers (offices) of anti-rabies care:

Decide on the amount of anti-rabies treatment in each specific case and decide on the cancellation of such treatment in accordance with the indications;

An analysis of the appealability, causes and circumstances of animal bites on humans is carried out;

Submit proposals to the bodies exercising state sanitary and epidemiological supervision, according to the necessary preventive measures;

Organize explanatory work with the population on the prevention of rabies. "

Who is a rabiologist and where can I find him?

A rabbiologist will usually see and advise patients, administer rabies vaccinations and follow-up.

Usually it can be located in territorial clinics or emergency rooms. The availability of such a doctor at your place of residence should be checked with the health department of your city (district).

Where can a healthcare professional get advice on rabies and its prevention in humans?

The Center for Combating Rabies (FSBI "Scientific Center for Examination of Funds medical use"). difficult cases the Center carries out a determination of the immune status in persons affected by bites different kinds animals whose treatment was carried out with various violations of the "Instructions for the use of antirabies drugs" in order to make adjustments to the ongoing or conducted course of vaccination.

What is prophylactic (pre-exposure) rabies immunization?

Pre-exposure (pre-exposure) vaccination should be given in people at high risk of rabies. These can be both people of a certain profession (veterinarians, animal catchers, etc.), and travelers to rabies-endemic areas of the world, where they can come into contact with animals, and immediate access to adequate medical care is limited.

What contingents in the Russian Federation are subject to pre-exposure vaccination against rabies and where is it regulated?

Sanitary and Epidemiological Rules of the Joint Venture 3.1.7. 2627 -10 "Prevention of rabies among humans"

X. Prophylactic immunization against rabies

10.1. Preventive vaccinations against rabies are included in the national immunization schedule for epidemic indications.

10.2. For immunoprophylaxis, medical immunobiological preparations approved for use in the Russian Federation are used.

10.3. Storage and transportation of medical immunobiological preparations at all stages must be carried out in compliance with sanitary and epidemiological requirements.

10.4. Prophylactic vaccination against rabies is subject to:

10.4.1. Service workers carrying out the capture of animals (catchers, drivers, hunters, foresters and others.);

10.4.2. Workers of veterinary stations for combating animal diseases who have contact with animals (veterinarians, paramedics, laboratory assistants, junior staff);

10.4.3. Workers of research institutes and diagnostic laboratories conducting research on rabies;

10.4.4. Workers of vivariums and other institutions working with animals.

Which health care provider can receive pre-exposure prophylaxis against rabies?

Sanitary and Epidemiological Rules of the Joint Venture 3.1.7. 2627 -10 "Prevention of rabies among humans"

10.5. In medical and prophylactic institutions, only persons with a high risk of infection (pathologists, specialists involved in parenteral interventions for patients with rabies) are subject to prophylactic vaccination against rabies.

What can be side effects when vaccinated against rabies? Where to contact?

Side effects are likely to occur with any vaccine and are local or general. A list of possible adverse reactions to a specific vaccine can be found in its instructions for use.

Which anatomical area should you administer rabies vaccine to? Can it be injected into the gluteus muscle?

When can the introduction of rabies vaccine start, are there deadlines? Is the dosage of the vaccine different for children and adults?

The instructions for the COCAV vaccine indicate that “... Doses and immunization regimens are the same for children and adults. The course of treatment with the vaccine is prescribed regardless of the period of appeal of the victim for help, even several months after contact with a patient suspected of rabies or an unknown animal (except for anti-rabies immunoglobulin). "

The first vaccination should be carried out as soon as possible.

Is it possible to refuse vaccinations with post-exposure (after exposure) vaccination against rabies?

In accordance with the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens' Health (Article 33) "A citizen or his legal representative has the right to refuse medical intervention or demand its termination."

It is your right to refuse medical care and vaccinations. Rabies is 100% fatal. If clinical symptoms of rabies develop (in humans, this disease is also called Hydrophobia), then it cannot be cured in any country in the world.

Can vaccinations be waived for prophylactic (pre-exposure) rabies prophylaxis?

In accordance with the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens' Health (Article 33) "A citizen or his legal representative has the right to refuse medical intervention or demand its termination ..".

In accordance with Federal law of September 17, 1998 N 157-FZ "On immunization of infectious diseases" Article 5. Rights and obligations of citizens in the implementation of immunization:

1. Citizens in the implementation of immunization have the right to:

Refusal of preventive vaccinations.

2. Lack of preventive vaccinations entails:

• a ban for citizens to travel to countries in which, in accordance with international medical and sanitary rules or international treaties of the Russian Federation, specific preventive vaccinations are required;
• temporary refusal to admit citizens to educational and health-improving institutions in the event of mass infectious diseases or the threat of epidemics;
• refusal to admit citizens to work or suspension of citizens from work, the performance of which is associated with a high risk of illness infectious diseases.

Decree of the Government of the Russian Federation of July 15, 1999 N 825 approved a list of works, the performance of which is associated with a high risk of contracting infectious diseases and requires mandatory preventive vaccinations:

1. Agricultural, irrigation and drainage, construction and other work on excavation and movement of soil, procurement, field, geological, prospecting, expeditionary, deratization and disinsection work in areas unfavorable for infections common to humans and animals.

2. Work on logging, clearing and landscaping of forests, health improvement and recreation areas of the population in areas unfavorable for infections common to humans and animals.

3. Work in organizations for the procurement, storage, processing of raw materials and livestock products obtained from farms unfavorable for infections common to humans and animals.

4. Work on the procurement, storage and processing of agricultural products in areas unfavorable for infections common to humans and animals.

5. Work on the slaughter of livestock sick with infections common to humans and animals, the procurement and processing of meat and meat products obtained from it.

6. Work related to the care of animals and the maintenance of livestock facilities in livestock farms, unfavorable for infections common to humans and animals.

7. Work on the capture and maintenance of stray animals.

8. Maintenance work sewerage facilities, equipment and networks.

9. Work with patients with infectious diseases.

10. Work with live cultures of infectious diseases pathogens.

11. Work with human blood and body fluids.

12. Works in all types and types of educational institutions.

Thus, if a profession is associated with the need for prophylactic (prior to exposure) vaccination against rabies, then a person has the right to refuse vaccination, but then he does not have the right to work in this profession.

Bitten by a monkey (dog, cat, etc.) while vacationing in another country. They were vaccinated against rabies with a foreign-made vaccine. How can you continue to vaccinate against rabies when you return to Russia?

In Russia, for detailed cases, there are no official recommendations for switching from foreign manufacturers' anti-rabies vaccines to domestic vaccines.

In practice, regardless of the specific vaccine of which the course was started, then the vaccination scheme is continued with any anti-rabies vaccine registered in Russia. It is advisable to bring a certificate of vaccinations made abroad (date, dose, name) to the emergency room.

An updated WHO position paper on rabies vaccines was published on 9 July 2010 in the Weekly Epidemiological Record (WER) in Russian:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm (in English).

In July 2009, the ACIP Committee voted to exclude the fifth dose of vaccine for post-exposure prophylaxis in previously unvaccinated individuals in the absence of immunosuppression. The decision is based on evidence that the immune response will not be reduced, the need for vaccines will decrease, and there will be benefits to both patient health and the economy from fewer medical visits and fewer doses. Updated guidelines for a four-dose schedule for post-exposure rabies prophylaxis were published in the MMWR on March 19, 2010.

Rabies can be called one of the most serious fatal infectious diseases that have spread throughout the globe. And if the victim of the disease does not receive timely assistance, then the possibility of death is high. That is why this article will focus on graphics and its features.

It is worth starting with the fact that antirabies is called a special medication that contributes to the development of immunity to the rabies virus.

The indications for the use of the vaccine are:

• associated with the capture and further maintenance of stray animals;
• as well as preventive immunizations for people at high risk of rabies infection (for example, hunters, foresters, veterinarians, gamekeepers, taxidermists, etc.).

All of the above categories of people must be vaccinated against rabies without fail. However, the rabies vaccine, like any medicine, has its own contraindications.

cannot be put to persons with:

• for antibiotics;
• a negative response to previous vaccinations that caused swelling or rash;
• exacerbation of infectious (or non-infectious), as well as chronic diseases and during pregnancy.

All contraindications are mandatory, and ignoring them can lead to many complications.

Route of administration and dosage for adults and children

The rabies vaccine is given exclusively intramuscularly (in the deltoid muscle)... For children under five, it is inserted into the upper thigh. In this case, grafting into the buttocks area is not allowed.

The schedule, schemes and doses of vaccinations for children and adults do not differ. The rabies vaccine does not require any special preparation for it on the part of the vaccinated. The only thing is that it is desirable to have a vaccine good analyzes and good health.

For two weeks after the injection, the patient should forget about alcohol. The fact is that alcoholic beverages can severely weaken the immune system, reducing the effectiveness of anti-rabies immunization and causing many side effects.

A person can be given both live and dead rabies vaccines. The difference is that the former are much more effective. And the latter are recommended only in cases where a live vaccine poses a danger to the patient's health.

Before using the ampoule with the medicine, its contents are dissolved in a special liquid for injection (one milliliter in volume). You can store the resulting dissolved drug for no more than five minutes.

Rabies vaccinations for humans: vaccination schedule

The routine prophylactic immunization schedule is as follows:

• primary immunization is carried out on the first, seventh and thirtieth day (one milliliter of vaccine);
• the first revaccination is given after one year (one milliliter, once);
• all other immunoprophylaxis is carried out every 2-3 years (again, one milliliter at a time).

In cases of abrasions, bites or scratches caused by pets (and farm animals), vaccination begins immediately as follows:

• first day;
• third day;
• seventh day;
• fourteenth day;
• thirtieth day;
• and ninetieth.

In this case, the agent is also administered one milliliter at a time. Treatment is not prescribed if there has been no direct contact with an animal infected with rabies.

Cases require special attention:

• bites received from wild animals, various rodents or bats;
• deep and multiple wounds;
• and bites on the head and face, hands or neck.

Then an immediate combination treatment is carried out, individually prescribed by the doctor. First of all, the places of bites and injuries are cut off (in order to slow down the spread of infection throughout the body).

After injection, there may be swelling and redness at the injection site. It goes away over time. When talking about rabies vaccines, you need to understand that this is by no means a harmless serum.

The task of this medicine is to fight one of the most dangerous (fatal) zoonotic infections. The vaccine contains sufficiently strong components that have an aggravating effect on human organs.

But remember - the benefits of the medicine in this case significantly exceed the harm caused to them. If the animal (which inflicted wounds) remains alive and healthy for ten days, then the patient's immunization stops after the third injection.

Thanks to the development of modern medicine, it has been possible to reduce the number of required vaccinations from forty to six.

However, all of them must be carried out on strictly defined days, without missing a single vaccination. We must not forget: negligence in this case can lead to death.

The rabies vaccine is only effective if it is delivered no later than the tenth day after the injury. After this period, the virus already goes through the incubation stage, and injections are not able to destroy it.

What to do if the immunization schedule is violated?

The initial rabies vaccination is given at the emergency room where the injured person has gone. Then vaccination is carried out in medical institutions assigned to the patient.

Before each procedure, the doctor examines the patient, monitoring the appearance of any negative symptoms. Violation of the timing of immunization with rabies vaccine is fraught with a decrease in its effectiveness.

The efficacy of the drug was investigated only in cases of strict adherence to the vaccine prophylaxis schedule. A person who missed the vaccination schedule should see a doctor as soon as possible. Only a specialist will give necessary recommendations and will adjust the vaccination schedule.

Usually, in such cases, the current status of the vaccinated immune system is determined. The results obtained determine the course of further treatment and its correction.

How long does rabies vaccination work?

Each rabies vaccine has its own duration. Foreign drugs are effective on average for about two or three years. And many domestic ones are able to maintain efficiency for no more than a year.

Only regular and routine vaccinations make the procedure effective.

Rabies vaccine names

In the Russian Federation, it is used to immunize the population against rabies. It is a concentrated and purified product manufactured by Microgen, a leader among domestic vaccine manufacturers.

The composition of the Kokav vaccine includes:

• inactivated viral strain "Vnukovo-32";
• distilled water;
• albumen;
• sucrose;
• and gelatin.

Already after four vaccine prophylaxis with this drug, the body produces required amount antibodies to protect against rabies. And immunity lasts one year.

Other rabies vaccines include Rabivak (for rabbits) and (prophylactic).

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Allergist-immunologist on the rules and schemes of rabies vaccination:

According to statistics, more than 50 thousand people die from rabies a year. The disease is transmitted with saliva, both animals and people are susceptible to it. The causative agents of the virus enter the blood vessels, and from there into the cerebral cortex, provoking its inflammation. And if timely assistance is not rendered, then the person may simply die.

Therefore, it is so important to carry out vaccinations on time and keep track of their schedule. And although now rabies is not fully understood, medical science does not stand still, continuing to create more and more effective means to combat this disease.

Rabies (hydrophobia) is an infectious disease caused by the deadly Rabies virus.

Infection occurs after contact with a sick animal - a bite, salivation, in rare but described cases of inhalation of contaminated air in attics, in caves, through food, water and through the placenta during pregnancy. Today, there is a lot of discussion about the possibility of contracting rabies as a result of organ transplant operations. The rabies virus affects the central nervous system, which is why sick people develop encephalitis (inflammation of the brain).

Upon contact with a sick animal, the virus enters and spreads in the human blood along the nerve pathways, gradually affecting the salivary glands, and getting into the brain, affects the hippocampus and bulbar centers. This leads to irreversible and serious disorders, which almost always end in death. If you do not start treatment immediately, then death is inevitable. The rabies virus in an infected person can be detected in saliva, tears, and urine tests.

Infection with the rabies virus occurs mainly through contact with animals, both domestic and wild. Among animals, rabies can affect dogs, cats, cattle or small ruminants, pigs, foxes, wolves, badgers, jackals, raccoons, rodents, bats, eagles and parrots. The greatest danger to humans is posed by stray dogs living outside the city. From the moment of infection to the onset of symptoms, it takes 1 to 2 months, there are cases when the incubation period is only one week.

An infected animal can be identified by severe salivation and lacrimation, red eyes, and signs of hydrophobia. At the site of the bite of an infected animal, redness, burning, itching and increased sensitivity appear, which makes the person feel strong pain... People who have been infected with the rabies virus and have not received timely preventive treatment develop a fever, severe muscle pain and headaches. Ultimately, the rabies virus, spreading, leads to severe brain inflammation, seizures and paralysis, the person falls into a coma and dies suddenly.

Administration of the rabies vaccine (rabies vaccination) and medical advice on abstinence from alcohol

Today, there is no definitive treatment for rabies with a 100% guarantee of cure. It is important to remember that after being bitten by a rabid animal, it is necessary to urgently consult a doctor, otherwise the outcome will be fatal. Anti-rabies therapy should begin no later than 14 days after infection. If clinical signs begin to appear, then no treatment will help. If an infected animal has injured the skin, it is necessary to wash the wound with a soap solution and go to the doctor.

The doctor will inject the rabies vaccine, which will help the body fight the rabies virus before it invades the nervous system. With this vaccine, a person acquires "active immunity" for a period of 1 year. The rabies vaccine is injected only 6 times into the deltoid muscle of the shoulder, less often intramuscularly into the thigh. Depending on the expected length of the incubation period, your doctor may use rabies immunoglobulin. It helps the body to get "passive" immunity immediately, but on short term, and after 2 weeks the vaccine will work.

The essence of all vaccines and inoculations is that weakened pathogens of bacteria and viruses of various diseases are introduced into the body, which are subsequently defeated by the immune system. Antibodies are gradually produced in the body, which means that a natural defense against the disease appears. If the immune system is weakened, it is likely that the introduced pathogens will lead to the development of the disease.

Doctors do not recommend drinking alcohol after any vaccinations, as this leads to a temporary weakening of immunity, and alcohol is strongly discouraged when vaccinating against rabies. Remember not to drink alcohol after rabies vaccination! Patients often have a question about how much alcohol should not be drunk after being vaccinated against rabies?

Vaccination lasts 3 months. At this time and in the next 6 months, that is, the full course of specific therapy is 9 months, the intake of alcoholic beverages is strictly contraindicated. Alcohol causes severe harm to the body as a whole, and if abused after being vaccinated against rabies, it becomes deadly.

The rabies vaccine (rabies vaccine) will have maximum effect and will help the human body to overcome the rabies virus, if you follow and strictly adhere to the following rules of conduct during the vaccination period and within 6 months after its completion:

1. Eliminate the use of all alcoholic beverages and drinks containing alcohol.
2. Avoid hypothermia.
3. Avoid overheating.
4. Avoid sun exposure for too long, including tanning beds.
5. Eliminate heavy physical activity, including vigorous sports, weightlifting, etc.
6. Avoid severe fatigue, emotional and mental overload.
7. It is imperative to complete the entire course of therapy (vaccination) with rabies vaccine, previously prescribed by a doctor and carried out at a certain interval of time.

Only by observing the above rules and refusing to drink alcohol, an infected person can count on the positive effect of anti-rabies therapy.

The doctors' recommendations are related to the fact that any vaccine is based on the effect on the immunity of the human body. Today everyone knows that there are medications that should not be consumed simultaneously or during a course of therapy with a certain type of vaccine. This is especially true for alcoholic beverages, which weaken the immune system. With the introduction of a vaccine, human immunity begins to work in an enhanced mode and fight the spreading virus.

During the course of vaccination against rabies and in the next 6 months, the effect of the rabies vaccine can be significantly reduced after drinking alcohol. Drinking alcohol during therapy for rabies, a person further weakens his immune system. Weakened immunity is not able to fight the deadly virus, which begins to spread rapidly in the human body and is fatal. In order to develop persistent immunity to the deadly virus, doctors advise to stop drinking alcohol during the period of therapy.

What else may affect the effectiveness of rabies vaccinations

In addition to drinking alcohol during rabies therapy, the following diseases and causes can significantly reduce the effectiveness of the rabies vaccine:

1. Acquired or congenital failure of the human immune system. Such inconsistency can be caused by diseases of the immune system itself, disorders of the blood system, oncological diseases, etc.
2. Quite long-term use of immunosuppressants, which reduce the activity of the immune system and reduce its resistance to disease. Significantly reduce the activity of the immune system hormonal drugs(glucocorticoids), which are used for asthma, diseases with rheumatoid manifestations, etc.
3. Incorrect maintenance, storage, poor quality of the vaccine.
4. Late start of vaccination.
5. Incorrect or incorrect vaccine administration technique.
6. Violation of the vaccination scheme by the patient himself (late attendance, omissions, etc.).

If the above factors are present, then the patient must periodically take blood tests to monitor the concentration of antibodies.

Why is it important to follow the rules of vaccination

Compliance simple rules and the recommendations of doctors will allow an infected person to avoid complications hazardous to health and lead to maximum efficiency the effects of the rabies vaccine.

Rabies is a serious and dangerous disease. Each patient must understand this and approach timely therapy, as well as adherence to the necessary rules with full responsibility.

Keeping in mind that alcohol should not be consumed after rabies vaccination and during therapy, it is best to avoid alcohol altogether. This is the only way to help your body fight a fatal disease and try with all your might to preserve your one and only life.

Thank you for your feedback.

Comments (1)

Megan92 () 2 weeks ago

Did anyone manage to save your husband from alcoholism? Mine drinks without drying out, I don’t know what to do ((I thought about divorce, but I don’t want to leave the child without a father, and I’m sorry for my husband, so he’s a great person when he doesn’t drink

Daria () 2 weeks ago

I have already tried so many things and only after reading this article, I managed to wean my husband from alcohol, now he does not drink at all, even on holidays.

Megan92 () 13 days ago

Daria () 12 days ago

Megan92, so I wrote in my first comment) I will duplicate just in case - link to article.

Sonya 10 days ago

And this is not a divorce? Why are they selling on the Internet?

Yulek26 (Tver) 10 days ago

Sonya, what country do you live in? They sell on the Internet, because shops and pharmacies set their marginal markup. In addition, payment only after receipt, that is, first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs and furniture.

Editorial response 10 days ago

Sonia, hello. This drug is used to treat alcohol addiction really is not sold through the pharmacy network and Retail Stores to avoid overpricing. To date, you can order only on official website... Be healthy!

Sonya 10 days ago

I apologize, I did not notice the information about cash on delivery at first. Then everything is in order for sure if the payment is on receipt.

Margo (Ulyanovsk) 8 days ago

Has anyone tried folk methods to get rid of alcoholism? Father drinks, I can not influence him in any way ((

Andrey () A week ago

What kind of folk remedies did not try, father-in-law both drank and drinks

The rabies vaccine is designed to protect people from the saliva-transmitted rabies virus when bitten by sick animals. Rabies is a fatal human disease that does not respond to treatment. Only the timely administration of rabies vaccine can prevent death.

Rabies is caused by viruses genus Lyssavirus, family Rhabdoviridae... The main vectors of the disease are wild animals and bats. Infection occurs through the infected saliva of a sick animal, after a bite, through which the virus enters the bloodstream through the damaged human skin. Then the infectious agent spreads along the nerve pathways, reaching the nerve cells of the spinal cord and cerebral cortex, causing acute encephalitis. Death occurs 7-10 days after the onset of the first symptoms of the disease. The cause of death is paralysis of the respiratory center. The incubation period ranges from 10 days to 3-7 weeks.

Rabies prevalence

In highly developed countries, rabies is very rare due to the vaccination of pets against the virus. In past years, the main source of human disease was dogs, through whose bite the rabies virus was infected. Some time later, the number of sick dogs decreased and bats became the main carrier. The only place where the rabies virus is absent are the Hawaiian Islands.

Rabies virus cases are reported worldwide. They are especially common in developing countries in Africa, Asia and Latin America. In the UK, outbreaks of this disease are almost completely eliminated. In many countries with a low level of economic development, foci of the disease of rabies are periodically recorded. This is due to insufficiently organized control over the vaccination of humans and animals. According to WHO statistics, annually about 10-12 million people worldwide receive timely anti-rabies care and about 35 thousand people (mainly children) die from rabies.

How did the rabies vaccine come about?

The invention of the rabies vaccination belongs to the French scientist Louis Pasteur. In 1885, he injected a weakened strain of the virus into a nine-year-old boy bitten by a rabid dog and saw that the child was still alive. In the future, scientists have repeatedly improved the rabies vaccine.

There is currently no cure for this disease. In the 80s. In the twentieth century, scientists have invented a new effective vaccine that provides protection against the virus, both in order to prevent the disease, and in order to protect the body after contact with the virus. This vaccine is represented by killed rabies virus. With the introduction of this drug into the human body, the immune system begins to develop antibodies against viral particles (), forming strong immunity, which develops in 7-10 days, providing protection against rabies for up to two years. The second type of rabies vaccine is rabies immunoglobulin. It provides short-term protection to the body after being infected with a virus.

When is rabies vaccine used?

In order to prevent vaccination, groups of persons with a high risk of rabies should be subject to vaccination. These include: veterinarians and clinical laboratory diagnosticians. Also prophylactically and children who are at risk of developing the disease after contact with rabid animals. They are injected with rabies immunoglobulin. In turn, it reduces the number of vaccinations needed after exposure to the rabies virus. Primary prevention, in which the rabies vaccine is given, is very important for children early age since most of them may simply not talk about contact with a sick animal.

Children abroad are at high risk of developing rabies. Children undergo primary prevention in cases of finding:

• in places unfavorable for the spread of the rabies virus;
• in camps located in rural areas;
• Areas where rabies vaccine or rabies immunoglobulin is not available.

Rabies vaccine is mandatory after being bitten

The risk of developing rabies in children after contact with a sick animal is assessed based on the following signs:

• whether the animal has been vaccinated against the rabies virus;
• kind of animal;
• whether the animal can be caught and tested for the rabies virus;
• geographic location;
• whether a human bite was provoked by this animal (since many bites can be obtained as a result of careless handling of the animal).

Secondary prophylaxis, in which it is mandatory to be administered against rabies, are exposed to children in cases where:

• the child has been bitten by any kind of animal, including (cat, dog, etc.), which has not been vaccinated;
• the child has been scratched or bitten by a wild animal; especially pay attention to the bites of a bat, raccoon, skunk, fox and wolf. (Please note that some animals, such as bats, may not leave bite marks.).

If a child has been bitten by a healthy pet, the animal is isolated for 10 days to detect signs of rabies and further secondary prevention. It is possible to determine the virus in such animals by taking blood for the presence of specific antibodies, or, after the animal is euthanized, take the brain substance.

Without fail, secondary prevention is carried out at all contacts of children with bats even if there are no bite marks or scratches. For example: prevention is carried out if a child with a bat is found in the room.

Rabies vaccine for humans and how to use it

Inactivated rabies vaccines are administered once in a volume of 1.0 ml. It contains a minimum of 2.5 IU / ml rabies virus antigen (WHO standard dosage) and is dosed in the same way for adults and children. Cases of adverse reactions and lack of effectiveness of this vaccine have been recorded. The vaccination injection is relatively painless. Rabies vaccine for humans can be used in several ways

Primary prevention

For prophylactic purposes, for the formation of stable immunity in children, inactivated rabies vaccine is administered at a dose of 1.0 ml three times; the second dose is given 7 days later, and the third dose 21 or 28 days after the first injection. The vaccine is given in the upper third of the upper arm. Scientists have found that antibodies against rabies are formed in the blood serum of all living things.

Secondary prevention

After establishing the fact of a bite of an unvaccinated child by any animal, it is necessary to determine whether the animal is infected with the rabies virus. If there is a threat of infection, the child receives rabies immunoglobulin and a series of five rabies vaccines within 28 days. Ideally, treatment should be started within the first 2 days after infection with the virus.

If possible, local wound care should be carried out as early as possible after the bite. First, you need to clean the wound surface, inject rabies immunoglobulin into the bite site, as well as into the surrounding soft tissue to prevent the virus from entering the central nervous system (CNS). The recommended dosage is 20 IU / kg of body weight (this is equivalent to 22 mg of immunoglobulin G (IgG) per kg of body weight). The remaining volume is injected intramuscularly anywhere away from the bite (n .: gluteus muscle). Rabies immunoglobulin is never given at the same site where the vaccine was given. Its injection is done once, which contributes to the appearance of specific antibodies in the blood, until the child's body itself begins to produce these antibodies in response to the injected vaccine. An additional injection of rabies immunoglobulin can lead to impaired synthesis of antibodies to the rabies virus.

The inactivated rabies vaccine is given at a dose of 1.0 ml on days 3, 7, 14 and 28 after the first vaccination. If it is established that the animal is not infected with the rabies virus, then the started series of vaccinations can be discontinued.

Vaccination

Children at high risk of rabies virus infection receive 1.0 ml of the vaccine on day 1 and a second dose 3 days later. They do not receive rabies immunoglobulin because they it inhibits the production of specific antibodies to the virus.

Contraindications for rabies vaccination

Before medical procedures, it is necessary to identify contraindications for vaccination against rabies. Children with:

• immunodeficiency states in HIV / AIDS;
• tumors;
• adverse reactions with previous vaccinations.

Children with weakened immune systems do not receive primary rabies prophylaxis. If a hypersensitive reaction to the vaccine occurs, it is necessary to treat with antihistamines. Babies who are allergic to egg white are not vaccinated with viral vaccines grown in chicken embryos.

It is not recommended to vaccinate a child if he has a history of a serious illness. Children are not vaccinated against measles, chickenpox for 4 months, if purified anti-rabies immunoglobulin was administered before.

Rabies vaccine side effects

It has been proven that at present, most modern vaccines have practically no adverse effects after vaccination, or they are extremely rare. The risk of various complications increases with the number of vaccine doses injected. The main side effects of the rabies vaccine are associated with the patient's intolerance to the individual components of the drug.

Side effects of injecting rabies vaccine:

• soreness, redness, swelling, itching or pain at the injection site (occurs in 30-74% of all vaccinated);
• headache, nausea, abdominal pain, muscle pain and dizziness (occur in 5-40% of all vaccinated).

More severe complications include:

• hives, joint pain, fever (occurs in about 6% of cases);
• Guillain-Barré syndrome is extremely rare. With it, flaccid paresis, sensory disturbances, autonomic disorders occur, which disappear without a trace after 12 weeks.

In all doubtful cases, you must contact your doctor.

Side effects following rabies immunoglobulin administration include:

• local pain;
• subfebrile temperature.

Most vaccines are known to cause, with the exception of rabies vaccine. When administered, allergies are extremely rare. Symptoms of an allergic reaction:

• pallor of the skin;
• weakness;
• dizziness;
• hoarseness of voice;
• labored breathing;
• tachycardia.

In case of serious complications from rabies vaccine, you must:

The medical institution or local health center, in turn, must draw up documentation on this fact and report to the Vaccination Center about the identified complication.

Interaction of rabies vaccine with other medicines

Immunosuppressive drugs (treatment is aimed at strengthening the immune system), chemotherapy, cytostatics, radiation therapy, glucocorticosteroids can adversely affect the production of specific antibodies against the virus. When giving a series of rabies vaccinations, all of the above treatments must be suspended. In patients receiving immunosuppressive therapy, as well as in those with immunodeficiency conditions, vaccination may not be effective in developing the necessary immunity.