Rabies is an incurable disease for animals and humans. Therefore, people who are constantly in contact with animals or subjected to bites need the introduction of an rabies vaccine. Doctors know that you can’t procrastinate. As soon as the first symptoms begin to appear, it will be extremely difficult to save a person. The patient is protected from irritants in every possible way, they must be placed in an isolated room and only symptomatic treatment is carried out, because there are no specific medicines for this disease. Doctors use antiviral, anticonvulsant, sleeping pills and large amounts of morphine.
Cure is possible
There are several cases where rabies was defeated. However, there are only three confirmed cases in the world and five more that are not officially recorded. For treatment, the so-called Milwaukee protocol was used, when the patient is injected into an artificial coma and various antiviral drugs are used.
The first patient who survived the bite of a rabid animal was a girl named Giana Gis. Her therapy did not use the rabies vaccine, but the Milwaukee protocol was used. However, such a method is very dangerous and in itself can lead to death of a person or severe damage to the brain. To avoid such effects, an anti-rabies culture concentrated vaccine was invented. It is a medical tool that induces the production of its own immunity against the rabies virus.
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 such a technique is no longer used or is rarely used, as it is considered morally obsolete.
At the moment, doctors have in their arsenal a concentrated rabies vaccine, which must be used after contact with an infected beast or animal of suspicion. It is important to give an injection on the first day after a bite. It should be noted that after vaccination, standard therapy is not canceled, but an 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 itching, redness and rashes at the injection site may bother.
The composition of the medication
Inactivated culture rabies vaccine is produced in the format of lyophilisate, which is used for the preparation of 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, which contain 1 ml of the product. For greater effectiveness, the following auxiliary substances are present in the composition:
- human albumin;
- gelatin;
- sucrose.
The kit also comes with a solvent bottle containing water for injection.
Vaccination efficacy
The drug is designed to prevent human infection from the animal. As medical practice and doctors' reviews show, the injection efficiency allows avoiding death in 96% of cases and preventing the development of the disease. However, the maximum effect should be calculated with immediate administration or when using the drug within two weeks after contact with a potentially dangerous animal. There is danger in this, because the symptoms may appear much later, but there is also the point of administering the vaccine after a couple of months.
Indications for an injection
Rabies vaccines for humans have been invented specifically to prevent the development of such a formidable disease as rabies. It is used without fail if a person was bitten by an unknown animal or if a suspicious beast has salivated. Also, an injection is given as a preventive measure to certain categories of people:
- veterinarians;
- people who work in animal virus research laboratories;
- persons involved in the maintenance of stray animals, their capture and surveillance;
- avid hunters;
- taxidermists;
- workers of flayers;
- foresters;
- anyone who works with the study of rabies virus.
The drug is allowed to be administered to adults and children. The differences are in the route of administration. If adults receive an injection into the superficial muscle of the shoulder, then children receive an injection into the upper thigh. It is forbidden to administer the vaccine into the gluteus muscle.
The instruction prescribes
The introduction of the rabies vaccine is shown as soon as a person is bitten by an infected animal or with signs of the presence of rabies virus. To do this, the doctor takes the ampoule with the medicine and mixes it with water intended for injection. It should be remembered that the prepared solution cannot be stored, because the duration of dissolution of antibodies should not be more than one minute.
If there is no damage to the skin, no traces of saliva and direct contact with a potentially dangerous animal has not occurred, then vaccination and additional treatment are not required.
Vaccine treatment and prophylaxis regimens differ depending on the presence of damage and the fate of the animal.
Upon contact with saliva
If the person was not bitten, but the saliva of the animal got on the skin, then the following rabies prophylaxis scheme is assumed:
- It is necessary to introduce 1 ml of the drug on the first day, then injections are made on days 3, 7, 14, 30, 90.
- However, the further fate of the animal is important here. If it is possible to monitor him, then take into account his state of health. When on the 10th day the beast has no signs of rabies, then human therapy is also stopped. It turns out that a person will receive only three injections.
If scratched
If after contact with a suspicious animal there are scratches or minor bites on the body, then the scheme is assumed to be similar to the previous one. It is advisable to seek medical help on the first day of the incident, then give repeated injections on days 3, 7, 14, 30 and 90. They also carefully monitor the condition of the animal and stop the therapy if, after 10 days, the animal does not show signs of rabies. However, if scratches occurred in the area of the head, neck, genitals and hands, then the scheme is used, which is discussed below.
Deep Bite Therapy
If a person is severely bitten, or there are scratches and desalination in potentially dangerous places (genitals, neck, head, fingers and toes), an rabies vaccine should be given immediately. The instruction also prescribes additional complex therapy with immunoglobulin. The scheme remains the same and repeated injections are required after the time interval described above. A heterologous rabies immunoglobulin is needed if:
- single deep bites are observed;
- there are scratches and oozing of the mucous membranes, neck and head;
- you cannot track the further health of the animal;
- bit by bats or rodents.
In these cases, only after the introduction of immunoglobulin is used rabies vaccine. The instructions indicate that 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, the remainder is injected into the upper part of the shoulder, gluteus maximus or thigh. However, the locations should not coincide with the area of administration of the vaccine itself.
It is used equally for adult patients and children rabies vaccine. The instructions for use indicate that the dosage in both cases is the same and does not depend on age.
Vaccine contraindications
If an injection is necessary for vital indications, when it is known for sure that the animal is infected with a rabies virus, then no contraindications are taken into account. A vaccine can save a patient's life, and its absence almost always leads to death. But, if prophylactic administration of antibodies to the virus is supposed, then there are certain contraindications:
- pregnancy and lactation;
- individual reaction to injection components;
- acute diseases;
- chronic diseases in the acute stage;
- previously identified negative allergic reactions that threaten the life and health of the patient (Quincke's edema);
- heart failure;
- intolerance to antibiotics.
Adverse reactions
Inactivated dry rabies vaccine is usually well tolerated by patients at any age. It is noted that after the injection there are no consequences. However, sometimes negative reactions are recorded, both local and general.
Local manifestations:
- swelling of tissues at the injection site;
- itching and redness;
- hyperthermia of the skin;
- swollen lymph nodes near the injection site.
Also, patients note that the following general negative symptoms may be disturbing:
- headache;
- short-term fever;
- increased weakness;
- neurological symptoms rarely appear.
Is replacement possible
The rabies culture vaccine has no full analogues. But there are drugs with a similar principle of action. This means that the composition of the drugs varies somewhat, but the effect 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".
The principle of the vaccine
The rabies vaccine promotes the appearance of antibodies against 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 activation of the immune system may not be sufficient if the bite area affects 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 help of a vaccine, the patient gains a stable 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 within half an hour after the injection under the close supervision of medical personnel. If such complications arise, then urgent hospitalization and symptomatic therapy are required, including:
- antihistamines;
- hyposensitizing drugs.
Vaccination must be carried out in a medical office equipped with everything necessary. Otherwise, it is important to provide personnel with anti-shock drugs. Mandatory issuance of a person a certificate, which indicates:
- vaccination date;
- series and type of vaccine;
- conducted course;
- post-vaccination symptoms.
After seeking medical help after contact with a suspicious animal, the following types of procedures are mandatory:
- treatment of abrasions, wounds, scratches and other damage;
- vaccine administration;
- patient monitoring;
- accounting for the condition of the animal.
These procedures must 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 remains unchanged.
Prohibited Actions
A dry rabies vaccine may not be effective if glucocorticosteroids or immunosuppressants are taken at the same time. Therefore, it is important to always notify your doctor of all drugs used.
It is impossible during the entire course of therapy and six months after vaccination:
- drink alcohol;
- supercool and overheat;
- overwork.
If the ampoules have expired or broken, then they can not be used. You must also dispose of the medicine that has changed color.
Vaccine Reviews
Patients who injected the vaccine noted that it is well tolerated and protects against the possibility of infection with the virus. Doctors say that it is better to suffer some deterioration in health, but not to pick up the virus. Usually the reaction occurs after the first injection. It happens that the temperature rises, but not above 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 has a very large load 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 life, and this is the most important thing. Well, if you can track the further fate of the animal, and if it is healthy, then after three injections it is allowed to stop therapy.
Children are especially difficult to tolerate vaccination, because the dosage and administration schedule are not reduced. Their temperature rises, physical activity decreases, a swelling and redness occurs at the injection site. But an injection can protect against a dangerous virus from which children cannot be otherwise protected.