Humanity lives on the planet in the neighborhood with many life forms, including microscopic ones. First of all, these are viruses and bacteria. Paradoxically, but such negligible organisms have a huge impact on the human population.
Rabies Briefly
During the existence of the human species, much has changed: climatic conditions, landscape, social formations, achievements in science, technology and medicine. It is thanks to the latter that people no longer die from rampant pandemics that raged just a few centuries ago. But there remained a number of diseases that persistently could not be cured, despite all the efforts made. Among them, rabies stands out most clearly.
This ailment 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 rabies virus (rabies), which is transmitted by infected animals. The saliva that got into the wound during a bite is filled with a viral component, and if you do not immediately contact a trauma center, the disease will very soon enter the active stage.
The name of the disease has the word “demon” in it - it was the obsessed person who was considered a sick person 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 over the years. The essence of the disease is as follows: the virus infects the spinal cord and brain, causing photophobia, hydrophobia, hallucinations, paralysis, and other serious disorders. In other words, a person is not able to drink a sip of water, at the sight of which the patient immediately begins to cramp, and with the slightest air movement the patient experiences sharp muscle cramps. Death occurs due to paralysis of the respiratory muscles and heart muscle.
Two ways to protect
Since the disease is extremely dangerous and almost 100% fatal, people have been trying to find ways to treat it, or at least prevention, 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 on the planet.
Over time, scientists have found another way to help prevent the disease before the onset of the first symptoms. This is an 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 operation is based on other mechanisms.
Distinctive signs 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 administration 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 immunity for a certain time (about 2 weeks) develop ways to adequately protect the body. This occurs by the formation of specific proteins - antibodies. These substances remember everything about the antigens of the specified virus, and when an aggressive agent enters the body, they immediately destroy it. Most vaccines operate on this principle. Accordingly, active immunity is produced. For this, an rabies vaccine is used.
Rabies immunoglobulin acts somewhat 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 completely defenseless against the invasion of harmful microbes. Therefore, the patient is injected with rabies immunoglobulin - a drug based on donated blood of a person or animal (most often horses). Thus, a large number of antibodies and antigens enter the body (their medication also contains), which help to develop passive immunity. Basically, the drug is used as part of a combined course of immunization.
The difference between the described medicines is 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 from the virus is produced.
Rabies immunoglobulin: types
Depending on the origin of the antibodies, the drug is divided into two types:
- Heterologous.
- Homological.
The first type is called "Immunoglobulin anti-rabies from horse serum ." The second is a medication based on human donated blood. It is worth noting that to increase the number 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 safe than an animal product. The homologous dosage required for immunization is half that amount.
Four names of such a drug as anti-rabies immunoglobulin are registered. There is more than one manufacturer of the drug: two medicines are manufactured in Russia (Biopharma, FSBI ARRIAH), the rest are in China (FC Sichuan Yuanda Shuyan), Israel (Kamada Ltd.) and Ukraine (Biolek "). Given the special danger of the disease and the specifics of using such drugs, their implementation is carried out directly - from pharmacies to medical institutions.
"Rebinolin" - anti-rabies immunoglobulin
The first type of this medication is based on human biomaterial. It is positioned by scientists as more effective. When considering its properties and the nuances of application, attention should be paid to the following points:
- Dosage form. The anti-rabies immunoglobulin (the instruction clearly indicates this fact) is a transparent or slightly yellowish substance containing a slight precipitate. This drug has the form of a solution for administration to the body intramuscularly or subcutaneously.
- Effects on the body. Not less than three days after administration, the maximum concentration of antibodies aimed at the destruction of the rabies virus is achieved. These proteins are eliminated from the body for a month.
- Indications. It is prescribed by contact with infected animals, involving bites and saliva on the affected skin. The introduction of the drug is carried out in combination with an rabies vaccine to mutually enhance the effect.
- Undesirable manifestations. Since a foreign agent enters the body, the reaction can be quite 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. Short-term vomiting and hypotension were also noted.
- Interaction with other medicines. Incompatible with vaccines containing live viral cultures. Use with antibiotics and tetanus toxoid is allowed .
- Special instructions. During pregnancy and lactation, the use of the drug is possible, since a long study of the effect of immunoglobulins on the human body suggests 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 way to prevent rabies. It should be emphasized that this drug has no contraindications, since it is prescribed from the point of view of life criteria. Moreover, the sooner the victim seeks help, the more stable the result will be.
Method of using the drug
Before using anti-rabies immunoglobulin, the instructions for use involve the following algorithm:
- Thoroughly wash the wounds with running water, soap and antiseptic agents.
- Before the introduction of the drug, the integrity of the ampoule, the appearance of the medication and the expiration date are checked.
- Anti-rabies immunoglobulin (homologous) is administered taking into account this dosage: 20 IU per kilogram of human weight.
- It is better if almost the entire dose will be injected directly into the wound or nearby affected tissue. If this action is not possible, intramuscular injection is fully performed.
- For children, the drug is administered in the thigh area, for adults - in the buttock.
A remedy called Rebinolin of Israeli origin. The shelf life of the drug, subject to the storage regimen, is 2 years. Immunoglobulin freezing is strictly prohibited. Permissible storage temperature is from 2 to 8 ⁰.
A complex approach
As a rule, any type of immunoglobulin is administered together with the rabies vaccine. In this regard, there are several points that you should definitely pay attention to:
- The introduction of rabies immunoglobulin is carried out strictly before using the vaccine (a break between drugs - 30 minutes).
- To use the funds, different parts of the body are selected that are located as far as possible from each other. For example, immunoglobulin into the left buttock, and the vaccine into the deltoid muscle on the right.
- Syringes for drugs should be different.
- An intravenous drug is not administered.
- Raising the dosage of rabies immunoglobulin is strongly not recommended.
The drug is based on animal biomaterial
"Immunoglobulin anti-rabies from horse serum" (liquid) is classified as heterologous. It is considered a little less safe for the reason that the specific proteins that it contains can cause an unpredictable reaction of the body. At the same time, the use of a drug based on human biomaterial is relatively calmly tolerated by patients. In this regard, before using heterologous immunoglobulin, an intradermal test is mandatory in the forearm region.
If after 20 minutes no serious edema or redness has occurred, diluted immunoglobulin (1 to 100 solution) is injected subcutaneously. And only if after half an hour the sample is still negative, use the rest of the drug. And not immediately, but according to the following scheme: part of a heated dose of rabies immunoglobulin is injected into the wound area, after 15 minutes, the next portion is injected into the tissue 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 lasts about an hour.
If a 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 of this species from the previous one is the dosage. The horse serum product is used in a doubled dose (40 IU per kilogram of body weight).
Rabies Vaccine
Currently, 5 drugs of domestic production and one Indian are registered in the territory of the Russian Federation. This vaccine is made in transparent ampoules complete with distilled water and contains an inactivated rabies virus. After dilution, it looks like a pink or colorless liquid. When using this tool, there are important nuances:
- When introduced, the necessary antiseptic rules are mandatory, and the vaccination room must be equipped with anti-shock drugs and drugs for emergency care. After dilution, storage of the rabies vaccine is allowed for no more than 5 minutes.
- Half an hour after the introduction of homologous immunoglobulin, the use of a vaccine is permitted.
- 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 should be under the supervision of medical staff for at least half an hour after manipulation.
Types of Immunization
There are two types of immunization: preventive and therapeutic. The first is used if a person engages in potentially dangerous activities where there is a high risk of rabies infection. These are hunters, huntsmen, employees of bacteriological laboratories, veterinarians. The second type is used immediately after contact with a sick animal. Both options have a specific execution algorithm. In addition to schemes, there is another difference between these types. If in the first case a chronic disease in the acute stage or pregnancy can become a contraindication, then the second type of immunization is carried out according to vital indications.
Vaccination regimens
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 domestic animals, and all these wounds are in the area of the trunk and extremities, then the person is vaccinated immediately after processing the damage. A single dose of rabies vaccine is 1 ml. Immunization is carried out on the day of contact, and then on the 3rd, 7th, 14th, 30th and 90th day. The pattern can be changed if the animal under observation has not died or the rabies virus has not been detected. In this case, they are limited to three vaccines.
- Any wounds to the head, neck, hands, genitals, ankles and fingers caused by pets, as well as damage or soreness caused by wild animals, rodents and bats, require the application of immediate comprehensive measures. On the day of contact, before the introduction of the rabies vaccine, a mandatory injection of immunoglobulin, carried out in accordance with the above rules, is used. Next, immunization is carried out according to the standard scheme.
For health reasons
This phrase often sounds in doctors' offices or on the territory of hospital wards, so everyone is used to it. But unfortunately, sometimes people tend to forget how valuable human life is. Every day, seeing the smile of your child, hearing the voice of your mother in the receiver, watching the flight of birds - all this is so commonplace that it is taken for granted. And only when disaster strikes the house, do people remember this. Take care of yourself and your loved ones, and in case of potential danger do not delay the appeal for help.