Sometimes when you are bitten by a dog, is it not enough to just get a rabies vaccine? !

A few days ago, the child of Yaowa's friend saw a few dogs on the roadside: they were furry and round, swaying as they walked, and had innocent and naive eyes. They were so cute that they immediately touched the child's cute spot. So he stretched out his little hand, and the result was: he was bitten by the dog!!!

After being bitten, my friend took her child to the hospital. The doctor said that this time they needed to get anti-rabies serum and rabies vaccine, and the anti-rabies serum required a skin test. My friend was very surprised. He had heard people say that if you are bitten by a dog, you only need to get a rabies vaccine. Why did they need to add anti-rabies serum this time? Also, why do you need to do a skin test after getting anti-rabies serum?

Why do you need to get vaccinated after being bitten by a dog?

Rabies is an animal-borne infectious disease caused by rabies virus infection. Most human rabies cases are caused by bites or scratches from animals infected with the rabies virus, and a few are caused by virus contamination of wounds and mucous membranes. 99% of human rabies cases are transmitted to humans by rabid dogs. In recent years, the number of reported deaths from rabies has been among the top legally reportable infectious diseases in my country. Therefore, after being bitten (scratched) by a pet, regardless of whether there is bleeding or not, do not be lucky and go to the hospital for treatment in time. There is no saying that rabies vaccine is only effective within 24 hours of injection. As long as the disease has not yet occurred, you should get the vaccine as soon as possible, the sooner the better.

Why do I need to get anti-rabies serum after getting the rabies vaccine?

In fact, rabies vaccine is an antigen, which is active immunity; anti-rabies serum is an antibody, which is passive immunity. So vaccination and serum are not the same thing. Vaccines can cause the body to produce immune responses, produce antibodies, and gain immunity, which takes a certain amount of time to produce antibodies; while serum is the direct injection of antibodies into the body, which can quickly block the next "action" of the rabies virus in the body near the wound, and is an immediate measure to prevent and treat rabies.

When should I get rabies vaccine or (and) anti-rabies serum?

All people exposed to rabies at level II and III should be vaccinated. All first-time level III exposed people, as well as those with severe immunodeficiency, long-term and large-scale use of immunosuppressants, and level II exposed people with head and face exposure should use anti-rabies serum.

From the treatment of people with different levels of exposure in the table below, we can see that the condition for patients to receive anti-rabies serum is that they are "more seriously injured" than those who only receive rabies vaccine, and they also have to receive the vaccine at the same time.

Now it is easy to understand the doctor's treatment of Yaowa's friend's child. Because the child was bitten by a dog for the first time and had obvious bleeding, he was a first-time exposure level III exposed person, so he needed to be injected with rabies vaccine and anti-rabies serum at the same time.

Note: 1. When the patient has severe immune deficiency and other factors that affect the immune effect of the vaccine, those with Class II exposure should also be given rabies passive immunization agents. 2. The World Health Organization (WHO) recommends: Since the head, face, neck, hands and external genitalia are rich in nerves, it is recommended that exposure to these areas be classified as Class III exposure

Why is a skin test necessary when administering anti-rabies serum?

Anti-rabies serum is generally derived from heterologous serum, and the purity is not very high. Many people have allergic reactions after injection, so a skin test must be done first. If the result is positive, only desensitization therapy can be used with small amounts of multiple injections, which is time-consuming, may cause serum sickness, and has greater side effects.

Anti-rabies serum skin test method:

1. Allergy test: dilute the antiserum 10 times with sodium chloride injection (0.1 ml antiserum plus 0.9 ml sodium chloride injection), inject 0.05 ml intradermally on the forefoot, and observe for 30 minutes. If there is no obvious reaction at the injection site, it is negative. Anti-rabies serum can be directly injected under close observation. If the injection site appears enlarged, red, swollen, or infiltrated, especially in the shape of pseudopodia or itching, it is a positive reaction and must be injected with desensitization. If a strong positive reaction occurs, desensitization injection should be used, and emergency preparations should be made. If an allergic shock occurs, rescue immediately.

2. Desensitization injection method: Under normal circumstances, the antiserum can be diluted 10 times with sodium chloride injection and injected subcutaneously in small amounts several times. Observe for 20 to 30 minutes after each injection. The first injection can be 1 ml. When there is no cyanosis, asthma or significant shortness of breath, and accelerated pulse, the second injection of 2 ml can be injected. If there is still no reaction after the injection volume reaches 4 ml, the full amount can be slowly injected.

Prevention is the key to rabies. As long as you strictly follow the epidemic prevention procedures to treat the wound, you can avoid the risk to the greatest extent. At the same time, stay away from cats, dogs and wild animals of unknown origin to prevent accidents such as bites. In addition, alcohol, coffee, strong tea, cola and other irritating foods should be avoided during the vaccination process.