Don't be afraid! Let's learn about rabies prevention and treatment scientifically~

Author: Xiao Xuyan, Jiang Yanting, Zhou Yi, Xi'an Medical College

Reviewer: Xiao Xinli, Associate Professor, School of Medicine, Xi'an Jiaotong University

According to incomplete statistics, 40 million people are bitten by cats and dogs in my country every year, and the number of people seeking medical treatment is 10 to 15 million, of which 40 to 60% are level 3 exposures, and the rabies mortality rate is 100%.

In order to increase public awareness of rabies, the World Health Organization, the World Organization for Animal Health, and the U.S. Centers for Disease Control and Prevention jointly initiated the establishment of September 28 as "World Rabies Day."

Figure 1 Copyright image, no permission to reprint

Q : What is rabies exposure? How is it classified?

Answer : Rabies exposure refers to being bitten, scratched, or licked by a mucous membrane from an animal with rabies or suspected of having rabies, or having broken skin or open wounds come into contact with the animal's saliva or tissue.

The "Rabies Exposure Prevention and Treatment Work Specifications (2009 Edition)" divides rabies exposure into three levels.

Level Ⅰ: Contact or feeding of animals, or licking of intact skin.

Grade II: Exposed skin is lightly bitten, or there are minor scratches or abrasions without bleeding.

Grade III: Single or multiple penetrating skin bites or scratches, broken skin licking, open wounds and mucous membranes contaminated.

Q : What should you do first after being scratched or bitten by a cat or dog?

A : The wound should be rinsed repeatedly with saline or clean water as soon as possible; in severe cases, the wound should be pressed to stop bleeding first, and then the patient should be taken to the nearest medical institution for standardized treatment. After determining the exposure level, the outpatient doctor will immediately treat the wound as needed.

Those determined to be exposed at Level I do not need to take any action.

Those determined to be exposed at Level II should have their wounds treated immediately and receive rabies vaccinations. Those confirmed to be exposed at Level II and have low immune function, or those exposed at Level II are on the head or face and the health of the injuring animal cannot be confirmed, should be treated as those exposed at Level III.

For those determined to be exposed at Level III, the wound should be treated immediately and rabies passive immunization preparations should be injected, followed by rabies vaccination.

Figure 2 Copyright image, no permission to reprint

Q : What are the symptoms of rabies?

A : Rabies patients may have fear of water, fear of wind, fear of sound, fear of light, spasm of pharyngeal muscles, progressive paralysis, etc. Among them, fear of water is more prominent, so rabies is also called "hydrophobia".

Q : What is the incubation period of rabies?

Answer : Generally it lasts 1 to 3 months. It is rare for the disease to last more than 1 year.

Question : What is the “Ten-Day Observation Method”?

A : If you are bitten by a domestic pet that has been properly vaccinated, you can usually follow the "10-day observation method". The "10-day observation method" means that after being scratched or bitten by an animal suspected of having rabies, the animal should be kept for observation for 10 days. The bitten person should also be regularly vaccinated with rabies vaccine during the observation period.

If the animal remains healthy within 10 days, or if reliable laboratory diagnostic technology confirms that the animal does not carry rabies virus, the bitten person does not need to receive the remaining vaccine after 10 days.

Q : What is the difference between rabies vaccination and immunoglobulin?

A : Rabies vaccination is an active immunization. After vaccination, the body produces antiviral antibodies to prevent rabies. People with wound exposure reaching level III and who have not received a full course of rabies vaccination need passive immunization, that is, injection of rabies immunoglobulin and monoclonal antibodies.

Q : Which groups of people need to pay special attention to preventing rabies?

Answer : The following three groups of people should pay special attention to preventing rabies.

There are more cases in rural areas, accounting for more than 65% of the total cases.

The number of male cases is approximately twice that of female cases.

The disease is more common in children under 15 years old and people over 50 years old.

Question : How long should a woman wait before getting pregnant after receiving the rabies vaccine?

A : There is no requirement. Rabies vaccination does not affect pregnancy preparation.

Q : Is rabies only transmitted by cats and dogs?

A : No. Almost all mammals, including bats, horses, cattle, sheep, etc., can be infected and spread rabies.

Q : In addition to rabies, what other diseases should we be wary of when bitten by cats or dogs?

Answer : In addition to rabies, if you are scratched or bitten by a cat or dog, you should also pay attention to preventing and treating tetanus and wound infection.

Tetanus is an acute toxic disease characterized by sustained tonic contraction and paroxysmal spasms of skeletal muscles throughout the body. The disease develops rapidly, and severe patients may suffer from suffocation and organ failure, with a high mortality rate. Tetanus can be prevented by vaccination. It is recommended that high-risk groups be immunized before exposure; if they are not immunized before exposure, they should go to a medical institution in time for a full course of tetanus vaccination, which can provide protection for 5 to 10 years.

References

[1] 2021 Animal Injury Prevention and Control Summit Forum. Submitted by the Animal Injury Treatment Branch of the China Medical Rescue Association.

[2] The Ministry of Health issued the “Rabies Exposure Prevention and Treatment Work Specifications (2009 Edition)”.