50 practical knowledge points about dog bites, welcome to forward it!
With the improvement of residents' living standards, it is very common to raise cats and dogs in families. The more bizarre ones include wild animals such as pigs, pythons, and owls. Damage is inevitable during the feeding process. How to deal with it? Today, the editor will summarize it for you. Welcome to forward and collect it so that more owners can know the content of these dry goods.
01
Dog bite concept
Dog bite refers to skin damage, tissue tear, bleeding and infection caused by canine teeth bite and cutting human tissue.
02
Rabies virus structure
Rabies virus (RABV) belongs to the family Rotariviral family, rabies virus. The RABV particles are bullet-shaped, with a viral genome of about 12kb in length, and are single stranded negative strand RNA that is not segmented, 100-300nm in length and about 75nm in diameter. The rabies virus genome encodes five structural proteins from the 3-5 ends, namely nucleoprotein (NP), matrix protein (MP), phosphorylated protein (PP), glycoprotein (GP) and transcriptase protein (LP).
03
Biological characteristics of rabies virus
Currently, RABV is mainly prevalent in my country; RABV is not resistant to high temperatures, and the virus in the suspension loses its infectivity at 56℃ 30-60 min or 100℃ 2 min. RABV in brain tissue can maintain vitality for 7 to 10 days under normal temperature and autolysis conditions, and can be stored for 2 to 3 weeks at 4°C. RABV is relatively stable at pH 7.2~8.0, and is easily inactivated if it exceeds pH 8.0. RABV is sensitive to fat solvents (soap water, chloroform, acetone, etc.), ethanol, hydrogen peroxide, potassium permanganate, iodine preparations, and quaternary ammonium compounds (such as benzalkonium bromide). 1: 500 diluted quaternary amine disinfectants, 45% to 70% ethanol, 1% soapy water and 5% to 7% iodine solution can all inactivate the virus within 1 min, but it is not easy to be inactivated by the lesu solution.
04
99% of rabies cases are transmitted by dogs, and a small number are transmitted by wildlife (such as foxes, wolves, jackals, bats, raccoons, skunks or mongooses, etc.).
05
Distribution method
Dog bites are the main transmission method of rabies virus, and the mortality rate of rabies is almost 100%.
06
How rabies virus invades human body
1. Bites and scratches from animals infected with rabies virus.
2. The wound was licked by an animal carrying rabies virus.
3. The conjunctiva, oral cavity, and anal mucosa were licked by animals carrying rabies virus.
4. Transplant organs or tissues donated by rabies patients.
07
Incubation period of rabies
The incubation period of rabies varies, as short as a few days, usually no more than 3 months.
08 Factors influencing the length of incubation period
1. The bite site.
2. The depth of the wound.
3. The number of viruses entering the human body.
09
Dog bite risk exposure level
Level I: Contact, feed or licked with skin intact, which is a Class I exposure. Level I exposure, confirming the medical history is reliable without special treatment, just clean the exposed area;
Level II: No obvious bleeding minor abrasions, scratches, nibbles or wounds without obvious bleeding are classified as Level II exposure. If the naked eye cannot tell whether the skin is ulcerated, you can use alcohol to wipe the exposed area. If there is pain, it means that the skin is damaged. However, this method is only suitable for testing when the injury is injured. After grade II exposure, the wound should be treated immediately and vaccinated with rabies;
Grade III: A single or multiple bites or scratches that penetrate the skin with obvious bleeding, or a broken skin is licked or a mucous membrane is contaminated by animal body fluids, which is considered a grade III exposure. For Grade III exposure, the wound should be treated immediately and vaccinated with rabies vaccine and passive immunization preparations simultaneously. The pathogenesis of rabies
The pathogenesis of rabies
rabies virus, after invading the human body, first proliferates at the exposure, then enters nearby nerve endings, spreads to the central nerve through the nerve axons, and reproduces in large quantities in the nervous system, mainly affecting the brain and cerebellum. Finally, the virus spreads to the peripheral nerves and invades peripheral tissues and organs such as salivary nerve nucleus and glossopharyngeal nerve nucleus.
11
Typical stages of rabies
From infection to onset and death, rabies will go through four stages: latent period, prodromal period, acute neurological symptoms period, and paralysis period, and there will be different clinical manifestations at different stages.
Incubation period: From infection to no symptoms before onset, most of which are 1-3 months, and very few within a week or more than one year.
Prodromal period: Generally 2-10 days, usually with atypical symptoms such as discomfort, anorexia, fatigue, headache and fever, and symptoms such as unreasonable fear, anxiety, excitement, irritability, nerve allergy, insomnia or depression. Some patients will experience specific neuropathic pain or sensory abnormalities at the injured area, such as itching, numbness, and feeling the ants crawling.
Acute neurological symptoms (exciting period): Generally lasts for 1-3 days, patients will experience typical clinical symptoms of rabies, which are divided into manic and paralytic types. Manic type is manifested as fever accompanied by hyperactivity, disordered orientation, hallucinations, spasm attacks, strange behavior, and stiff neck. It is prominently manifested as extreme fear, fear of water, fear of wind, severe choking, difficulty swallowing, difficulty breathing, difficulty urinating, and excessive sweating and salivation. Patients with paralysis do not have typical excitement periods and fear of water. Paralysis period: generally lasts 6-18 hours. After the acute neurological symptoms period, the patient gradually enters a quiet state. At this time, the spasm stops, the patient gradually becomes quiet, and flaccid paralysis occurs, especially limb paralysis. The patient's breathing becomes weak or irregular; gradually decreases blood pressure, disappears reflexes, and dilates in the pupils.
12
II III Exposure The above treatments
ⅡⅡ and Ⅲ grade exposure, whether it is a normal dog or a sick dog, the treatment of the wound should be paid attention to.
13
Dog bites are handled by
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The classification of rabies vaccines
15
The time for rabies vaccine injections
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The classification of rabies vaccines
The time for injections to be given after being bitten, and rabies vaccines are generally required to be administered within 24 hours after exposure. In principle, the earlier you get vaccinated, the better, because the earlier you get rabies vaccine, the earlier the body produces rabies virus antibodies, and then you can resist rabies virus in the shortest time, so that the probability of rabies will be greatly reduced.
16
conventional injection sites of rabies vaccine
1, under 2 years old: anterior and lateral thigh muscles;
2, 2 years old and above: deltoid muscles.
17
rabies vaccination procedure
1, 4-ocuse method (i.e. 2-1-1 immunization procedure): 2 doses were given on the same day, 1 dose was given on the 7th and 21th, 1 dose was given on the 5th day: 1 dose was given on the same day, 3rd day, 7th day, 14th day, and 28th day, after receiving the vaccine throughout the whole process, how to get vaccinated?
① Re-exposed within half a year: no need for vaccination;
② Re-exposed after six months but less than one year: 2 doses are given, that is, days 0 and 3;
③ Re-exposed after 1-3 years: 3 doses are given, that is, days 0, 3 and 7;
④ Re-exposed after 3 years: 5 or 4 doses are needed for full immunization.
19
Rabies Immunoglobulin
Rabies Immunoglobulin (referred to as rabies) is an anti-rabies immunoglobulin (IgG) obtained by collecting plasma from humans immunized with rabies vaccines and using cryogenic ethanol protein isolation or other approved isolation and manufacturing processes.
20
Which group of people need to inject rabies immunoglobulin
1, Class III exposure and multiple bites;
2, Body parts with deep wounds or rich nerves are bitten, such as: head, neck, hands;
3, severe immunodeficiency;
4, bitten animals are confirmed or possible cases of rabies;
5, bitten or scratched by bats, or mucosa exposed to bats.
21
The difference between rabies immunoglobulin and rabies vaccine
1. Immunoglobulin used in rabies patients is a passive immune preparation. After injection, the body immediately contains a large amount of antibodies to neutralize rabies virus. Therefore, it is best to inoculate it within 24 hours. Immunoglobulin is used in rabies for a short duration.
2. Rabies vaccine is an active immune preparation. After injection into the body, it can stimulate the human body to actively produce antibodies, but the production of antibodies takes a period of time. The antibodies produced after rabies vaccine are maintained for a long time. The two complement each other in preventing rabies.
Class III exposure patients still have a vaccination. One of the main reasons is that they have not given timely injection of immunoglobulin.
Class III exposure, or wounds located on the head, face, perineum, anus, etc., should be injected with rabies immunoglobulin as soon as possible while receiving rabies vaccine. Severe Level III exposure should be given priority to enable the 211 program! ! !
22
Can pregnant women get vaccinated during breastfeeding?
1. Since rabies is a fatal disease, there are no contraindications for vaccination.
2. Pregnant women and breastfeeding women also need to be vaccinated if they cause injuries, and priority is given to vaccination; it is safe for pregnant women and breastfeeding women to be vaccinated, and breastfeeding women can continue breastfeeding. Can dog bites be sutured?
Answer: Yes! Then there is treatment for dog bites or scratches:
1. First, rinse the wound continuously with soapy water for at least 20 minutes, then rinse with saline and disinfect the wound.
2. Inject rabies vaccine or use rabies immunoglobulin in combination. If the wound is deep, you need to inject tetanus antitoxin or tetanus immunoglobulin.
3. For wounds caused by dog bites or scratches, first-stage sutures are generally not recommended for limbs. Second-stage sutures can be performed after the wound is stable. However, on the premise of thorough debridement of facial wounds, we also recommend beauty sutures to reduce later scars. Can newborns be vaccinated after dog bites?
There are no contraindications for immunization after exposure (issued by the State Food and Drug Administration). No matter who is injured by a suspected animal, you must be vaccinated. The central nervous system and immune function of the newborn are not yet sound. After being bitten by a mad dog, the risk of rabies is much higher than that of adults, so it should be vaccinated as soon as possible.
25
About the 10-day observation method, according to WHO research, it is only a few days before the death of a dog or cat, and it is dangerous to be bitten. If a cat and dog die within the 10-day observation period, a person can get a rabies vaccine instead of having to be bitten within 24 hours.
If it is other animals that cannot be observed in captivity, do not use the 10-day observation method and get rabies vaccination immediately. It is recommended to complete the entire vaccination according to the procedures.
26
rabies vaccine is lifelong immunity.
rabies vaccine is time-efficient, not lifelong immunity. If you are bitten by a dog, you must seek medical treatment in time and keep your medical records well. If you are bitten again shortly after the vaccine, be sure to bring your medical records and ask the doctor to decide whether you need to get a reinjection or add a few shots. Don’t stop getting vaccinated if you think you are fine..
27
If you have rabies, you will learn to bark on dogs
The clinical manifestations of rabies are unique water fear, wind fear, pharyngeal spasm, progressive paralysis, abnormal or tingling pain in the bitten area. Because the symptoms of water fear are more prominent, this disease is also called water fear.
The patient may change his speech sound due to pharyngeal muscle spasm after the onset of the disease, but the patient will not experience obvious barking or crawling like a dog!
28
The significance of rabies antibody detection
●Accurate and well-founded evaluation of the effect of rabies vaccination
●In the face of 100% dead rabies, build a last firewall for life safety
●Eliminate the panic psychology of the injured, so that they can restore a relaxed and happy mood as soon as possible
29
How much protective significance is the rabies antibody reached?
The World Health Organization (WHO) and the Technical Guidelines for Rabies Prevention and Control (2016 Edition) clearly state that the titer of rabies virus neutralizing antibody in serum after immunization can be effective protection.
30
Rabies antibody test results?
antibody level is less than 0.5IU/mL and can be re-examined after 1 injection of each of 0 days and 3 days.
The antibody level and maintenance time produced after vaccination of rabies vaccination varies from person to person. If it is exposed again, it is recommended to deal with it in accordance with current regulations.
31
When is the most effective rabies antibody test for blood draw? Blood tests can be performed on the 28th day after the first rabies vaccine (or at the same time as the full rabies vaccination is completed) to 6 months, and the data are valid data.
32
Which population must undergo rabies antibody testing?
●People with low immune system function or insufficiency
●Patients who are taking immunosuppressants due to other diseases
●People who are not vaccinated strictly according to the vaccination procedure
●People who drink alcohol heavily and smoke during vaccination
●People who suffer from other diseases (such as colds) during vaccination
●Related occupations who are frequently exposed to rabies virus or rabies
33
Do normal people need to test antibodies after receiving rabies vaccine?
Not required. According to the documents such as "WHO Position Document (2018 Edition), "Rabies Exposure Prevention and Disposal Standards (2009)", "Rabies Prevention and Control Technical Guidelines (2016 Edition)", etc., it is generally not necessary to test the immune effect after using qualified and formal routes of rabies vaccinated.
34
Dogs or cats who have been vaccinated with rabies have bites? Should they still be vaccinated with rabies?
Need still! Because after animals are vaccinated with rabies vaccine, the protection rate is not 100%, and there may still be cases of carrying rabies virus. Therefore, after being scratched or bitten by cats/dogs who have been vaccinated with rabies, they also need to be vaccinated with rabies.
35
Precautions after receiving rabies vaccine
The current instructions for domestic rabies vaccines include the following "Precautions": "Avoid drinking, strong tea and other irritating foods, and strenuous exercise."
Therefore, drinking excessively after receiving rabies vaccines may cause alcohol poisoning or drunk driving, but will not cause rabies.
Exercising too vigorously after getting rabies vaccinated can only die of excessive exercise or stroke, nor will it die of rabies.
36
Definition of rabies exposure
Bit, scratch, lick the mucosa or broken skin by rabies, suspected rabies, or host animals that are not sure whether they have rabies, or are directly exposed to saliva or tissue that may contain rabies virus. In addition, in rare cases, rabies virus infection can be infected by organ transplantation or inhalation of aerosols. What should I do if a certain shot of rabies vaccine is delayed?
Rabies vaccination should be completed on time. Correct vaccination according to the procedures is very critical to the body's immunity against rabies. If a certain dose is delayed by one day or several days, the subsequent dose vaccination time will be delayed according to the time interval of the original immunization procedure, and there is no need to re-vaccinate.
38
Replace the vaccine variety. Was vaccination effective in the past?
Try to use the same brand to complete the entire vaccination process. If it cannot be achieved, you can use different brands of qualified rabies vaccines to continue to complete the entire vaccination according to the source procedures.
39
If the wound is deeper, do you still need to break the tetanus? The wounds caused by animal injuries are high-risk wounds for tetanus. During the treatment process, the risk of tetanus needs to be evaluated and reasonable preventive measures are taken. Level II exposure is low risk, and Level III exposure is high risk.
40
Will you suffer from rabies after eating food that was licked by a dog?
is unlikely, rabies virus is generally not transmitted through food.
41
Do you need to get rabies vaccinated if you are bitten by rabbits and mice?
is generally not recommended unless such animals die abnormally or have rabies.
42
Can rabies be transmitted by human contact?
is unlikely! General contact between people will not cause rabies.
43
The incubation period of rabies is 20 years?
The incubation period of rabies is wrong, with a 10-1 year period, generally 30-90 days. The World Health Organization (WHO) records a maximum of 1 case for 6 years.
44
Can you get rabies after eating mad dog meat?
Rabies virus is mainly stored in dog saliva. The rabies virus is easily inactivated by heat. The virus will die after heating at 100°C for 2 minutes. Therefore, eating cooked dog meat itself cannot lead to viral infection.
45
Can other vaccines be vaccinated according to normal immunization procedures during rabies vaccination?
At present, no research has found that the concurrent use of rabies vaccines and other vaccines will have mutual influence on the immune effect.. Other vaccines can also be vaccinated according to normal immunization procedures during rabies vaccination. But try to avoid the occurrence of vaccination reactions.
46
Can rabies vaccine be vaccinated during medication?
Given that rabies is 100% lethal, there are no contraindications and rabies vaccine should still be vaccinated during the medication period. General drugs have no direct impact on the immune effect of rabies vaccines, but they should be avoided in combination with immunosuppressive drugs.
47
If you are bitten by a dog, do you still need to clean the wound?
The more timely the wound is treated, the better the removal and killing of viruses that invade the wound. Therefore, regardless of whether the injured person is preparing to go to the hospital for treatment, it is very important to treat the wound yourself as soon as possible after the injury. Will the vaccination effect on the fetus after exposure?
Because rabies is a fatal disease, pregnant women should also get rabies vaccination as soon as possible after being injured by dogs and cats.
Study shows that the use of qualified rabies vaccines generally will not cause adverse reactions to pregnant women, nor will it affect the fetus, and there is no need for artificial abortion.
49
Can young couples have children after receiving rabies vaccine?
Existing studies have not found that rabies vaccine will have an impact on pregnancy and delivery. Therefore, you can have children during rabies vaccination.
50
Can I take a bath during vaccination?
Bathing has no effect on the immunization effect of rabies vaccine, but you should try not to take a bath on the day of vaccination, with the purpose of preventing infection at the injection site.
