Rabies is a disease. Rabies in humans and animals. Clinical stages of the disease

Modern science and medicine today are absolutely powerless in the fight for the lives of people infected with rabies. Since there is no medicine anywhere in the world that can resist this virus, and the number of cases of infection is not decreasing. More than 150 countries around the world are suffering from the effects of the rabies virus.

The statistics are disappointing: every year more than 50 thousand people die as a result of the disease. The virus mainly affects residents of Asian and African countries.

Children are most at risk of infection, because half of the registered cases of infection occur in young patients under 16 years of age. Children are the most trusting of animals and come into contact with them more often than adults, which leads to the most dire consequences. To prevent the disease, the population is immunized against rabies every year, which affects more than 10 million people.

Rabies is a viral infection that destroys nerve cells in the central nervous system. The disease occurs with pronounced signs of a nervous disorder (aggression, dementia) and ultimately leads to the death of the body.

The main causative agent of the disease is a virus that quietly penetrates the immune and nervous systems, rapidly spreads throughout the body and destroys various parts of the spinal cord and brain. As a result, many functions of the central nervous system fail, and the virus affects the nervous tissues of the body, mucous membranes, and the skin suffers.

Causes

The viral infection is transmitted from an infected four-legged animal to humans. This occurs after the bite of a wild infected animal. There is another option - transmission of rabies through a scratch or open wound/abrasion on the human body, when infected saliva of a four-legged animal gets onto the damaged area or open mucous membrane. Rabies carriers are not only wild animals. Livestock and domestic animals can also become infected from another animal. Most often, carriers of the virus are wild foxes, badgers, raccoons, hedgehogs, wolves, and rodents. Among domestic animals, the most affected are livestock, dogs and cats, which have free range and can encounter wild animals.

The speed of infection depends on many factors. For example, the location of the bite, its depth and the intensity of the animal’s salivation are taken into account. Lacerations on the face, head and hands of a person’s upper extremities are considered especially dangerous.

There are cases of transmission of rabies from person to person. But they are exceptions to the rule rather than statements. The routes of transmission of infection are similar; infection occurs in the same way as in the case of animals - through saliva and open mucous membranes.

How not to become infected with an infectious disease

A person in a panic is prone to overestimate the situation and, in a state of panic and fear, rushes headlong to the hospital for rabies vaccination, even in cases where this is not required. Cases where there is no threat of rabies infection:

• rabies cannot be transmitted if the animal’s saliva gets on an intact area of ​​the skin and does not touch the mucous membranes;
• the scratch or other damage to the skin was caused by a bird;
• during the attack, the animal did not even damage outer clothing, contact with the body was excluded;
• consumed processed (boiled, fried) meat or boiled milk from infected cattle;
• the bite was made by an animal that had been vaccinated within a year and had no obvious signs of the disease;
• the viral infection is found exclusively in the animal’s saliva. There is no infection in the urine, feces or blood.

There is such a thing as lysophobia - the fear of becoming infected with rabies. This is a fairly rare disease and is treated using psychotherapeutic methods or hypnosis.

It is known how rabies is transmitted, but you need to know that if a pet is bitten, it is necessary to monitor it. If within a few days the animal begins to show signs of infection, it is necessary to immediately begin vaccinating the affected person. It is important to know how you can become infected with the virus and avoid such situations, because in the modern world there is no panacea for rabies.

Symptoms

The incubation period can last differently for each person, because its duration depends on the location of the bite and the depth of the lesion. If the area of ​​the head and face is affected, this is approximately 15-20 days; if the foot or leg is bitten, this period can last up to a year, accompanied by unpleasant sensations. There have been cases around the world where dog rabies manifested itself only 2-3 years after the bite.

There are three periods of the disease: depression, agitation and paralysis.

The first period is depression. During this period, a person infected with rabies may feel a burning sensation and itching in previously affected areas. Sometimes it is possible to feel swelling and hyperemia in the area of ​​the previous wound.

A person’s nervous system is depressed, he has no mood, loss of appetite and sleep, anxiety states, panic, fear, apathy towards everything.

The next period is excitement. It can begin to act on the third day and manifest itself with a high temperature, over 37 degrees. At the same time, various phobias may develop, for example, aerophobia or hydrophobia, heart rate may increase, blood pressure may increase, etc. The patient becomes aggressive, may behave inappropriately, rudely, salivation increases, and speech sometimes becomes slurred.

The most pronounced symptom is hydrophobia - constant thirst, in which a person cannot drink water due to spasms of the respiratory-swallowing system. In the future, spasms overcome the patient even in the absence of thoughts about water. Because of this, aggressiveness and anger are gaining even greater momentum.

Due to constant nervous tension, periods of excitement begin to increase and become more vivid. A person with rabies may lose clarity of consciousness and experience visual and auditory hallucinations. At the same time, be completely adequate between attacks and be aware of what is happening to him. This period can last about 3 days.

The paralytic period is the final one. During this period, the stage of excitement gives way to depression. The patient experiences apathy. The muscles of the body stop contracting involuntarily, and the spasm goes away. The body temperature rises sharply, the heart begins to contract faster, paralysis of the limbs and immobilization appear. Paralysis affects the cardiovascular system, respiratory system and death in this case is inevitable. You can extend the patient’s life by several hours or days with the help of artificial ventilation, but death will occur in about a day or two.

Diagnosis of the disease

In order to correctly and quickly identify the diagnosis, it is necessary to take into account the following nuances:

• detection of the site of an animal bite or scratch on a person;
• presence of signs characteristic of rabies;
• laboratory tests of the eye shell, in which the virus can be identified by an imprint of the surface of the eye shell.

To eliminate the risk of rabies infection, it is necessary to carry out vaccination on time, which prevents infection in 98% of cases, since this problem is very serious and leads to irreversible consequences - death.

Unfortunately, final confirmation of the diagnosis can only be after the death of the patient. This is carried out using the following means:

• histological examination for the presence of Babes-Negri bodies in the body. The cerebral cortex, cerebellum and amnon horn are examined;
• biological puncture. Brain cells of experimental rodents that receive a dose of intracerebral infection are being studied;
• immunofluorescence test. Nerve tissue, salivary glands and brain cells are examined for the presence of the rabies virus.

Treatment of the virus

When the first symptoms appear, emergency care is needed with hospitalization of the patient, because you can become infected with rabies immediately after a bite.

Are there effective treatments for this disease? No, there is symptomatic therapy to alleviate the patient’s condition and alleviate suffering.

People with the rabies virus should be placed in a warm room or ward, free from bright light and noise. An enema of morphine, diphenhydramine, aminazine or pantopon is promptly administered.

With severe spasms of the respiratory tract and the inability to inhale air on their own, the patient is connected to an artificial lung ventilation system, which will prolong his life. In the presence of clinical symptoms, immunoglobulin is powerless in the fight against this disease.

Everyone wonders if rabies can be overcome. But in the history of medicine, there are only isolated cases of recovery without further consequences after a full course of immunization with vaccines. In other cases, the prognosis is disappointing - the person will face inevitable death.

Preventive measures

Primary prevention should consist not only of studying the question of whether it is possible to become infected with rabies from domestic animals and how people become infected among themselves. But it must also identify foci of infection and methods to combat them. It is necessary to monitor the health and proper care of pets, carry out their timely vaccinations, and help catch stray dogs.

All infected animals must be immediately killed and taken to the laboratory for study and research of biomaterial. It is especially important in cases where a person has suffered from this animal. If an apparently healthy dog ​​has been bitten or otherwise injured by a person, it is isolated in a special room for 10-14 days to monitor behavior and rule out rabies infection.

For those who have constant contact with animals, vaccination is simply necessary, because infection can occur even while feeding the animal.

There is a division into specific and nonspecific methods of prevention. In the first case, various types of immunization are carried out using anti-rabies immunoglobulin and serum, as well as a special culture vaccine. All these methods must be used comprehensively, because this is the only way they will give an effective result.

Nonspecific prevention consists of aseptic treatment of wounds using a soap solution, running clean water and iodine. Do not injure the wound by excising the damaged edges. Treatment of the wound ends with covering the damage with a special anti-rabies powder based on globulin.

Features of vaccination

Treatment after the appearance of signs and first symptoms is no longer effective, so rabies can only be prevented in advance through prevention and vaccination.

Rabies vaccinations are indicated in the following cases:

• attack by an obviously unhealthy animal with all signs of infection on exposed skin;
• infection can be transmitted through injury by objects containing saliva of an infected animal;
• scratches from an animal that died shortly after the incident for unknown reasons;
• due to the bite of a rodent (these animals are often carriers of various types of infections);
• contact with the saliva of an infected person, but only in cases where it gets on the mucous membrane or on an open wound;
• rabies can be transmitted through sexual contact (oral sex).

Rabies vaccination can cause a number of side effects: redness, various rashes, weakness or lethargy, dyspeptic disorders, fever, headache. But all these possible consequences are incomparable with the consequences of infection.

Vaccination can be carried out on an outpatient basis or in a hospital, it all depends on the desire and degree of damage of the patient.

After the vaccine is administered, you need to limit yourself in certain things: alcoholic drinks must be excluded not only for the period of the vaccine, but also for up to six months after it.

Rabies (hydrophobia, rabies) is an extremely dangerous viral disease (zoonosis), which is characterized by severe damage to the nervous system and usually ends in death. Every year, tens of thousands of people die from this disease (mainly in Africa and Asia).

Causes

The causative agent is the rabies virus Rabiesvirus. The virus is resistant to antibiotics, freezing, and phenol. When boiled, it dies in 2 minutes; when heated to 56 o C, it is destroyed in 15 minutes. Inactivated by alkalis and acids, sublimate, chloramine, Lysol, ethanol. The source of infection is infected animals (wolves, dogs, foxes, bats, cats, rodents, small and cattle, horses). The main mechanism of transmission is contact (when bitten by a sick animal, salivating on damaged skin), however, the possibility of aerogenic, transplacental and nutritional routes of infection has also been proven. Some cases of human infection due to corneal transplantation have been described.

Symptoms of rabies

The incubation period can last from one week to a year (usually 1-3 months). In the prodromal period (the first 1-3 days), the body temperature rises (to subfebrile levels), pain reappears at the site of the bite, the patient becomes depressed, restless, and sleeps poorly. At the height of clinical manifestations (from 1 to 4 days), the patient’s condition noticeably worsens, and respiratory or circulatory arrest may occur. The following symptoms appear:

• Anxiety, fear of hydrophobia (at the sight of water, attempting to drink, and then even at the mention of water, a painful spasm of the swallowing muscles, as well as auxiliary respiratory muscles, occurs);
• Aggression, fear, violence, sometimes even hallucinations;
• (a jet of air directed at the face can cause convulsions in such patients);
• Photophobia (bright light can provoke painful convulsions), dilated pupils and exophthalmos;
• Acousticophobia (severe irritability in response to loud sounds);
• Sialorrhea (excessive drooling);
• , increased sweating;
• Consciousness can become clear only during the interictal period;

Next comes a “period of ominous calm” (stage of paralysis), which is characterized by loss of activity of the cerebral cortex, a significant decrease in sensory and motor functions. Attacks of hydrophobia, aerophobia and convulsions stop. Body temperature rises to 40-42 o C, blood pressure drops, tachycardia intensifies. Death occurs within 24 hours from paralysis of the respiratory or cardiovascular centers.

Diagnostics

The basis for diagnosing this disease is a carefully collected anamnesis and clinical picture, since diagnosis is difficult before the symptoms of the disease appear. A general clinical blood test can detect lymphocytic leukocytosis with aneosinophilia. The rabies virus antigen can be detected in imprints from the surface of the cornea. The total duration of the disease from the onset of symptoms rarely reaches 10-12 days.

Types of disease

Rabies is divided according to clinical manifestations into:

• Meningoencephalitic form;
• Bulbar form;
• Cerebellar form;
• Paralytic form.

By stages there are:

• Initial stage (fear, anxiety);
• Excitation stage (stage of increased convulsive activity);
• Stage of paralysis (death of areas of the cortex and subcortical formations).

Patient Actions

If you are bitten by an unfamiliar (or suspicious) animal, you must immediately wash the wound with soap for 10 minutes and seek specialized help from a specialist. It is recommended to report the location of the animal and provide its description for further observation of the animal. If the animal does not show symptoms of rabies within 10 days, then it is considered healthy. If the animal cannot be caught, then vaccination is carried out in any case.

Treatment of rabies

Vaccination is effective within the first two weeks after an animal (or human) bite. The rabies vaccine is injected daily for 20-25 days into the subcutaneous tissue of the abdomen, the dose is calculated individually depending on the location and duration of the bite. For bites near the brain (face, neck, head) or multiple bites, rabies immunoglobulin (0.5 ml per kg) is administered due to the high probability of a short incubation period.

Complications of rabies

There are virtually no complications of the disease itself, as death occurs quickly. However, complications from vaccination often develop (local reactions, shock, late neurological complications, development of the disease).

Prevention

Prevention of rabies consists of eliminating the disease in animals and preventing the development of the disease in people who have been bitten by infected animals. Vaccination of animals and control of stray dogs and cats are carried out. Immunization of people with an increased risk of infection is also carried out (those traveling to endemic areas, employees catching wild and stray animals, people living for a long time in tents, etc.).

Every year, tens of thousands of people around the world die from rabies. The disease is common in more than 150 countries.

Synonyms for the name of the disease are “rabies”, “hydrophobia”, “hydrophobia”.

This disease has been known since ancient times. Cases of human rabies infection from animals (wild or domestic) were described in ancient manuscripts. Until the end of the 19th century, a person infected with rabies was doomed to inevitable death. It wasn't until 1885 that Louis Pasteur invented the rabies vaccine, which has since saved the lives of millions of people.

Facts about rabies:

• There is still no specific treatment for rabies.
• According to the World Health Organization (WHO), more than 40% of infected people are children and adolescents. And in more than 95% of cases, the source of infection is domestic animals - dogs and cats.
• The incubation period usually lasts from several months to one year. Cases have been described in which the clinical picture of rabies developed two to three weeks after infection, and even several years later.
• Basically, the duration of the incubation period directly depends on the location of the source of virus penetration (site of bite, salivation, etc.). Thus, with a bite to the face and head, signs of the disease develop faster than with damage to the extremities, especially the lower ones.

CAUSES

The causative agent of the disease is the rabies virus, which belongs to the Rhabdovirus family.

Facts about the rabies pathogen:

• The virion is bullet-shaped and contains ribonucleic acid in its genome.
• The rabies virus is heat sensitive. Thus, elimination of the pathogen at a temperature of 56 degrees occurs in one hour, and at 80-100 degrees - in one minute.
• Alkaline solutions, iodine, most antiseptics and ultraviolet radiation are also harmful to this virus.
• The virus is neurotropic, that is affects mainly the nervous system.
• After the virus invades the body of a warm-blooded animal or person, the mechanisms of its active replication are launched in the muscle tissue surrounding the site of penetration. Further, along the axons of nerve cells, the pathogen enters the structures of the central nervous system, and from there again moves to the periphery, which causes damage to almost the entire nervous system in this pathology.
• The speed of movement of the rabies virus through the structures of the nervous system is quite high - approximately 3 mm per hour. That is why the duration of the incubation period for rabies is very dependent on the localization of the site of infection and its distance from the brain and spinal cord.

Ways of infection with the Rabies virus:

• The circulation and preservation of the rabies pathogen in natural conditions occurs in a variety of warm-blooded animals. Moreover, some of them (for example, bats) have rabies may remain asymptomatic for a long time.
• The most susceptible to infection are some members of the canine family (for example, wolves, dogs, foxes), felines - lynxes, cats, as well as raccoons, badgers and other species of animals.
• Humans are infected when infected animal saliva comes into contact with damaged skin or mucous membranes. Most often it is a bite or salivation of scratches, abrasions and other external injuries.
• Infection from humans is extremely rare and is disputed by some scientists.

CLASSIFICATION

Rabies is classified according to several criteria.

By type of infection:

• Urban.
• Natural.

Clinical stages of the disease:

• Initial (depression).
• Excitation.
• Paralysis.

The duration of each stage is usually from one to three to five days.

According to clinical forms:

• Bulbarnaya.
• Meningoencephalitic.
• Cerebellar.
• Paralytic.

SYMPTOMS

The rate of development of the disease depends on the location of the bite and the amount of virus that has penetrated.

Main manifestations of rabies:

• The first symptoms of the disease are unusual sensations in the bite wound(even if it has already healed): tingling, burning, itching, hyperesthesia, etc.
• Body temperature rises, headache appears, nausea often occurs, and repeated vomiting. Muscle and throat pain and a dry cough may appear.
• Feelings of melancholy and fear are expressed. The patient appetite and sleep disturbances, which manifests itself as insomnia or nightmares. Apathy sets in.
• After a few days, apathy is replaced by sudden excitement and anxiety.
• The most characteristic manifestation of the disease at the second stage is hydrophobia (phobia of water). When trying to drink, the patient experiences convulsive spasms of the pharyngeal muscles. Subsequently, such muscle spasm occurs even at the mention of water.
• Convulsions can also occur when the face is exposed to a stream of air, a sudden bright light or a loud sound.
• The patient's gaze is fixed on one point, the pupils are dilated. Painful salivation (sialorrhea) is often detected.
• Characteristic is the occurrence of violent mental and motor excitement, accompanied by attacks of unmotivated aggression, violence and rage. At the same time, the patient rushes about in bed and may hit or bite someone around him for no reason. A clouding of consciousness occurs, accompanied by visual or auditory hallucinations, which are often frightening in nature.
• At the third stage, widespread paralysis of the muscles of the limbs, face, pharyngeal muscles, tongue, etc. Death usually occurs within one to two days as a result of cardiorespiratory arrest.

The duration of the disease is usually 6-8 days. There are also cases of a short course of the disease - from one to three days.

Sometimes an atypical course of the disease occurs, especially in children. In this case, there may be no period of excitation, and muscle paralysis spreads to the entire body gradually, starting from the site of the bite.

DIAGNOSTICS

Diagnostic measures for suspected rabies include several approaches.

Diagnostic criteria:

• The history contains indications of a violation of the integrity of the skin and/or mucous membranes with the ingress of saliva from an animal with suspected rabies.
• Specific clinical manifestations of the disease.
• Positive test results for rabies in the suspected animal (if possible) and in the infected person.

When carrying out general clinical research methods, pathognomonic signs of the disease are not detected. Various specific laboratory tests are used to confirm the diagnosis.

Principles of laboratory diagnosis of rabies:

• To confirm the diagnosis intravitally, skin biopsies (usually from the back of the head and back of the neck), smears of the cornea, smears of saliva and cerebrospinal fluid are examined.
• Laboratory methods are used based on the isolation of the virus itself, determination of its RNA and antigen.
• Several tests are necessary to confirm the diagnosis.
• Post-mortem diagnosis mainly uses histological examination of a brain biopsy. In this case, characteristic Babes-Negri bodies are revealed. Sometimes other immunological tests are required.

Methods for laboratory confirmation of rabies:

• Immunofluorescence reaction (RIF). Used for rapid rabies analysis.
• Enzyme-linked immunosorbent assay (ELISA).
• Diffusion precipitation reaction. It is used less frequently due to lower specificity compared to ELISA and RIF.
• Polymerase chain reaction (PCR). Used to determine pathogen RNA in biological material. A modern and highly sensitive diagnostic method.
• Methods for isolating the virus (bioassay on white mice and cell culture) are now used very rarely.

TREATMENT of rabies

Specific there is no therapy for the disease. Unfortunately, all patients with clinical symptoms of rabies die.

If manifestations of the disease occur, it is only possible to carry out symptomatic treatment: the use of anesthetics, anticonvulsants, etc.

If, within the shortest possible time after the suspected infection, a course of preventive measures is carried out, then the development of the disease in most cases can be avoided.

COMPLICATIONS

As manifestations of the disease develop, death is inevitable due to the lack of effective treatment. Death occurs from paralytic arrest of respiratory and cardiac activity.

PREVENTION

If you come into contact (bite or salivate) with an animal with signs of rabies, you should immediately seek medical help at any nearest health care facility.

In this case, if possible, such an animal should be monitored for ten days. To do this, the suspicious animal is taken to a veterinarian, who reports the results of the observation to the medical institution that vaccinates the affected person.

Areas of preventive measures:

• Non-specific. Local treatment of the wound - immediate washing with soap and water, detergents, disinfectant solutions, etc. The duration of such treatment should be at least 15 minutes.
• Specific. The use of rabies vaccine and specific immunoglobulin as immunization.

Indications for vaccination:

• Contact with obviously sick, suspicious, unknown or wild animals.
• In case of any injury by objects containing particles of saliva or brain matter of such animals.
• Contact with an apparently healthy animal at that time, which during the ten-day control period became ill, died or disappeared.
• In case of salivation or injury to the skin and/or mucous membranes caused by a sick person.

The rabies vaccine is administered immediately on the day of the bite and then five injections are given according to a certain schedule over four weeks. WHO recommends an additional injection of the vaccine three months after the start of specific vaccination.

Rabies immunoglobulin is used according to indications. As a rule, its solution is applied to the bite site.

Another area of ​​specific prevention is vaccination of people at risk: hunters, veterinarians, speleologists, etc.

Pets must undergo rabies vaccination in accordance with the veterinary calendar.

PROGNOSIS FOR RECOVERY

Prognosis for the development of a typical clinical picture of rabies always unfavorable. Death is likely in virtually all cases.

With timely and correct use of preventive measures after suspected infection, it is almost always possible to avoid progression of the disease.

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In modern society there are diseases from which no one is immune. A pleasant rest in the forest can be disturbed by the bites of poisonous snakes, and the sweet smell of your favorite ice cream can provoke a wasp sting.

However, there is a special disease that is unlike any other, provoked by the Neuroiyctes rabid virus. It is important to know the signs of rabies in humans and animals in order to be able to protect yourself and loved ones and prevent the disease from developing. After all, even our beloved Murkas and Balls - without proper care for them - can become sources of insidious illness.

In this article we will look at the symptoms of a viral infection and tell you what measures need to be taken to prevent its development. Let's answer the question why a seemingly minor pet bite is worth the most precious thing for some people - life. We hope that our publications will allow you to feel more confident in any situation.

How is the disease transmitted?

The insidious disease is provoked by a special rabies virus, which is found in the salivary fluid of a sick animal. Let's look at how the virus is transmitted, infection occurs, and sources.

It happens:

• when a person is bitten by animals,
• when salivary fluid gets into open wounds, abrasions, scratches.

However, there have been cases where the disease was diagnosed in workers involved in processing the skins of sick foxes. Particularly dangerous are numerous bites, as well as injuries to the hands and head. The infectious agent has the ability to “leak” into the fibers of the central nervous system, multiply quickly, spread to the periphery, and cause paralysis.

The main breeding grounds for infection in cities and villages are numerous dogs, as well as cats and cattle. In nature, rabies carriers are foxes and wolves, raccoon dogs and jackals, and bats. Bears and hedgehogs, lynxes and moose get sick less often.

You should know: lesions in the head cause illness in 88%, in the wrist – in 68%, in the ankles and feet – 20%.

Concerned people often ask doctors questions: Is it possible to get infected through a scratch? It is possible if it has been salivated by a sick individual. Is rabies transmitted from person to person? This happens extremely rarely. Medical publications indicate the following exceptional cases:

• transmission of the pathogen through household items used by the patient;
• through food, water;
• infection of the fetus during pregnancy;
• when transplanting an organ removed from a sick person.

Main signs of ill health

The main problem is that although the incubation period usually lasts from 1 to 3 months, it can also be as short as 10 days or as long as one year. Symptoms of infection may be absent, and the full clinical picture appears already in the agony stage.

Special signs of rabies in humans, which appear at the very beginning of the disease:

• increased excitability,
• insomnia,
• redness and swelling of the healing scar,
• nagging pain, burning and itching at the site of injury,
• temperature increase,
• problems swallowing food.

Please note that signs of rabies in a person are a signal for immediate hospitalization. Every minute is precious! The development of “sores” in children occurs much more intensively than in adults. Also during this period, a person may be overcome by causeless fear, melancholy, and anxiety. This is the prodromal phase. The first signs are observed within 2-3 days, sometimes the phase drags on to 5-6 days.

Muscle spasms may begin suddenly:

• when trying to quench thirst (hydrophobia),
• with small breezes (aerophobia),
• in bright light (photophobia),
• with loud sounds (acoustic phobia).

During the peak of the attack, uncontrollable violence, aggressive behavior, uncontrollable profuse salivation, and tachycardia are observed. The person literally begins to sweat, the pupils dilate significantly, the face becomes cyanotic, the pulse accelerates. Patients may tear their clothes, bite others, spit, break furniture, and behave inappropriately. A characteristic sign of this phase is foam at the mouth. Hallucinations, delusions, and general anxiety are also possible.

Excitement is replaced by the paralytic phase of the disease. The patient seems more balanced, can drink liquids and eat food without the help of others, and is less bothered by spasms and cramps. However, this is only an appearance of improvement; the disease inevitably leads a person to death. Death occurs from complete paralysis of the respiratory center and cessation of the work of the heart muscle.

Important: immediately if it is unknown whether the animal is sick or not? Be sure to contact a doctor! Despite the fact that there are no medications that can stop the persistence of the virus, a timely vaccination against rabies in a person can easily prevent the development of a fatal disease.

Signs of infection in four-legged friends

To feel protected, you should know the signs of rabies in cats, dogs, and other animals. There are three forms of development of malaise:

• Hidden. The previously cheerful and playful four-legged friend suddenly becomes suspiciously calm and indifferent, very reluctant to respond to the owner’s call, and does not always make contact. He loses his appetite. The eyes are often sad and watery. The animal is huddled in the farthest corner of the apartment, cats often leave the house forever. Sometimes the symptoms manifest themselves differently - the animal becomes overly intrusive, very friendly. The approximate duration of this form is 2-3 days.
• Aggressive. The main characteristics are excitability, activity, aggression, wildness. The pet constantly looks around, as if sensing danger. Symptoms of the disease begin to appear - clouding of the cornea and strabismus, excessive salivation. During this period, the animal may begin to bite, swallow various objects, and run away from home. Vomiting, excessive salivation, and imbalance are often observed.
• Paralytic. Aggressive attacks alternate with imaginary recovery. However, the disease is progressing. First, paralysis affects the hind limbs, moves to the muscles of the trunk, and then to the forelimbs. Death occurs from paralysis of the respiratory organs and heart.

Always remember that illness in animals is incurable. Testing at a veterinary hospital can be done if alarming symptoms are observed.

Important: Please note that an infected baby animal is not necessarily a scary monster with red-veined eyes. A cute dog can also be a victim of a terrible disease.

Why does the disease sometimes progress?

It would seem that it is possible to give injections to a person immediately after an animal attack. Why do people continue to die from the virus? There are three main reasons why people enter treatment in extremely serious condition, when the chances of recovery are zero:

1. It is too late to seek medical help.
2. Violation of the schedule during vaccination.
3. Interrupted treatment period.

Carelessness and basic illiteracy in matters of personal health allow the disease to progress. By perceiving injuries received from an animal as ordinary scratches, a person puts his life at risk. Always remember that timely rabies injections will save the lives of you and your loved ones!

How to prevent the disease

Doctors never tire of repeating that prevention is the best protection against all illnesses. Within three days after the accident, an anti-rabies vaccination is extremely necessary for a person - side effects are rare, accounting for only 3%. Later administered immunoglobulin has no effect.

Important: For six months after vaccination, you should not visit the sauna or bathhouse, overwork, overheat in the hot sun, or drink strong drinks. Failure to comply with the regimen can provoke an imbalance of the immune system, further development of the disease, and lead to death.

When sending your kids on vacation to a camp or to their grandmothers for fresh milk, be sure to teach them what to do with some other insect. Pay special attention to bites from unfamiliar dogs and cats.

To ensure that your beloved pet avoids negative consequences from unexpected contacts with other animals, do not ignore annual vaccination.

We wish you to be reasonably careful on vacation, and do not forget that even the cutest and most affectionate animals can be sick. It is better to admire them from afar, without trying to caress, stroke or pick them up. If contact with an animal does occur, contact a doctor immediately. Remember that signs of rabies in humans do not appear immediately. The rabies vaccine is the only way to stop the virus from progressing. Let your four-legged friends bring only joy!

Rabies(Latin - Lyssa; English - Rabies; hydrophobia, hydrophobia) is a particularly dangerous acute zooanthroponotic disease of warm-blooded animals of all species and humans, characterized by severe damage to the central nervous system, unusual behavior, aggressiveness, paralysis and death.

Historical background, distribution, degree of danger and damage. The disease was described about 5000 thousand years ago. There are messages about it in the code of laws of Babylon, the works of the ancient Greeks, in particular Aristotle. Even the names “Rabies” and “Lyssa” reflect the main clinical sign of the disease and are translated as fury, insane rage. Ancient doctors were able to determine the transmission of the disease through the saliva of “mad” dogs. Back in the 2nd century. n. e. Doctors used surgical removal of tissue at the site of the bite and cauterization of wounds with a hot iron as a preventive measure against rabies.
The period of L. Pasteur's discoveries is the next stage in the history of the study of rabies (1881-1903). Pasteur discovered the viral etiology of rabies. In 1890, Pasteur's students E. Roux and E. Nocard established that the saliva of sick animals becomes infectious 3-8 days before the clinical manifestation of the disease. L. Pasteur proved the possibility of reproducing the disease by intracerebral injection of material, and during such passages through the brain of rabbits the biological properties of the virus can be changed. In 1885, the first vaccinations were made to people, which became the crown of all L. Pasteur’s efforts to save humanity from rabies. The introduction of Pasteur vaccinations into practice led to a decrease in mortality from rabies by 10 times or more.

Currently, rabies is registered in most countries of the world. According to WHO, despite the fact that every year more than 5 million people and tens of millions of animals are vaccinated against rabies in the world, about 50 thousand cases of death from this disease are recorded annually, and the total number of sick productive animals is hundreds of thousands.

Despite the successes achieved, the problem of rabies is far from being solved; it has become very urgent due to the progressive spread of the disease among wild animals - the so-called natural rabies. Epizootics among wild animals have led to an increase in the incidence of disease in farm animals, primarily cattle.

The causative agent of the disease. Rabies is caused by a bullet-shaped RNA virus of the family Rhabdoviridae, genus Lyssavirus.

Rice. 1 - rabies virus model:
a - decreasing turns of the nucleocapsid; b - relative position of the spines and the underlying micellar protein (top view); c - spikes; g - micellar protein; d - inner membrane-like layer; e - a section of the virion showing the ratio of lipids to the micellar layer; the spine threads can extend deeper into the shell. The spineless part of the shell can form voids inside the nucleoprotein helix.

Previously, all strains of the rabies virus were considered antigenically the same. It has now been established that the rabies virus has four serotypes: the 1st serotype virus has been isolated in different parts of the world; virus serotype 2 was isolated from the bone marrow of a bat in Nigeria; serotype 3 virus was isolated from shrews and humans; serotype 4 virus has been isolated from horses, mosquitoes and mosquitoes in Nigeria and has not yet been classified. All variants of the virus are immunologically related.

The central nervous system is the selective site of the rabies pathogen. The highest titer of the virus was found in the brain (horns of ammon, cerebellum and medulla oblongata). After damage to the central nervous system, the pathogen penetrates all internal organs and blood, except the omentum, spleen and gall bladder. The virus is constantly found in the salivary glands and eye tissues. Cultivated by intracerebral passages in rabbits and white mice and in a number of cell cultures.

In terms of resistance to chemical disinfectants, the rabies pathogen is classified as resistant (second group). Low temperatures preserve the virus, and throughout the winter it persists in the brains of animal corpses buried in the ground. The virus is thermolabile: at 60°C it is inactivated after 10 minutes, and at 100°C it is inactivated instantly. Ultraviolet rays kill it in 5-10 minutes. It remains in rotting material for 2-3 weeks. Autolytic processes and putrefaction cause the death of the pathogen in the brain of corpses, depending on the temperature, after 5-90 days.
The following disinfectants are most effective: 2% solutions of chloramine, alkalis or formaldehyde, 1% iodine, 4% hydrogen peroxide solution, Virkon S 1:200, etc. They quickly inactivate the virus.

Epizootology. Basic epidemiological data of rabies:

Susceptible animal species: warm-blooded animals of all kinds. The most sensitive are fox, coyote, jackal, wolf, marsupial cotton rat, and vole. Highly sensitive animals include hamster, gopher, skunk, raccoon, domestic cat, bat, lynx, mongoose, guinea pig and other rodents, as well as rabbit.
The sensitivity to the rabies virus in humans, dogs, sheep, horses, and cattle is considered moderate, and in birds - weak.
Young animals are more susceptible to the virus than older animals.

Sources and reservoirs of the infectious agent. The reservoir and main sources of the rabies pathogen are wild predators, dogs and cats, and in some countries of the world, bats. In urban epizootics, the main spreaders of the disease are stray and street dogs, and in natural epizootics, wild predators (fox, raccoon dog, arctic fox, wolf, corsac fox, jackal).

Method of infection and mechanism of transmission of the pathogen. Infection of humans and animals occurs through direct contact with sources of the rabies pathogen as a result of a bite or salivation of damaged skin or mucous membranes.

Rice. 2. Spread of the virus in animals and humans

It is possible to become infected with rabies through the mucous membranes of the eyes and nose, nutritionally and aerogenously, as well as transmissibly.
The aerogenic mechanism of infection transmission to foxes and other wild carnivores in caves where millions of bats were observed was observed under experimental conditions. Carnivores were infected with a bat virus using an aerosol generator. Aerosol-infected wild animals kept in separate rooms and isolated cages infected foxes and other animals: over the course of more than 6 months, 37 foxes and other carnivores died from rabies. These experiments confirmed the respiratory transmission of rabies infection among wild carnivores. It was possible to isolate the rabies virus from the air of the observed caves by intercerebral infection of mice (Winkler, 1968). Constantine (1967) also noted that two orderlies developed hydrophobia as a result of supposed aerogenic contamination in a cave center of bats. Winkler et al. (1972) in a laboratory colony of coyotes, foxes, and raccoons identified an outbreak of rabies, probably as a result of aerogenic transmission of a virus adapted to bats. It should be noted that the aerogenic mechanism of infection transmission is reproduced mainly with the rabies virus maintained by bats.
In mice, hamsters, bats, rabbits, and skunks, rabies was reproduced under experimental conditions when infected through the intranasal route.

The intensity of manifestation of the epizootic process. At a high population density of foxes, corsacs, raccoon dogs, wolves, jackals, and arctic foxes, the disease spreads quickly; at an average population density, rabies manifests itself in isolated cases. When the population density of wild carnivores is low, the epizootic dies out.

Seasonality of disease manifestation, frequency. The maximum increase in incidence is in the fall and winter-spring period. A three- to four-year cycle of rabies has been established, which is associated with the population dynamics of the main reservoirs.

Factors contributing to the occurrence and spread of rabies. The presence of stray dogs and cats, as well as
sick wild animals.

Morbidity, mortality. The morbidity rate among unvaccinated animals bitten by rabid dogs is 30-35%, mortality is 100%.

According to the epizootological classification, the causative agent of rabies is included in the group of natural focal infections.

There are currently three types of rabies infection in Russia:

1. Arctic (reservoir - arctic foxes);
2. natural focal forest-steppe (reservoir - foxes);
3. anthropourgic (reservoir - cats, dogs).

Taking into account the nature of the pathogen reservoir, rabies epizootics are distinguished between urban and natural types. In urban epizootics, the main sources of the pathogen and spreaders of the disease are stray and stray dogs. The scale of the epizootic depends on their numbers. In natural epizootics, the disease is spread mainly by wild predators. The localization of natural foci of the disease corresponds to the distribution patterns of foxes, corsac foxes, raccoon dogs, wolves, jackals, and arctic foxes. They are very sensitive to the virus, aggressive, often prone to long-distance migrations, and when sick, they intensively secrete the virus in their saliva. These circumstances, along with the significant population density of some predators (fox, raccoon dog), the rapid change of their generations and the length of the incubation period for rabies, ensure the continuity of the epizootic process, despite the relatively rapid death of each individual diseased animal.

Pathogenesis. The possibility of developing a rabies infection, the causative agent of which is usually transmitted by a bite, depends on the amount of virus that has entered the body, its virulence and other biological properties, as well as the location and nature of the damage caused by the rabid animal. The richer the tissue in the area of ​​the infection gate is with nerve endings, the greater the possibility of developing the disease. The degree of natural resistance of the body, depending on the type and age of the animal, is also important. Basically, the virus enters the animal’s body through damaged skin or mucous membrane.

The appearance of the virus in the blood is often observed before clinical signs of the disease appear and coincides with an increase in body temperature.

The pathogenesis of the disease can be divided into three main phases:

• I - extraneural, without visible replication of the virus at the site of inoculation (up to 2 weeks),
• II - intraneural, centripetal spread of infection,
• III - dissemination of the virus throughout the body, accompanied by the appearance of symptoms of the disease and, as a rule, the death of the animal.

Reproduction of the virus in the gray matter of the brain causes the development of diffuse non-purulent encephalitis. From the brain, along centrifugal nerve pathways, the virus enters the salivary glands, where it multiplies in the cells of the nerve ganglia and, after their degeneration, enters the ducts of the glands, infecting saliva. Isolation of the virus in saliva begins 10 days before the onset of clinical signs. During the incubation period, the virus is also transported from the brain via a neurogenic route to the lacrimal glands, retina and cornea, and to the adrenal glands, where it apparently also reproduces. The impact of the pathogen initially causes irritation of the cells of the most important parts of the central nervous system, which leads to an increase in reflex excitability and aggressiveness of the sick animal, causing muscle cramps. Then degeneration of nerve cells occurs. Death occurs due to paralysis of the respiratory muscles.

Course and clinical manifestation of rabies symptoms. The incubation period varies from several days to 1 year and averages 3-6 weeks. Its duration depends on the type, age, resistance of the animal, the amount of virus that has penetrated and its virulence, the location and nature of the wound. The closer the wound is to the brain, the faster the symptoms of rabies appear.

The disease is often acute. The clinical picture is similar in all animal species, but has been better studied in dogs. Rabies usually manifests itself in two forms: violent and silent.

At violent rage There are three periods: prodromal, excitement and paralysis.
Prodromal period (precursor stage) lasts from 12 hours to 3 days. This period begins with a slight change in behavior. Sick animals become apathetic, boring, avoid people, try to hide in a dark place, and are reluctant to respond to the owner’s call. In other cases, the dog becomes affectionate towards its owner and acquaintances, and tries to lick its hands and face. Then anxiety and excitability gradually increase. The animal often lies down and jumps up, barks for no reason, there is increased reflex excitability (to light, noise, rustling, touch, etc.), shortness of breath appears, and the pupils are dilated. Sometimes severe itching occurs at the site of the bite; the animal licks, scratches, and gnaws the area. As the disease progresses, a perverted appetite often appears. The dog eats inedible objects (stones, glass, wood, earth, its own feces, etc.). During this period, paresis of the pharyngeal muscles develops. Difficulty swallowing is noted (it seems that the dog has choked on something), drooling, hoarse and abrupt barking, an unsteady gait, and sometimes squint.

The second period - excitement - lasts 3-4 days and is characterized by an intensification of the symptoms described above. Aggression increases, the dog can bite another animal or person, even its owner, without a reason; it gnaws iron, sticks, the ground, often breaking its teeth and sometimes its lower jaw. Sick dogs have an increased desire to break free and run away; within a day, a rabid dog runs tens of kilometers, biting and infecting other dogs and people along the way. It is typical that the dog silently runs up to animals and people and bites them. Bouts of violence, lasting several hours, are followed by periods of oppression. Paralysis of individual muscle groups gradually develops. The change in the dog's voice is especially noticeable due to paralysis of the laryngeal muscles. The bark sounds hoarse, reminiscent of a howl. This sign has diagnostic value. The lower jaw is completely paralyzed and droops. The oral cavity is open all the time, the tongue falls out halfway, and there is profuse salivation. At the same time, paralysis of the swallowing muscles and tongue muscles occurs, as a result of which the animals cannot eat food. Strabismus appears.

The third period - paralytic - lasts 1-4 days. In addition to paralysis of the lower jaw, the hind limbs, the muscles of the tail, bladder and rectum are paralyzed, then the muscles of the trunk and forelimbs. The body temperature in the excited stage rises to 40-41°C, and in the paralytic stage it decreases below normal. Polymorphonuclear leukocytosis is noted in the blood, the number of leukocytes is reduced, and the sugar content in the urine is increased to 3%. The total duration of the disease is 8-10 days, but often death can occur after 3-4 days.

At silent (paralytic) form of rabies(more often observed when dogs are infected from foxes) excitement is weakly expressed or not expressed at all. In the complete absence of aggressiveness, the animal experiences severe drooling and difficulty swallowing. In ignorant people, these phenomena often cause an attempt to remove a non-existent bone, and in doing so they can become infected with rabies. Then the dogs experience paralysis of the lower jaw, muscles of the limbs and torso. The illness lasts 2-4 days.

Atypical form of rabies does not have an arousal stage. Muscle wasting and atrophy are noted. Cases of rabies have been recorded that occurred only with symptoms of hemorrhagic gastroenteritis: vomiting, semi-liquid feces containing bloody mucous masses. Even less common are the abortive course of the disease, which ends with recovery, and recurrent rabies (after apparent recovery, clinical signs of the disease develop again).

For rabies in cats clinical signs are basically the same as in dogs, the disease proceeds mainly in a violent form. Often an infected animal tries to hide in a quiet, dark place. Sick cats are highly aggressive towards people and dogs. They cause deep damage by digging in with their claws, trying to bite into the face. Their voice changes. In the stage of excitement, cats, like dogs, tend to run away from home. Paralysis of the pharynx and limbs subsequently develops. Death occurs 2-5 days after the onset of clinical signs. In paralytic rabies, aggressiveness is weakly expressed.

Foxes when sick, they are alarmed by unusual behavior: they lose their sense of fear, attack dogs, farm animals, and people. Sick animals quickly lose weight, and itching often occurs in the area of ​​infection.

For rabies in cattle the incubation period is more than 2 months, most often from 15 to 24 days. In some cases, 1-3 years may pass from the moment of the bite until the first signs of the disease appear. Rabies occurs mainly in two forms: violent and silent. In the violent form, the disease begins with excitement. The animal often lies down, jumps up, beats its tail, stomps, throws itself at the wall, and strikes with its horns. Aggression is especially pronounced towards dogs and cats. Salivation, sweating, frequent urge to urinate and defecate, and sexual arousal are noted. After 2-3 days, paralysis of the muscles of the pharynx (impossibility of swallowing), lower jaw (salivation), hind and fore limbs develops. Death occurs on the 3-6th day of illness.
In the quiet form, signs of excitement are weak or absent. Depression and refusal of food are observed. Cows stop producing milk and chewing cud. Then paralysis of the larynx, pharynx, lower jaw appears (hoarse mooing, drooling, inability to swallow), and then the hind and fore limbs. Death occurs on the 2-4th day.

U sheep and goats the symptoms are the same as in cattle: aggressiveness, especially towards dogs, increased sexual excitability. Paralysis develops quickly, and on the 3-5th day the animals die. In the paralytic form of rabies, agitation and aggressiveness are not noted.

Rabies in horses At first it manifests itself as anxiety, fearfulness, and excitability. Itching is often possible at the site of the bite. Aggressiveness is shown towards animals, and sometimes towards people. During periods of excitement, horses throw themselves at the wall, break their heads, gnaw feeders, doors, and sometimes, on the contrary, fall into a state of depression, resting their heads against the wall. There are muscle spasms of the lips, cheeks, neck, and chest. With further development of the disease, paralysis of the swallowing muscles and then the limbs develops. The animal dies on the 3-4th day of illness. But sometimes death occurs within 1 day. In the paralytic form of rabies, the excitation stage is eliminated.

Rabies in pigs often occurs acutely and violently. Pigs rush around in the pen, refuse food, gnaw at feeders, partitions, and the bite site. There is severe salivation. Aggression towards other animals and people appears. Sows attack their own piglets. Paralysis soon develops, and the animals die 1-2 days after their appearance. The duration of the illness is no more than 6 days.
In the paralytic form of rabies (rarely recorded), depression, refusal of food and water, slight drooling, constipation, and rapidly progressing paralysis are noted. Animals die 5-6 days after signs of the disease appear.

Pathological signs. Pathological changes are generally nonspecific. When examining the corpses, exhaustion, bite marks and scratches, damage to the lips, tongue, and teeth are noted. Visible mucous membranes are cyanotic. At autopsy, they establish cyanosis and dryness of the serous covers and mucous membranes, congestive plethora of internal organs; the blood is dark, thick, tarry, poorly coagulated; dark red muscles. The stomach is often empty or contains various inedible objects: pieces of wood, stones, rags, bedding, etc. The mucous membrane of the stomach is usually hyperemic, swollen, with minor hemorrhages. The dura mater is tense. Blood vessels are injected. The brain and its soft membrane are edematous, often with pinpoint hemorrhages, localized mainly in the cerebellum and medulla oblongata. The cerebral convolutions are smoothed, the brain tissue is flabby.
Histological changes are characterized by the development of disseminated non-purulent polyencephalomyelitis of the lymphocytic type.

An important diagnostic value for rabies is the formation in the cytoplasm of ganglion cells of specific Babes-Negri inclusion bodies of round or oval shape, containing basophilic granular formations of viral nucleocapsids of various structures.

Diagnosis and differential diagnosis of rabies. The diagnosis of rabies is made on the basis of a complex of epizootic, clinical, pathological and anatomical data and laboratory test results (final diagnosis).
To test for rabies, a fresh corpse or head is sent to the laboratory; for large animals, the head is sent. Material for laboratory research must be taken and sent in accordance with the Instructions on measures to combat animal rabies.

The general scheme for diagnosing the disease is presented in Figure 3:

In recent years, new methods for diagnosing rabies have been developed: radioimmunoassay, enzyme-linked immunosorbent assay (ELISA), enzyme-linked immunosorbent assay (ELISA), virus identification using monoclonal antibodies, PCR.

In differential diagnosis, it is necessary to exclude Aujeszky's disease, listeriosis, and botulism. In dogs - a nervous form of plague, in horses - infectious encephalomyelitis, in cattle - malignant catarrhal fever. Suspicion of rabies can also arise from poisoning, colic, severe forms of ketosis and other non-communicable diseases, as well as the presence of foreign bodies in the oral cavity or pharynx, or blockage of the esophagus.

Immunity, specific prevention. Animals vaccinated against rabies produce virus-neutralizing, complement-binding, precipitating, antihemagglutinating and lytic (destroying cells infected with the virus in the presence of complement) antibodies. The mechanism of post-vaccination immunity has not been fully deciphered. It is believed that vaccination causes biochemical changes that reduce the sensitivity of nerve cells to the virus. The essence of artificial immunization for rabies comes down to the active production of antibodies that neutralize the virus at the point of entry into the body before penetration into the nerve elements or, during forced immunization, neutralize the virus on its way to the central nervous system. T-lymphocytes responsible for the production of interferon are also activated. Therefore, for this disease, post-infectious vaccination is possible: the vaccine strain, penetrating nerve cells earlier than the field strain, causes them to produce interferon, which inactivates the wild rabies virus, and antibodies that block specific cell receptors.

In veterinary practice, both live tissue and culture vaccines and inactivated rabies vaccines (rabies vaccines) are currently used - up to 84 varieties of rabies vaccines in 41 countries of the world.

Rabies vaccines are classified into three groups: brain vaccines, which are made from the brain tissue of animals infected with a fixed rabies virus; embryonic, in which the virus-containing component is tissue from chicken and duck embryos; cultural rabies vaccines made from the rabies virus reproduced in primary trypsinized or transplanted BHK-21/13 cells.

In the Russian Federation, an inactivated rabies vaccine has been developed from the Shchelkovo-51 strain, reproduced in VNK-21 cell culture, which has high immunizing activity.
For preventive and forced vaccinations of large and small ruminants, horses, pigs liquid cultured (“Rabikov”) anti-rabies vaccine is used.
For preventive vaccinations for dogs and cats dry cultured rabies inactivated vaccine from the Shchelkovo-51 strain (“Rabican”) is used. A universal vaccine has been developed - for cattle, horses, sheep, pigs, dogs, cats.
Imported vaccines are widely represented on the Russian market. Veterinarians use anti-rabies vaccines Nobivak Rabies, Nobivak RL, Defensor-3, Rabizin, Rabigen Mono and others.
For oral vaccination of wild and stray animals, vaccination methods have been developed based on the animals eating various baits with the vaccine “Lisvulpen”, “Sinrab”, etc. Currently, work is underway on the creation of genetically engineered (recombinant) vaccines.

Prevention. In order to prevent rabies, they carry out registration of dogs owned by the population, control over compliance with the rules for keeping domestic animals, catching stray dogs and cats, annual preventive vaccination of dogs, and, if necessary, cats. Unvaccinated dogs are prohibited from being used for hunting or to guard farms and herds.
Forestry and hunting officials are required to report suspected rabies in wild animals, deliver their carcasses for examination, and carry out measures to reduce the number of wild predators in areas unaffected and threatened by rabies. Prevention of rabies in farm animals is carried out by protecting them from attacks by predators, as well as preventive vaccination in infected areas.
The sale, purchase, and transportation of dogs to other cities or regions is permitted only if there is a veterinary certificate indicating that the dog has been vaccinated against rabies no more than 12 months and no less than 30 days before export.

Treatment of rabies. There are no effective treatments. Sick animals are immediately isolated and killed, since their overexposure is associated with the risk of infecting people.

Control measures. When organizing measures to combat rabies, one should distinguish between an epizootic focus, an unfavorable point and a threatened zone.
Epizootic foci of rabies are apartments, residential buildings, private farmsteads of citizens, livestock buildings, livestock farms, summer camps, areas of pastures, forests and other objects where animals with rabies are found.
A locality unaffected by rabies is a populated area or part of a large populated area, a separate livestock farm, farming enterprise, pasture, forest area, on the territory of which an epizootic focus of rabies has been identified.
The threatened zone includes populated areas, livestock farms, pastures and other areas where there is a threat of rabies introduction or activation of natural foci of the disease.

Activities to eliminate rabies are presented in Figure 4:

Measures to protect people from rabies infection. Persons who are constantly at risk of infection (laboratory personnel working with the rabies virus, dog breeders, etc.) should be immunized prophylactically.

All people bitten, scratched, slobbered by any animal, even apparently healthy ones, are considered suspected of being infected with rabies.

After exposure, the development of infection can be prevented by prompt wound care and appropriate prophylactic treatment of the victim. The injured person should wait a while for a small amount of blood to flow out of the wound. Then it is recommended to wash the wound abundantly with soap and water, treat it with alcohol, tincture or an aqueous solution of iodine and apply a bandage. Wash the wound carefully to avoid further tissue damage. Local treatment of wounds is most beneficial if done immediately after an animal attack (within 1 hour if possible). The victim is sent to a medical center and given a course of therapeutic and prophylactic immunization with anti-rabies gamma globulin and anti-rabies vaccine. Persons with rabies are hospitalized.