Recently, the news that a 3-year-old boy in Henan was bitten by a dog and died is embarrassing. On May 14, a media reporter contacted the boy's mother, Ms. Fan. She said that on April 21, Xiaoxing (pseudonym) was seriously injured by a husky attack that suddenly ran out of the road while playing on the side of the road near Zhaogang Village, Xinye County. A village cadre in Zhaogang Village confirmed that Xiaoxing was bitten to death by a vicious dog.
Ms. Fan said that Xiaoxing was bitten in multiple places on his face, neck, legs, etc. "A piece of flesh was bitten off on the leg, neck, and around the eyes, and there were several large tooth marks behind the ears and on the neck, and there were multiple broken skin spots on the body." On the same day, they were urgently vaccinated against rabies, and because there was no rabies immune globulin in the local area, and Xiaoxing's injuries were serious, the local hospital recommended that they go to the Nanyang Center for Disease Control and Prevention for wound treatment.
There was obvious blood stains on Xiaoxing's facial wound
Ms. Fan said that when they arrived in Nanyang City, it was already eight or nine o'clock in the evening, and they ran to two or three places, either without rabies immune globulin, or they had closed the door, and finally they found a place called Ruihe Hospital's 24-hour canine injury treatment and vaccination clinic, where they cleaned the wound and injected rabies immune globulin, and it was already early in the morning after treatment, and then rushed to Nanyang Central Hospital for hospitalization, and the doctor injected Xiaoxing with tetanus vaccine and debrided the wound.
Xiaoxing was hospitalized in Nanyang Central Hospital for 9 days and was discharged on May 1. Ms. Fan said that Xiaoxing was still in good condition for a few days after being discharged from the hospital and wanted to go to kindergarten, but the situation became worse day by day since May 7. "On the morning of the 7th, the child kept crying, his body temperature was more than 37 degrees, and he went to the hospital for a blood test and found no abnormality. On May 8, although the child did not have a fever, he kept trying to sleep, his eyes could not be opened, and he was in a semi-coma. Ms. Fan said that on May 8, Xiaoxing began to vomit frequently and became emotionally manic, and she felt that the condition was very serious and asked to be transferred to Nanyang Central Hospital. The doctor said that there may be a certain risk on the road, and the child may be in danger of life at any time, but I still want to transfer the child to the hospital, at 8 o'clock in the evening on the 8th, we were admitted to the ICU of Nanyang Central Hospital and Nanyang Maternal and Child Health Hospital, the child was still conscious, and would call his parents, but he could not swallow anymore. ”
The wound on Xiaoxing's neck
Ms. Fan said that in the early morning of the 9th, Xiaoxing could no longer breathe on her own, but they still wanted to fight for it, hoping to rescue the child.
At about 3 o'clock in the morning on the 9th, the ambulance carrying Xiaoxing drove to Zhengzhou City, but unfortunately, before the ambulance arrived at the Henan Provincial People's Hospital, Xiaoxing lost his heartbeat. At this time, Xiaoxing had not yet had time to get the fifth dose of rabies vaccine.
Ms. Fan said that on April 21, the day Xiaoxing was bitten, they went to the local police station to report to the police, but so far they have not found the owner of the dog. Ms. Fan said that she is particularly helpless now and only hopes to find the dog owner as soon as possible and seek justice for the child.
According to the diagnosis certificate provided by Ms. Fan, the diagnosis made by Nanyang Central Hospital and Nanyang Maternal and Child Health Hospital for Xiaoxing was: 1. severe encephalitis, 2. rabies, and 3. acute respiratory failure. However, the second item of rabies is marked with a question mark. On May 14, the reporter called the phone number of Nanyang Central Hospital, and the staff said that the condition was personal privacy and it was inconvenient to disclose.
Proof of diagnosis of Xiaoxing's hospitalization (provided by the interviewee)
Subsequently, the reporter contacted a village cadre in Zhaogang Village, who confirmed that Xiaoxing was bitten to death by a vicious dog, and they also went to the hospital to express condolences during Xiaoxing's hospitalization. After Xiaoxing was bitten, they immediately sent a photo of the vicious dog to the grid group, calling on everyone to pay attention to safety and hunt and kill, and the vicious dog was killed by the villagers of the surrounding villages when it hurt people again. The village cadre said that the injured dog did not know where it came from, and the owner of the dog had not yet been found, and it was likely to be a stray dog, and they had reported the situation to the township, and planned to apply for subsidies to the victims' families through the civil affairs department, but the other party did not agree.
So far, the exact whereabouts of the vicious dog that hurt people have not been identified, and the owner of the dog has not been found.
What is Rabies?
Rabies is an infectious disease of the acute central system caused by rabies virus, and it is an infectious disease with a high mortality rate of both humans and animals (animals).
What are the symptoms of rabies?
After being infected with the rabies virus, symptoms will appear after an incubation period, which is generally 20-60 days or longer, and it is rare to see symptoms after more than 1 year.
In the early stage of the disease, symptoms such as fever, fatigue, headache, general malaise, irritability, fear, irritability, etc., and most patients will have symptoms such as numbness, itching, burning, stinging and other symptoms around the wound that has healed, or paresthesia such as insect crawling and ant walking, which generally lasts for 2-4 days. The typical symptoms are very sensitive to stimuli such as water, light, wind, and sound, causing episodic pharyngeal muscle spasms and dyspnea. Manifestations such as profuse sweating, salivation, high fever, increased heart rate, and increased blood pressure may also occur. There are also a small number of patients who do not have typical manifestations such as fear of water, light, wind and sound, salivation, spasms, etc., mainly with limb weakness, paralysis as common symptoms, muscle paralysis, laryngeal muscles, vocal cord paralysis and loss of voice.
How does the rabies virus infect people?
The rabies virus mainly comes into direct contact with saliva or tissues containing the rabies virus through bites, scratches, licking of mucous membranes or broken skin of host animals, or open wounds or mucous membranes. However, consumption of thoroughly cooked animal meat and pasteurised milk and milk products does not transmit rabies virus.
So what do we do if we are injured by an animal?
Management after rabies exposure mainly includes wound irrigation, debridement management, active and passive rabies injections, and tetanus active and passive injections.
Rinse immediately
Rinse all bites and scratches thoroughly with soapy water (or other weak alkaline detergents or professional rinsing liquids) and running water under a certain pressure for about 15 minutes, then wash the wound with normal saline, and finally use sterile absorbent cotton wool to absorb the residual fluid at the wound site to avoid residual soapy water or detergent on the wound. When the deep wound is irrigated, the inside of the wound can be perfused and irrigated with a syringe or special irrigation equipment to achieve a comprehensive and thorough treatment.
Wound management
After the wound is irrigated, the wound should be rubbed with diluted iodophor or other skin and mucosal disinfectants with virus-inactivating effects (such as quaternary ammonium disinfectants). If the wound has a large amount of fragmented tissue, debridement should be performed first.
Wounds were treated differently based on factors such as the type of exposed animal, the size and location of the wound, and the time interval after exposure.
When the wound is minor, cover the wound with a breathable dressing.
When the wound is large or the facial injury is severe and affects the face or function, the wound should be closed in the first stage as much as possible. Debridement and infiltration of passive immunologic agents should be completed before wound closure. Wound drainage is done as needed.
Vaccinations
According to the wound exposure and contamination status, combined with the immune history of the exposed subject, active and passive immunization against rabies and tetanus is performed.
According to the "Rabies Exposure Prevention and Treatment Work Specification (2023 Edition)", exposure is divided into three levels
Class I exposure
Touching or feeding animals, or licking intact skin.
Level II exposure
Bare skin is bitten lightly, or minor scratches or abrasions without significant bleeding
Level III exposure
Single or multiple penetrating skin bites or scratches, or licking of broken skin, or open wounds, mucous membranes contaminated with saliva or tissue, or direct contact with bats.
Source: CCTV Network, Farmers Channel, Urban Scene