Recently, a 3-year-old boy in Nanyang, Henan Province was bitten by a dog, and although he was urgently vaccinated against rabies, he unfortunately passed away 18 days later, causing widespread concern.
△ Diagnosis certificate
The Nanyang Municipal Center for Disease Control and Prevention, the Nanyang Xinye County Center for Disease Control and Prevention, and the Nanyang Wolong District Center for Disease Control and Prevention have all completed a preliminary investigation into the matter, and no abnormalities have been found in the management of rabies vaccines and passive immunization agents (rabies immunoglobulin, anti-rabies serum or monoclonal antibodies), rabies exposure treatment and medical treatment, and neither immunoglobulin nor vaccines can ensure 100% blocking of viral infection.
After rabies vaccination and immunoglobulin
Why is it still sick?
First, the boy was bitten on the head, face, and neck, and the amount of rabies virus entering the body was relatively large.
Second, rabies virus is a neurotropic virus, and the head and face wounds are relatively close to the central nervous system, and the virus is irreversible once it enters the nerves.
Third, the patient is young, has a small body weight, has a relatively small amount of immunoglobulin, and has many bite sites, which makes it difficult to neutralize all the invasive rabies viruses.
Fourth, the vaccine does not produce immune antibodies immediately after one injection, and it usually takes 7-10 days. The patient's bite site is the head and face, which is close to the central nervous system, and the injected vaccine may not have a good blocking effect, and the virus has already entered the brain, resulting in immune failure.
Common myths about rabies
Have you been tricked?
Myth 1: Only cats and dogs can transmit rabies
The hosts of rabies virus in nature mainly include dogs, cats, foxes, jackals, bats and other animals, and dogs and cats are the main ones in the mainland.
Myth 2: Being scratched by a cat or dog will not cause rabies
The "Rabies Exposure Prevention and Treatment Work Specification (2023 Edition)" clearly points out that the following conditions are rabies exposure, and should be properly prevented and treated as soon as possible: being bitten or scratched by rabies, suspected rabies or rabies host animals that cannot be identified as healthy, licking mucous membranes and broken skin, or open wounds and mucous membranes coming into contact with animal saliva or tissues that may be infected with rabies virus.
Myth 3: The rabies vaccine can be given a few days later
After being scratched or bitten by an animal at high risk of rabies, rabies prevention is to "race against death". The incubation period of rabies is usually 1-3 months, and it is rare to have less than 1 week or more than 1 year. While a few days later may be effective, the rabies fatality rate is almost 100% and this risk should not be taken at all.
Myth 4: After being bitten, you should bandage before going to the hospital
Once bitten, bandaging the wound should be avoided if there is no significant heavy bleeding. The first step is to rinse the wound with 20% soapy water (or other mildly alkaline detergent) and a amount of pressure running water for at least 15 minutes. After thoroughly rinsing the dirt and blood, apply iodophor or alcohol to the skin around the wound. Immediately after rinsing, go to the hospital for professional treatment by a doctor.
After being scratched or bitten
How can rabies be prevented?
First of all, it is necessary to assess the risk of the animal carrying rabies virus: if you are accidentally injured by a rabies, suspected rabies, or a host animal that is not sure whether it has rabies, remember to go to a qualified dog injury clinic for treatment!
According to the exposure mode and exposure degree, the exposure risk classification and corresponding treatment are carried out, which are divided into three levels:
- Class I exposure
Touching or feeding animals, or licking intact skin, wash only exposed areas.
- Level II exposure
Minor scratches or abrasions on exposed skin should be treated and vaccinated against rabies if the wound is lightly bitten or there is no obvious bleeding.
- Level III exposure
Single or multiple penetrating skin bites, scratches, licking of broken skin, open wounds, mucous membranes contaminated with saliva or tissue, or direct contact with bats should be treated and given passive rabies immunization agents and rabies vaccines.
Note: Alcohol, strong tea or coffee should be avoided during vaccination; Avoid irritating, spicy foods; Avoid strenuous exercise or heavy physical exertion; Avoid cortisol hormones, antimalarials, and immunosuppressants.
Here's an appeal
Strengthen dog management
Popularize first aid knowledge
Prevent such tragedies from happening again
Source: National Emergency Broadcasting
Process edit: u060