Hydrophobia, hydrophobia, is an infectious disease caused by the Rabies virus and occurs after being bitten or salivated by an infected animal, which is characterized by severe damage nervous system and usually ending with fatal... Rabies is manifested by motor excitement, cramps of the respiratory and swallowing muscles and the development of paralysis in the final stage of the disease.

Rabies virus

The rabies virus (Neuroryctes rabid) belongs to the group of mixoviruses of the genus Lyssavirus of the family Rhabdoviridae. It is found in saliva, as well as in tears and urine. The virus is unstable during external environment- dies when heated to 56. C in 15 minutes, when boiled in 2 minutes. Sensitive to ultraviolet and direct sunlight, ethanol and many disinfectants. However resistant to low temperatures, to phenol, antibiotics.

After entering the body, the rabies virus spreads along the nerve endings, affecting almost the entire nervous system. Edema, hemorrhages, degenerative and necrotic changes in the nerve cells of the brain and spinal cord are observed. The source of the rabies virus is both wild and domestic animals. Wild animals include wolves, foxes, jackals, raccoons, badgers, skunks, the bats, rodents, and pets - dogs, cats, horses, pigs, small and large cattle... However, the greatest danger to humans is represented by foxes and stray dogs outside the city in the spring and summer.

Animals are considered infectious 3-10 days before the onset of signs of the disease and then throughout the entire period of the disease. Often animals with rabies can be distinguished by profuse salivation and lacrimation, as well as by observing signs of hydrophobia. Human infection occurs when bitten by a "rabid" animal. And also if the saliva of a sick animal gets on the damaged skin or mucous membrane.

V last years airborne, alimentary (through food and water) and transplacental (through the placenta during pregnancy) routes of virus transmission are described. Several cases of human infection with rabies as a result of organ transplant operations are a source of much debate.

Signs of rabies

The incubation period (the period from the bite to the onset of the disease) averages 30-50 days, although it can last 10-90 days, in rare cases - more than 1 year. Moreover, the farther the bite is from the head, the longer the incubation period. Bites to the head and hands and child bites are especially dangerous. The incubation period lasts the longest with a bite in the legs.

There are 3 stages of the disease:

• I - initial;
• II - excitement;
• III - paralytic.

The first stage of rabies is characterized by the following symptoms:

• general malaise;
• headache;
• a slight increase in body temperature;
• muscle pain;
• dry mouth;
• decreased appetite;
• sore throat;
• there may be nausea and vomiting.

Unpleasant sensations appear at the site of the bite - burning, redness, pulling pains, itching, increased sensitivity.

Rabies symptoms

The following symptoms of rabies are distinguished: the patient is depressed, withdrawn, refuses to eat, he has inexplicable fear, melancholy, anxiety, depression, less often - increased irritability. The symptoms of rabies are also characterized by insomnia, nightmares, olfactory and visual hallucinations. After 1-3 days, a patient with rabies begins the second stage - excitement.

There is anxiety, anxiety, and, most characteristic of this stage, attacks of hydrophobia. When trying to drink, and soon even at the sight and sound of pouring water, there is a feeling of horror and spasms of the muscles of the pharynx and larynx. Breathing becomes noisy, accompanied by pain and cramps. At this stage of the disease, the person becomes irritable, excitable, very aggressive, "mad".

During seizures, patients scream and rush about, they can break furniture, showing superhuman strength, and throw themselves at people. There is increased sweating and salivation, it is difficult for the patient to swallow saliva and constantly spits it out. This period usually lasts 2-3 days. Then comes the third stage of the disease, for the onset of which calming down is characteristic - fear, attacks of hydrophobia disappear, there is hope for recovery.

After this, symptoms of the last stage of rabies appear:

• the body temperature rises above 40-42 degrees;
• paralysis of the limbs and cranial nerves of various localization occurs;
• disturbances of consciousness;
• convulsions.

Death occurs from respiratory paralysis or cardiac arrest. Thus, the duration of the disease rarely exceeds a week.

Rabies vaccine

There are no methods of treatment as such for rabies. If the disease is already in the first stage, most likely there will be no other outcome than fatal. Although in the world there are isolated cases of cure for rabies. But for now it is exotic. However, there is a way to prevent the disease by killing it in the bud.

This is a method of specific prevention - rabies vaccination, no later than the 14th day from the moment of the bite.

The best specific prophylaxis is the introduction of a specific immunoglobulin and / or active immunization (vaccination). The vaccine is administered intramuscularly, 1 ml 5 times: on the day of infection, then on the 3rd, 7th, 14th and 28th day. With this scheme, good immunity is created, but WHO also recommends the 6th injection 90 days after the first. The best place rabies vaccination is the deltoid muscle of the shoulder or thigh.

In the event that a person is bitten, but was vaccinated according to the full scheme before the bite, and he has a sufficient level of antibodies, he is vaccinated according to a special scheme without the use of immunoglobulin. Therapy may be discontinued if the animal is found to be healthy during the 10-day observation period or if the animal has not been found to have rabies virus. Some people who are at risk (veterinarians, dog handlers, hunters) need to be vaccinated in advance. Vaccinations are also carried out specifically established scheme with the first revaccination after 12 months. and then every 5 years.

What if you get bitten?

The first thing to do is immediately wash the bite with soap. You need to wash it quite intensively, for 10 minutes. It is recommended to flush deep wounds with a stream of soapy water, for example with a syringe or catheter. No need to cauterize wounds or stitches. After that, you need to immediately contact the nearest emergency room, because the success of rabies vaccination strongly depends on how quickly you turned to a doctor for help.

It is advisable to inform the doctor in the emergency room the following information - a description of the animal, its appearance and behavior, the presence of a collar, the circumstances of the bite. This is followed by a course of vaccinations prescribed by a doctor. Nobody has given forty injections to the stomach for a long time, they will inject you with the vaccine and let you go home. And so five or six times. A bitten person can be left in the hospital if his condition is especially severe, those who are vaccinated again, as well as people with diseases of the nervous system or allergic diseases, pregnant women, as well as people who have been vaccinated with other vaccinations within the last two months.

At the time of vaccination and 6 months after it, you must refrain from drinking alcohol. In addition, if you are undergoing a course of vaccination against rabies, you must not overwork, overcool or, on the contrary, overheat. During vaccinations, you must carefully monitor your health. And for any complaints about the deterioration of the condition, you must consult a doctor, and temporarily stop vaccinations. Only after examination by a neuropathologist, therapist and a rabiologist is the issue of continuing vaccinations resolved in consultation.

Questions and answers on "Rabies"

Question:Good afternoon. 11/7/17 I was bitten by a dachshund when I entered the entrance of the house. The owner was with the dachshund on a leash and had a child with her and said that her dog had been vaccinated and microchipped. The same dog once grabbed my leg in the summer. The bite went through the pants, but broke the skin cover (now on the wound that healed for a long time, traces of three teeth are visible). On 11/15/17 I went and got my first rabies vaccine. On the same day I saw both the dog and the owner. The dog was vigorous, barking at me. But I continued the course of vaccinations. During vaccination, I used alcohol 1 time (at a wedding, I forgot something). I told the doctor about this, she said that if there were no side effects, then a little alcohol consumption will not affect the effect of the vaccine in any way (2nd day after 3 vaccinations). Passed the entire course of vaccinations (5 vaccinations with Kokav vaccine). In early December I saw this dog - I played with the child in the yard. She barked at me again. But until now, my soul is somehow not calm and the fear of getting sick appears (since in NG! And after, after 3 weeks, I drank a little alcohol again). I am very worried ... Can a vaccine somehow \ "revive \" and cause a disease? (Although I understand that this is unrealistic .. but still ..) Thank you for your answer.

Answer: Don't worry, everything is in order: you have been vaccinated, the dog is not sick, alcohol is not affected.

Question:Hello! How long after vaccination can a pregnancy be planned?

Answer: Hello. The rabies vaccine belongs to the so-called inactivated (killed) vaccines, and therefore does not require any delay in the planned pregnancy. The vaccine forms protective immunity against the rabies virus, no other internal organs it has no effect.

Question:Hello. 4 days ago, at night after the rain, I was returning home on the way in the yard, I met a dog with puppies. I fed them, and one of the puppies bit his finger when I gave him food. Puppies run all day in the yard. It seems that there are not any symptoms. Is there a chance they are infected? I talked with the neighbors and they say that this dog has been living in the yard for several years. Is it worth doing prevention?

Answer: Hello. If it is not possible to check the dog at the veterinarian, you need to undergo a course of vaccinations.

Question:Hello! The cat bit her finger, very hard. Has taken 5 vaccinations against rabies, the cat is alive and well. The wound has healed. Is it possible to go to the sea after 5 months? Thank you.

Answer: Hello. During the entire course of vaccination and within 6 months after its completion (total 7-9 months) are strictly contraindicated: alcoholic beverages, physical exhaustion, overheating in the sun or in a bath, hypothermia. But, if the cat is alive and well, then you can.

Question:Hello. I went to vaccinate my dog ​​against rabies, and on the second day after the vaccination, my dog ​​climbed onto the bed and licked me on the edge of his lips, it seems that saliva got on the mucous membrane. Is it possible to get infected with this?

Answer: Hello. Observe the dog for up to 10 days, if nothing happens to it, then everything is fine.

Question:Good day! completed a course of 5 vaccinations against rabies .... Now they cannot find the cause of the temperature for 4 months. Is it possible to get sick with rabies due to an incomplete course if the bite was in the hand of an animal that was in the hands of the photographer, if 4 months have passed and from what there may be a temperature that drops at 23:00 and rises in the morning? Temperature 37-37, 5 in the daytime all possible tests for viruses, except rabies, were passed

Answer: In this case, it is recommended to conduct an examination for the rabies virus, for this it is necessary to consult an infectious disease doctor and donate saliva to determine the rabies virus by PCR method... Only after receiving the results of the survey it will be possible to make a complete conclusion. It is also recommended to exclude the presence of thyroid pathology, because dysfunction of this organ leads to the appearance of subfibrillation.

Question:It has been 9 months since the dog bite. I saw her alive after 10 days, but I thought it would be better to get vaccinated, just in case, they told me not to drink and that's it. Nobody talked about overwork and it turned out that I went to the sea, and worked, and sunbathed, and swam, and went in for sports, and now 9 months have passed. Tell me: have the restrictions been lifted?

Answer: Overwork, emotional stress, alcohol consumption in the period after vaccination against rabies, can weaken the effect of the vaccine and, thus, increase the risk of contracting rabies (if the dog that bit you was sick). If you are sure that the dog did not have rabies, your state of health is not disturbed at the moment - there should be no reason for concern.

Question:I was bitten by a dog, which was examined by a veterinarian and given a certificate that she was healthy. In the emergency room, I was given a 3-time course of vaccination according to the scheme: 0, 3, 7. On the 10th day, the veterinarian examined the dog and gave a certificate that it was healthy. Do I need to continue to vaccinate? How long are the restrictions on not sunbathing or drinking alcohol? Thanks!

Answer: In the situation described by you, you may not continue the course of vaccination against rabies, since the state of health of the dog that bit you is not impaired. Strictly adhere to the restrictions you mentioned, preferably at least three months. Also, for a month after vaccination, it is necessary to avoid increased physical activity.

Question:Hello, in October it will be 8 months since they began to vaccinate me against rabies. I want to know: are I already allowed physical exercise? I heard that you shouldn't be overworked, and if you can't, then how much more shouldn't you? And how much alcohol can you not drink?

Answer: After vaccination against rabies, the restrictions must be observed for 6 months (do not drink alcohol, do not overwork, do not overcool). After 6 months, the restrictions are removed, but you should not change your lifestyle dramatically, you should give the body an opportunity to adapt.

Question:Hello. Recently, the fox strangled the chickens, my mother butchered them and gave them to the dogs. What is the likelihood that mom and dogs can get infected? The fox has been living in the neighboring garden for a long time. Thanks in advance.

Answer: Human infection with rabies occurs when a sick animal bites. Infection is also possible when the saliva of a sick animal gets on the mucous membrane or damaged skin, as well as when eating the meat of sick animals. To exclude the likelihood of infection, you should contact an infectious disease specialist and conduct laboratory diagnostics (isolation of the virus from biological fluids). If an infection is suspected, it will be necessary to vaccinate with a specific serum.

Question:tell me: is the dog contagious during the incubation period? Can she infect? Somewhere they write - yes, somewhere - no. I don’t know who to believe.

Answer: The incubation period for rabies in dogs is 14-60 days on average, in some cases this period can increase and is 6-12 months. During all incubation period the animal poses a threat to humans, as infection can occur in the event of a bite.

Question:A dog was whelping at work. The puppies were about 2 months old. I decided to take one home. They began to catch me and he bit me a little, there was no blood, but one scratch remained. Today is the second day - the redness has disappeared and the scratch is dragging on, but I still worry.

Answer: In this case, consult with an infectious disease doctor to decide whether to vaccinate against rabies and show the puppy to the veterinarian. In the event that during the week the dog's condition does not worsen, you have nothing to worry about. In the event that you decide to leave the dog at home, it is recommended to vaccinate the dog to protect the animal from various diseases, a veterinarian will help you choose a vaccination schedule.

Question:A month ago, I came across an affectionate dog in a cafe, playfully nibbling at my trouser leg and leg. But no wounds remained on the leg, not even traces. And now a month later I go to the same cafe. And I see the same dog, it moves sluggishly, mostly lies, and so several last days... Should I be worried? And what to do?

Answer: In the event that during the bite you did not have a violation of integrity skin, the likelihood of contracting rabies is excluded, vaccine prophylaxis in this case is not needed.

Question:Hello. Can you please tell me, I was bitten by a homeless dog, the first vaccination was done within two hours. 19 days have passed since the bite, the dog is alive and looks healthy. Most likely she was protecting the puppies. But I will continue the course of vaccinations anyway. I do not drink, I do not sunbathe, I monitor my health. Please tell me if it is possible to get a tattoo, otherwise you don’t want to walk for another 2 months with an unfinished tattoo? Thank you.

Question:Hello. Yesterday my daughter (9 years old) went for a walk with a domestic cat. The cat is vaccinated with all the necessary vaccinations, including against rabies. The cat was in her arms. The street dog, seeing the cat, began to jump around, tried to reach it, with its paws trying to lean against the child, barking at the cat. The dog did not growl, saliva did not drip, it was sometimes seen in our yard. When I ran into the yard, the dog stood aside from the child. The girl has very small and not deep on her hand minor scratches from which blood came. Out of fright, she could not immediately say who put the scratches and could not tell whether the dog bit or not. Then she said that the scratches were from the cat when she climbed onto her back. I worry. And my daughter has a slightly enlarged pancreas, we have been treating her stomach for a year, we are on a diet. The stomach was examined and treated. Could this vaccine make your health worse? And is it worth getting vaccinated against rabies in general in our case?

Answer: In this case, it is recommended to consult with an infectious disease doctor for a personal examination and examination, as well as to resolve the issue of the need for vaccination. In the event that a specialist doctor decides on the need for vaccination, you should not refuse and the presence of concomitant pathology of the gastrointestinal system will not be a contraindication.

Many people find themselves in a situation where contact with a wild animal or small rodent ended in a bite. And not always an unpleasant incident was limited to pain at the site of the bite and unpleasant memories... Many wild or homeless animals are sick with rabies, which means that a deadly virus that threatens death enters the human body with saliva. Only the rabies vaccine (rabies vaccine) can save lives in such a situation.

Modern medicine has 2 types of vaccines in its arsenal. The first is used to prevent bites from rabid animals, and is assigned to zoo workers, veterinarians, as well as people who want to insure themselves against possible infection. The second vaccine is called rabies serum and is given in an emergency after an animal has bitten a person. But even realizing the need for such vaccinations, many people wonder about the side effects of vaccination and try to find out from the doctor what the state of the body is after being vaccinated against rabies. We will consider this issue in detail.

Need for rabies vaccination

According to WHO statistics, more than 35,000 people a year die from infection with the Rabies virus or the rabies virus. Moreover, the overwhelming majority of this infection affects the inhabitants of underdeveloped countries, where medicine does not control the vaccination of people and animals from this terrible disease. On the contrary, in countries such as Great Britain and Germany, where the state cares about the safety of its citizens, the level of infection with this virus is practically reduced to zero.

Side effects of the vaccine

Any vaccination can be accompanied by unpleasant conditions. Anti-rabies vaccination also does not exclude the occurrence of side effects. True, when an infected animal has already bitten a person, the decision should be unambiguous - to urgently vaccinate, because it comes about saving a person's life. But in the case of preventive vaccination, many are overcome by doubts about the advisability of such actions and the main argument against vaccination is side effects. Let's list the possible reactions of the body.

Prophylactic vaccination reactions

Local reactions

Considering that prophylactic injections for rabies are given 3 times, and in case of infection, the serum is injected as much as 5 times (and the injections are placed in different places), it is possible that local reactions may appear. Usually everything is limited to mild itching, redness, induration and swelling of the injection site. Such reactions do not cause much discomfort and disappear within 3-4 days.

General reactions

The introduction of the vaccine sometimes causes general reactions of the body, manifested in the form of weakness and drowsiness, tremors in the limbs, fever, headache, muscle or joint pain. Digestive disorders (diarrhea, constipation or flatulence) are often disturbing.

Allergic manifestations

Much less often, the body reacts to the introduction of a vaccine with allergic manifestations such as urticaria or angioedema. Usually, this is faced by persons with a predisposition to allergic reactions. In case of manifestation of such unpleasant symptoms, it is enough to consult a doctor who will prescribe one of the suitable antihistamines (Claritin, Suprastin, Zirtek, Fenkarol and others).

Reactions to rabies serum administration

It is much more difficult for the body to tolerate the administration of serum in cases where the bite has already occurred and it is necessary to obtain immunity from the rabies virus before infection occurs. In addition to the reactions described above, the administration of this serum may be accompanied by the following conditions:

• serum sickness (about 20% of cases) - a condition similar to allergies, but with a more severe course;
• Guillain-Barré syndrome (in 5% of cases) is a disease in which the sensitivity of the limbs is impaired. This ailment disappears after 2-3 months;
• anaphylactic shock (0.05% of cases) - an acute allergic reaction that threatens the patient's life.

As you can see, the state of the body after rabies vaccination can be accompanied by severe reactions, but only in cases where there is a threat to human life. As for the prevention of infection, such vaccination in most cases proceeds without any trouble, so you should not be wary of it. Health to you!

This disease is caused by a virus that enters a person with the saliva of a sick animal. The most common way of transmission of rabies is by bite, after which vaccination is required, since the likelihood of developing the disease can be from 25 to 90%.

When rabies vaccinations are needed for humans

If a rabid animal bites a person, then saliva will surely get into the wound, after which the disease will begin to develop. The incubation period of the disease is from 1 to 8 weeks, and even through the smallest wound, the virus can enter the body. Common carriers are domestic cats, dogs, rodents that have been bitten by a rabid animal and are carriers of an infectious disease. Immediately after the bite, the person is given an emergency vaccination. There are people who regularly undergo preventive routine vaccinations by birth professional activity:

• gamekeepers;
• trainers;
• veterinarians.

How is rabies vaccination carried out?

In most cases, rabies injections are given to humans with two drugs: the rabies vaccine and immunoglobulin. They have a different principle of action, and their choice depends on the duration of the incubation period of the virus. The doctor takes into account the extent and depth of the bites, their localization and number. If they are mild, then one rabies vaccine is injected, since a person still has time before the virus begins to develop.

When the bites are severe, moderate, or more than 10 days have passed after infection, and there is no time to wait until immunity appears, then a combined course is carried out - rabies immunoglobulin is also added to the vaccine. It immediately grants passive immunity to a short time, whereas the vaccine gives it only after 2-3 weeks, but for a long time.

Rabies vaccine

The rabies vaccine alone will not kill the virus. Its task is to provide the human body with antigenic information about the infection immediately after the bite of an infected dog or other animal. By reading it, the immune system begins to produce antibodies and neutralizes the virus. Rabies vaccine against rabies for humans helps to acquire active immunity for a period of at least one year. The instructions say that rabies vaccination can be given after contact with a bitten or bitten animal, even after several months.

Rabies immunoglobulin

The vaccine against rabies with the help of the vaccine begins to "work" only after 2 weeks. During this entire period, the body remains defenseless from infection, and to support it, temporary ready-made antibodies are injected. Antirabies serum immunoglobulin - a preparation that contains concentrated antibodies obtained from donated blood. This can be a person or a horse that has been previously vaccinated. After administration, antirabies immunoglobulin is completely eliminated from the body within a few weeks, therefore such immunity is called passive.

How is rabies vaccination done in humans?

The vaccination schedule in all countries of the world is based on WHO requirements, but sometimes it can differ due to the prevalence of the virus in each specific region. Stomach injections have not been given for 40 years. Adults are vaccinated in upper part hands, and children - in the front of the thigh. In no case should serum be injected into the gluteus muscle.

The modern rabies vaccination consists of 6 injections of the rabies vaccine at 0, 3, 7, 14, 30 and 90 days from treatment. The schedule and dose of drugs for a child and an adult do not differ. Rabies immunoglobulin is administered once before the vaccine is administered in the following cases:

• with late treatment of the patient (more than 10 days after the bite of a suspicious animal);
• with heavy to medium bites.

Contraindications

According to the instructions, vaccinations for the prevention of rabies are not recommended for children who have a weakened immune system, women during pregnancy and people with exacerbations of chronic diseases. The rabies vaccine is administered with caution to patients suffering from AIDS, oncology, or intolerance to any of the components of the drug. After being bitten by a rabid dog or other animal, vaccination is mandatory, since refusal can lead to death of a person.

Side effects

The administration of the drug is sometimes accompanied by local or general reactions. In the most serious cases, Guillain-Barré syndrome develops, which is accompanied by autonomic disorders and other complications. Rabies injections are not compatible with alcohol, so its use is prohibited throughout the course. Common side effects

ANDREW asks:

A MONTH AGO I MADE THE THIRD VACCINATION, THE DOG SEEN A LIVE COURSE STOPPED. IS IT POSSIBLE FOR ME TO GO TO THE BATH NOW, IT IS IMPORTANT AND IS IT POSSIBLE TO USE ALCOHOL, AND IF IT IS NOT WHY :)

Recommendations after vaccinations: do not drink alcohol for at least 6 months, do not overcool, do not overheat and do not be exposed to prolonged sun exposure. So it is better to postpone the trip to the bathhouse.

Galina asks:

If only one rabies vaccination was given, and did not continue to do so, since the dog is alive, what restrictions should be observed and why? The main thing is for how long?

Regardless of the amount of vaccination, all requirements are recommended to be observed within 6 months: do not drink alcohol, do not overcool, do not overheat and do not be exposed to prolonged sun exposure, in order to avoid the development of side effects after vaccination.

Galina asks:

What are the side effects after one rabies shot? Is it normal for an itchy seal at the injection site?

Yes, such a reaction to the vaccine is possible, you need to additionally take antihistamines (Claritin or Zodak) for the entire period of vaccination.

Alena asks:

Hello, my name is Alena. I am very worried about this question. On January 13, my brother was bitten by a mad dog, the diagnosis was confirmed. The dog showed signs of illness after 12 days. My brother and our whole family have undergone a course of vaccination with Kokav and anti-rabies immunoglobulin. 6 months have passed, is there still a danger of developing the disease? I am very worried about this. Thank you.

Natalia asks:

Good day!
Are there any bans or restrictions on visiting swimming pools or water parks during and after rabies vaccinations, and if so, why? Unfortunately, the doctor at the trauma center could not really explain, and the question is very relevant, thanks in advance!

Recommendations after vaccinations: do not drink alcohol for at least 6 months, do not overcool, do not overheat and do not be exposed to prolonged sun exposure. All of the above procedures can reduce the effectiveness of vaccination.

Julia asks:

such a question, I was bitten by a dog, today there was 1 vaccination, there are 6 of them in total, it turned out that the dog is not mad, is it possible to take alcohol, but the vaccinations will continue. If not, what can happen?

Olga asks:

I was bitten by a stray dog. I started a course of vaccinations and wanted to ask if it is possible to go abroad (namely to Domenicana) when there is a 14-day interval between injections? If not, is it very dangerous (excluding the possibility of overheating)

In the event that you have already begun to take a course of vaccination against rabies, you cannot interrupt it - this may threaten the emergence of rabies. Overheating, as well as hypothermia during the course of vaccination, is extremely undesirable, as well as increased physical activity and overwork. All of the above factors can reduce the effectiveness of the vaccine. Therefore, such overloads are best avoided. If you do decide to travel, be sure to complete the vaccination course upon arrival, as only a full course of rabies vaccination can protect you from contracting rabies. You can read more about rabies, its manifestations, as well as vaccination against this disease in our thematic section with the same name: Rabies.

Alexander asks:

Tell me, I am being treated for depression, I need to take medications such as cipralex and gidozepam. I was injected with Imunoglobulin 15 mg. 0.3.7 from rabies and from tetanus OS - 0.5. It is necessary to do the fourth tomorrow, is it all compatible? I have panic attacks, poor health in general, fear for my health ...

In the event that you have started a course of vaccination against rabies, it is imperative to get all four vaccinations, otherwise there will be no immunity to rabies and there will be a risk of contracting this disease. Read more about the causes of rabies, its clinical manifestations, methods of prevention, you can read in our medical information section with the same name: Rabies. Vaccination against the background of the drugs you have listed (in the absence of allergies to them) is not contraindicated.

Katya asks:

After the 2nd vaccination, the temperature rose, the weakness was very strong, dizziness on the day of the vaccination and headaches. Lasts for several days.
Are all of the listed symptoms side effects and how long will they last? And is this normal at all?

Yes, unfortunately, such a reaction to the vaccine is possible. It is necessary to take an antihistamine (Claritin, Tavegil, Erius) for 3-4 days, as well as an antipyretic drug (for example, Ibuprofen). Before the administration of the next vaccine (the day before the administration), it is necessary to take an antihistamine again, before the administration of the vaccine, an antipyretic agent. Such measures can prevent the development of adverse reactions. Your condition should improve in 2-3 days, if this does not happen, be sure to seek personal advice from a general practitioner. You can read more about the possible negative effects of vaccination and how to prevent their occurrence in our medical information section dedicated to this problem: Vaccines and vaccination.

Anton asks:

Human immunoglobulin was introduced after being bitten by a street cat, vaccination is to be done, please tell me, besides overheating, hypothermia, stress and avoiding alcohol intake, what foods should you avoid?

If you do not have food allergies, you do not need to follow any special diet. In the event that you have noted any allergic reactions to foods or other allergens (for example, to products household chemicals, cosmetics) - contact with food or household items containing allergens should be avoided. You can read more about rabies and the prevention of this disease in our thematic section with the same name: Rabies.

Natalia asks:

Hello! I am taking a course of vaccinations against rabies. I read from you that all the recommendations for prohibiting alcohol intake, hypothermia, overheating and overwork must be observed at least 6 months after the last vaccine. In the anti-rabies center I was told that it must be observed within 2 months after the last vaccines - what to do?

For the effectiveness of the rabies vaccine, it is still recommended to adhere to a strict regimen for half a year after the last vaccination, this is necessary for the development of immunity. Read more about this disease and the rules of vaccination in a series of articles by clicking on the link: Rabies.

Ksyusha asks:

Hello!
On September 22, my husband was bitten by a dog (domestic) on the street.
09/29/19 got an injection for tetanus, because from rabies in the emergency room was advised not to do, they say, in practice, dogs will not die.
02.10 we learned that the dog died a couple of days ago, but it’s not known from what, maybe it was poisoned ?!
From 25.09, his throat began to hurt, then the temperature rose, is it possible that these are the consequences of the bite?
The dog did not bite through his pants, but there is a wound on his body.
Had she infected him with rabies?

In this case, I strongly recommend that you consult an infectious disease doctor to decide on a course of vaccination against rabies, since there is a risk, especially considering that the dog died in a couple of days. A rise in temperature may be due to a bite. Unfortunately, the diagnosis can only be made after laboratory diagnostics. Please do not postpone your visit to the doctor. You can learn more about rabies infection from the information section of our website: Rabies

Nastya asks:

I'm taking a course of rabies vaccinations. On December 21, put the last one, that is, the sixth. There is a chance that I will simply forget about it, because about the fifth, I almost missed it. Is it very dangerous? Also, on many sites they say that the effect of alcohol is not so harmful, and that there is no scientific justification for the dangers of alcohol when vaccinated. From here the question is, is it possible not to put the sixth vaccination, and is it possible to drink alcohol ???

Nastya comments:

I am interested in what will happen if I DO NOT give the sixth vaccination, and what will happen if I drink alcohol. Many of my friends and acquaintances Drank during vaccination and nothing happened. I'm specifically interested in implications, not recommendations .. If possible. Thanks in advance.

If you DO NOT get the vaccine and you have been infected with the rabies virus, you will develop the disease. vaccination was not fully completed and a normal, adequate immune response did not develop. When alcohol is taken, the effect of the vaccine is also reduced, which can also lead to a worsening of the condition. You should not rely on situations when everything went well for your friends, you yourself, and not your friends, are responsible for your health! Refusal from alcohol has never harmed the body, but its use, as well as refusal of vaccination, is highly undesirable. Read more about rabies in the series of articles by clicking on the link: Rabies.

Alexey asks:

I apologize for the hundredth identical question, but still I would like to clarify more specifically about alcohol. Are there "safe" doses? for example, a bottle of beer or 50g of whiskey / cognac may already adversely affect or this is not critical.

Please clarify what you mean by the word safe doses, safe doses for what? What can alcohol have an effect on when using 50 grams?

Alexey comments:

Question for recommendation:

In the event that you have started a course of vaccination, all of the above recommendations are recommended to be observed within the next 6 months, in order to avoid the development of side effects after vaccination. That is why it is not recommended to consume alcohol and engage in sports where there is prolonged exposure to sunlight. Try to follow the recommendations as much as possible, then the effectiveness of vaccination will be high and there will be no side effects.
Read more about this disease in the series of articles by clicking on the link: Rabies.

Alexey asks:

And another question - is it possible to go snowboarding for a week in 2.5-3 months?

Please specify after what procedure do you want to go on vacation?

Alexey comments:

It seemed to me that I wrote in the section "PROHIBITS AFTER RABIES VACCINATIONS" (http: //www..html#viewcomments)
Question for recommendation:
"Regardless of the number of vaccinations, all requirements are recommended to be observed within 6 months: do not drink alcohol, do not overcool, do not overheat and do not be exposed to prolonged sun exposure, in order to avoid the development of side effects after vaccination."

Try not to consume alcohol, as there are no “safe-solvable” doses of alcohol during vaccination. Also try to avoid hypothermia and overheating. Compliance with all recommendations will avoid the occurrence of dangerous complications and will lead to the maximum effectiveness of the vaccine. Read more about vaccination in a series of articles by clicking on the link: Vaccination.

Alena asks:

Good afternoon. The last vaccine was in May. To this day, I periodically have a temperature of 37. Is this normal? After all, the vaccine is still valid for half a year after the last injection, or am I mistaken ?!

Please specify which vaccine you received. After that, we will be able to answer in detail the question you are interested in. You can get more detailed information about vaccination in the thematic section of our website by clicking on the link: Vaccination

Irina asks:

Hello! I'm getting the COCAV vaccinations on schedule. We have already received 4 vaccinations.
Before the fourth, she took Suprastin, tk. during the third, my arm was swollen and dizzy. Can Suprastin be taken? And then they tell me that it is impossible, - he can reduce the effect. Moreover, the nurse gave me the second vaccine in the gluteal region. Again, I did not know that it needed to be injected into the deltavid muscle of the shoulder and only then I read that it was impossible to enter the buttock. Can this also reduce the effectiveness of the vaccine? What should I do in these cases? Thanks in advance.

As a rule, this vaccine is injected into the deltoid muscle of the shoulder, but in practice, it is often used intramuscularly. In the event that an allergic reaction to the vaccine is observed, the use of antihistamines, in particular suprastin, is indicated. Suprastin does not reduce the effectiveness of the rabies vaccine. More on this issue You can learn from the section: Rabies

Vladimir asks:

Recently received treatment for rabies (COCAV). Can I go to the gym (weightlifting)?
And another question: I have a rash on my hands, can this be a reaction to injections? I just recently had a "slight" hypothermia. It got a little warmer outside and I was hot in my usual autumn clothes (I was sweating), and when I returned home there was a strong draft on the floor

Exercise is not recommended for one year after the introduction of the rabies vaccine. Visit gym it is advisable to minimize it by limiting general strengthening exercises. A rash that appears is unlikely to be related to vaccinations. I recommend that you visit a dermatologist to assess the nature of the rash, after which the attending physician will be able to prescribe adequate treatment for you and give further recommendations. You can get more information on rabies disease, vaccination and prevention from the thematic section of our website by clicking on the link: Rabies

Anton asks:

Good day! I got my 6th COCAV vaccination and prescribed Ingavirin (antiviral and immunomodulatory). Will Ingavirin reduce the effectiveness of the vaccine?

Ingavirin does not reduce the effectiveness of the COCAV vaccine, so you have nothing to fear. For more information about the disease of rabies, its treatment and prevention, you can obtain information in the corresponding section of our website by clicking on the link: Rabies

Tatiana asks:

I was bitten by my dog, the wound is small, but deep, I immediately went to the emergency room, I was vaccinated against tetanus and rabies, but since my dog, and she was vaccinated against rabies and is now healthy, is it possible not to do the other 5 vaccinations?

Generally, once rabies vaccination is started, it must be completed. You can get more information on issues of interest to you, learn more about a disease such as rabies, its prevention, you can in the thematic section of our website by clicking on the following link: Rabies

Tatiana comments:

The doctors said that if you bring them a certificate, then you do not need to take the full course, and the dog had bitten before that (all the times it was provoked by ourselves) another person and vaccinations were not done and everything is fine with people. I am interested because the doctor only accepts by appointment and today, when, in theory, I need to give a second injection, there was no longer an appointment and I was not accepted at the polyclinic

In the event that the dog has been examined by a veterinarian and no suspicions of rabies have been identified, and the animal has been vaccinated in full, further vaccination can be refused. More information on this issue can be obtained in the section: Rabies

Alena asks:

Good day! Can you please tell me, I got the last rabies vaccination on November 20, 2013, and on 11:11 pm I have Botex injections, isn't it dangerous? Need to postpone injections and for how long? And is it possible to inject hyaluronic acid (cosmetic procedures on the face)
Thanks in advance for your reply.

According to the instructions for use of the rabies vaccine, Botox, hyaluronic acid are not contraindicated, so they can be used. Read more about a disease such as rabies, vaccination and recommendations after it is carried out in the thematic section of our website by clicking on the link: Rabies

Alice asks:

Yesterday I got the last rabies vaccination and I was upset by the doctor's statement that alcohol should not be consumed for 6 months. But it is approaching New Year! Are the consequences really serious if I drink a little?

After rabies vaccination, drinking alcohol in large quantities contraindicated, but not a large number of low alcohol drink will not do harm. You can learn more about such a disease as rabies, vaccinations and precautions in the thematic section: Rabies

Alena asks:

I was bitten by a dog, they gave me the first vaccine. But I decided to stop vaccination. Is it possible just not to come for vaccinations or is it necessary to write a refusal?

In the event that there is a risk of contracting rabies, it is recommended to vaccinate in full. The issue of refusal to vaccinate is decided by the attending physician taking into account all the circumstances. Learn more detailed information on this issue you can in the thematic section of our website by clicking on the following link: Rabies

Vera asks:

On Tuesday I fell ill with a sore throat with high temperature and swollen lymph nodes. Today, on Thursday, returning from the clinic, I was bitten by a yard dog, went to the emergency room, where I was vaccinated against tetanus and anti-rabies. I am very worried about how this will affect my body. this moment probably reduced, the lymph nodes are still inflamed. I treat angina with intramuscular injections of antibiotics and tablets. Is it all compatible?
Vaccinations were made at 11.30, now at 18.30, temperature 37, now I do not know what the main reason is.
I am 53 years old, woman.

In this situation, do not worry - continue the prescribed treatment for angina, vaccination should not adversely affect recovery, since the vaccine and the course of antibiotics are compatible. You can find out more detailed information on this issue in the thematic section of our website by clicking on the following link: Rabies

Vera comments:

Thank you very much for your reply. I want to ask you one more question. In one of your articles on the site I read that if the bite was through intact clothing, then the rabies vaccine should not be given. I had trousers and tights under them, there were no visible injuries on the clothes, the wound itself was from The bite looks like this: two marks a little deeper from the teeth and the internal cropping is small, the skin is slightly flayed, the blood did not come out. Now I doubt whether to continue my vaccination or not, because. it does not have a very good effect on immunity.

In the event that there was no direct contact of the animal's saliva with damaged surface skin, then vaccination can be waived. You can get more detailed information on the question you are interested in in the corresponding section of our website by clicking on the following link: Rabies

Dmitry asks:

Hello. I delayed the last injection for 3 days, but I still gave it. Will it work?

The shift in the timing of vaccine administration by 3 days does not significantly affect the final result, so in this situation you have no cause for concern. For more details on this issue, read the corresponding series of articles on our website by clicking on the link: Vaccine and vaccination

Vera asks:

During the illness, a sore throat was bitten by a dog, in parallel with the treatment for sore throat, they began to vaccinate. Two weeks after recovery, a complication after sore throat appeared - erythema nodosum, now again intensive treatment with two types of antibiotics, and three days later - another vaccination. that vaccination is contraindicated during an exacerbation of infectious diseases. How badly will this affect my body? I am very upset.

In the event that you are currently undergoing antibacterial treatment, it is advisable to change the timing of vaccination, therefore I recommend that you notify the attending infectious disease doctor about your present condition. You can get more information about vaccines, principles and features of vaccination in the next section of our website: Vaccine and vaccination. You can get additional information on the question you are interested in, learn more about the prevention of such a disease as rabies in the thematic section of our website by clicking on the following link: Rabies

Alexander asks:

Yesterday I was bitten by a drive cat, the bite was provoked. The cat is not observed adequate signs of rabies. Is it possible to avoid vaccination? The wound was small for one tooth, and is no longer visible.
What are the chances of getting sick with rabies, I live in the city of Ulyanovsk, in the city limits.

In this situation, it is quite difficult to exclude the likelihood of developing rabies, therefore, in such cases, vaccination is recommended. You can find out more detailed information on this issue, get information on indications for vaccination in the thematic section of our website by clicking on the following link: Rabies

Tatiana asks:

Good afternoon. Please tell me if you can take sports nutrition(Gainer, L-Carnitine, etc.)? And are there any contraindications to physical activity? From the whole course, 1 vaccine has been made so far, the next one tomorrow.

If you are currently receiving rabies vaccines, then physical activity should be limited, that is, pronounced exertion, chronic overwork should be excluded, while ordinary exercise is not contraindicated. Sports nutrition has no restrictions on vaccination and can be used. You can get additional information on the question you are interested in in the corresponding section of our website by clicking on the following link: Rabies Sports and sports nutrition

Anastasia asks:

She was bitten by her dog, now she is under supervision. They started to vaccinate me against rabies, but I am simultaneously being treated for a gynecological problem and am taking an antibiotic (clindamycin). Is it possible to combine? Or do you need to stop your treatment for a while?

Rabies vaccination can be combined with antibiotics (it is not recommended to combine only with immunosuppressants and corticosteroids, since these medications reduce the effectiveness of the rabies vaccine). You can get more detailed information on the question you are interested in in the corresponding section of our website by clicking on the following link: Vaccine and vaccination

If it is reliably confirmed that the animal is healthy, the vaccination course may be interrupted after consultation with the attending infectious disease doctor. 2-3 weeks after the first rabies vaccine was given, you can return to your normal lifestyle without any risk. You can get additional information on the issue you are interested in in the thematic section of our website by clicking on the following link: Rabies. You can also get additional information in the following section of our website: Vaccine and vaccination

Alexander asks:

Good afternoon. I am undergoing treatment for hepatitis C (antiviral therapy) with Altevir, Interferon alfa 2b (injections) and Ribaverin (capsules). Recently I was bitten by a hedgehog and they started to inject me with COCAV vaccinations. I was told that hepatitis C antiviral therapy can be continued. Please tell me if this is so, are altevir interferon alfa 2b (injections) and ribaverin compatible with COCAV injections?

That's right, it is possible and necessary to continue treatment with antiviral drugs in this situation, these drugs do not interact with each other and do not reduce the mutual effectiveness of each other. You can get more detailed information on the question you are interested in in the corresponding section of our website by clicking on the following link: Viral hepatitis C - diagnostics and prevention. Additional information also you can get in the next section of our website: Vaccine and vaccination and in a series of articles: Rabies

Alexander

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Preparations for vaccination against rabies.

What is the choice of drugs based on?

For rabies vaccinations (rabies immunization), two drugs are used:

These drugs have different principle actions.

The rabies vaccine by itself is unable to kill the virus. The job of a vaccine is to provide the body with antigenic information about the virus. The immune system is presented with a seemingly inanimate model of a real virus, devoid of its harmful power, but retaining its identification marks - antigens.

By reading and memorizing information about these identification marks, the immune system acquires the ability to produce specific proteins - antibodies. Antibodies recognize the virus by familiar antigens and neutralize it. With the help of the vaccine, they acquire the so-called "active immunity" for a period of at least 1 year.

However, this process takes about two weeks. All this time, the body remains defenseless against the virus.

What to do? Provide temporary "crutches" - inject ready-made antibodies.

Where to get them from? In another organism. The preparation containing concentrated antibodies is called "immunoglobulin" (previously used prerarate, unrefined from foreign protein fractions, was called "serum"). Immunoglobulin is obtained from donated blood. The donor can be a person (homologous immunoglobulin) or an animal, in practice a horse (heterologous immunoglobulin). In order for the donor to have enough antibodies, he is preliminarily immunized with an anti-rabies vaccine. Human immunoglobulin is more effective than equine immunoglobulin, therefore the dose is 2 times less. Plus it's safer.

Immunoglobulin, like any protein molecule, itself contains antigens. The more foreign the introduced protein, the more hostile it is perceived by the immune system. Within a few weeks after administration, the immunoglobulin is completely destroyed in the body. This type of immunity is called "passive".

Thus, immunoglobulin provides passive immunity immediately, but for a short time, and the vaccine provides active immunity after two to three weeks, for a long time.

The choice of drugs mainly depends on the expected length of the incubation period. Its duration is influenced primarily by the localization of the bite, as well as the number, depth and extent of the bites.

If there is confidence that the vaccinations will have time to create sufficient immunity before the onset of the development of the disease (light bites), they are vaccinated

If it is impossible to wait until active immunity appears (severe and moderate bites, as well as belated - more than 10 days - treatment for bites of any severity inflicted by unknown or suspicious animals of rabies) - a combined course of treatment is carried out - in addition to the vaccine, they also introduce

Rabies vaccine.

The first rabies vaccine was proposed in 1885 by Louis Pasteur. He obtained an attenuated (so-called "fixed") strain of the virus by 90 successive passages of the virus through the brain of a rabbit. The Pasteur strain was provided different countries for the production of vaccines. Since then, a large number of vaccines have been developed. For a long time used live vaccines (contained live viruses of a fixed strain).

For vaccinations against rabies, inactivated (that is, containing a killed virus) vaccines produced "in vitro" on tissue cultures are now used.

Doses and vaccination schedules are the same for children and adults.

Once the vaccine is dissolved, it should be used for no more than 5 minutes. The vaccine is injected intramuscularly into the deltoid muscle of the shoulder, and for children under 5 years old - into the upper part of the antero-lateral surface of the thigh. The introduction of the vaccine into the gluteal region is unacceptable.

The vaccinated person must be under medical supervision for at least 30 minutes.

Indications for vaccine administration:

Preventive immunization - vaccinate "just in case and in advance" of people exposed to increased risk- hunters, veterinarians, gamekeepers, laboratory staff working with the "wild" rabies virus, etc.

Contraindications for prophylactic immunization:

1. acute infectious and non-infectious diseases, chronic diseases in the stage of exacerbation or decompensation - vaccinations are carried out no earlier than one month after recovery (remission)
2. local and systemic allergic reactions to the previous vaccine administration (generalized rash, Quincke's edema, etc.)
3. pregnancy

• Therapeutic and prophylactic immunization - carried out in connection with an already held bite

  There are no contraindications in this case.

Side effects of the vaccine:

• local reactions - short-term edema, redness, edema, itching, induration at the injection site
• general reactions - moderate fever, tremors in the limbs, weakness, dizziness, headache, arthralgia (joint pain), myalgia (muscle pain), gastroenterological disorders (abdominal pain, vomiting)
• possible development of immediate allergic reactions (urticaria, Quincke's edema)

Rabies immunoglobulin.

Rabies immunoglobulin is indicated for the combined course of immunization against rabies in conjunction with the rabies vaccine:

• with late treatment (more than 10 days) with bites of any severity inflicted by an unknown or suspicious animal

Two types of immunoglobulin are used:

• heterologous (equine) immunoglobulin
• homologous (human) immunoglobulin obtained from donated blood.

Homologous (human) rabies immunoglobulin is prescribed at a dose of 20 IU per 1 kg of body weight.
Heterologous (equine) rabies immunoglobulin is prescribed at a dose of 40 IU per 1 kg of body weight.

Example: the patient's body weight is 60 kg, the immunoglobulin activity is bitten on the package (for example, 200 IU in 1 ml)
60 * 40/200 = 12 ml must be administered to this patient, after determining the sensitivity to a foreign protein.

How can you most of the calculated dose should be infiltrated near the wound and into the depth of the wound. If the anatomical location (fingertips, etc.) does not allow the entire dose of rabies immunoglobulin to be injected into the tissue near the wound, then the remainder is injected intramuscularly (into the upper thigh or deltoid muscle, on the side of the body opposite the vaccine injection site).

The administration of rabies immunoglobulin is most effective on the first day after the bite. The entire dose of the drug is administered on one day. Only with particularly wide and multiple bites inflicted mad wolf or other carnivores, the introduction of rabies immunoglobulin can be repeated, in the same dose, after which a course of vaccination is carried out with the obligatory introduction of an additional dose of the vaccine on the 60th day from the start of treatment (see).

Test for sensitivity to a foreign protein.

20 minutes before the drug is administered test for sensitivity to a foreign protein- 0.1 ml of diluted (1: 100) immunoglobulin is injected intradermally into the anterior surface of the forearm. An ampoule with diluted (1: 100) immunoglobulin is attached to each dose of the undiluted drug and is in the same package.

Diluted (1: 100) immunoglobulin in a dose of 0.1 ml is injected intradermally into the anterior surface of the forearm.
after 20 minutes - sample evaluation ⇓
The test is negative if edema or redness does not exceed 1 cm at the injection site of the immunoglobulin The test is positive if there is swelling or redness of 1 cm or more at the injection site of the immunoglobulin, or there is an allergic reaction
test negative ⇓		test positive ⇓
0.7 ml of diluted (1: 100) immunoglobulin is injected subcutaneously to reveal general sensitivity to a foreign protein.	when general reactions appear after 30 minutes ⇒	Diluted immunoglobulin (1: 100) is injected in doses of 0.5 ml, 2.0 ml, 5.0 ml injected at intervals of 20 minutes into the subcutaneous tissue of the shoulder
in the absence of general reactions after 30 minutes ⇓		in 20 minutes ⇓
		0.1 ml of undiluted immunoglobulin is injected subcutaneously
		in 30-60 minutes ⇓
		Before the first injection of immunoglobulin, antihistamines are prescribed (diphenhydramine, suprastin, etc.) and are recommended to be taken orally for 10 days. In order to prevent shock, subcutaneous administration of 0.1% adrenaline solution or 5% ephedrine solution at an age-specific dose is recommended.
		⇓
Introduce fractionally (in 3 doses at intervals of 15 minutes) the entire dose of immunoglobulin heated to 37 ° C, collecting the drug for each portion from an unopened ampoule. The entire dose should be infiltrated around and deep into the wound. If anatomical lesions preclude this (fingertips, etc.), then the drug can be injected intramuscularly in other places (muscles of the buttocks, thighs, shoulder, etc.). The entire dose is administered within an hour.