ABOUT Dean from the characters "Iliad" The Greek Warrior Teoker calls Hecter, the son of King Priama, a mad dog. This is the oldest in the literature mention of rabies, known, however, much earlier. Mad dogs, for example, were depicted in ancient Egyptian painting. They were afraid - they carried death. In Greek mythology, even the God of this terrible disease was Aristax, the son of Apollo, and Artemis (Romans - Diana) had a gift to heal her.

In the works of Plutarch, Ovid, Vergil we find detailed description rabies. Celsius, ancient Roman doctor, left extensive medical work (100 g. BC), which described cases of rabies from his slaves. He first pointed out the hydrophobia (hydrophobia). They were also given the first recommendations to combat this ailment - the cleansing of the Russian Academy of Sciences, washing with vinegar or strong wine, causticing wounds with hot iron. Another Ancient Roman doctor - Galen also advised to catch the wound. The moxibustion remained the most efficient means until the opening of the vaccine made by Louis Pasteur. Celsius, as well as donat, Dioscaride assumed the transfer of rabies through the saliva of the patient's animal. Their assumption was confirmed by science only in the XIX century. With antiquity it was believed that rabies were caused by a worm that nesting under the tongue. And many nations have existed a rule - to make an incision under the tongue against rabies.

In the XVIII century, famous Morgana's pathologist argued that many healthy dogs can transmit the disease. It was also considered that rabies can be transmitted through the air infected with the breath of sick animals and people. This explains the occurrence of cruel customs, for example, suffering patients between two mattresses, which were then burned.

High clarity in the mechanism of transmission of rabies was made in 1804 experiments with Usenke. He managed to infect dogs and rabbits, smearing the wounds on their skin with a salivary mad dog. So the source of infection was installed. But what's next?

For our ancestors, rabies were a real incarnation of horror. Alas, and now sick is doomed. The only chance for salvation is the vaccination made immediately after the bite of mad animals.

Opening of rabies vaccine is one of the greatest discoveries of the XIX century medicine.

In the history of medicine, many paradoxes. Here is one of them. Louis Pasteur (1822-95) is not a medic, but it owns several discoveries, which would be enough for a whole pleiad of great doctors.

At the nine-year-old age, Paster was present at the "treatment" of Kalenny gland the peasant, branched with a mad dog. The cries of this unfortunate for many years pursued him. And in 1880, being already a well-known scientist, he received a "gift" from veterinary doctor Pierre Burrel - two mad dogs in metal cells - asking for a study of the disease. Soon Burrel died, infected with rabies. This tragedy pushed Pasteur to research.

In the laboratory conditions, it was absolutely precisely proved that the disease never spontaneously arises: the pathogen is either in saliva or in the central nervous system. For the cultivation of the virus, a rabbit was selected. The scientist cultivates the pathogen in the brain of the rabbit, translates the pathogenic material from one animal to another, from the deceased to the living. Finally, the most responsible stage occurs - the creation of a vaccine for preventing the disease.

Stones passed, years of hard work. L.Pister, E.Ru, Sh. Shambarlan, did not come out of the laboratory. And the Bala vaccine is obtained!

After animal experiments, the vaccine effect was necessary to check in people. L.Paster was going to conduct an experiment on himself: "I still do not decide to try to treat people. I want to start from myself, that is, first infect himself with rabies, and then suspend the development of this disease - so great my desire to make sure of my experiments. "

But fate ordered otherwise. In incredible torment from rabies, people continued to die. To the scientist turned distraught from the grief of the mother of children, ski mad dogs and doomed to death. It was a 9-year-old Joseph Maister and 14-year-old Jean Batiste Zhupil (the latter on the territory of the Pasteur Institute in Paris was delivered by a monument depicting a boy, bravely struggling with a mad dog). Both boys were saved thanks to vaccination, and it became a truly outstanding event in the history of medicine.

Following the first patients who quickly spread rumor, other victims of animal bites were to arrive - from France, England, Austria, America. And on March 1, 1886, he received a telegram from the city of White Smolensk province: "Twenty people branted with a mad wolf. Can I send them to you? "

The tragedy of a small county town was not an exception for Russia, where this disease was delivered annually hundreds of lives. In the ancient hospitals, we find different methods of dealing with this ailment - from conspiracies before the burning of wounds by Kalenny Iron. According to this problem, there is a work of an outstanding Russian physician XVIII century D. Samovilovich "The current method of treatment with the instruction, as a simple people can be treated from the remorse of a mad dog and from the taste of the snake" (1780). In the XIX century, completely fiction recommendations appear in newspapers and medical journals. So, in the "Government Bulletin" a article "On the treatment of water-houses of a Russian bath" was published. But an effective means against rabies in Russia, as in other countries, has not yet been.

The tragedy of 20 Smolyan in the overall flow of deaths, most likely, would have passed unnoticed, do not be this telegram. L.Paster replied immediately: "Send branched immediately to Paris." Only on the third day after unfortunately, a meeting of the city Duma took place, allocated 16,000 rubles, the remaining 300 rubles were collected by subscription. And two days the victims were waiting for them when they were sent to Paris accompanied by a doctor ...

L.Paster was looking forward to the arrival of Smolyan. Expired a checkline for the introduction of the vaccine. In addition, people are sophisticated with a furious wolf, not a dog. Does vaccine affect? Seventeen people stayed alive. But the death of three, which became the result of the Volokat, with the sending of patients, caused the flow of attacks on L. Paster. The slanderous campaign began. The scientist continued to defend his method. Another group of seven people who branched with a mad wolf arrived from Russia, this time from the Oryol province. Paster already knew that the diagram of vaccinations so patients should be different. None of the arrivals of Orlovtsev died.

And then he was the hour of his triumph - a message at the Paris Academy of Sciences. A brilliant outcome was made in 1886: more than 2500 people escaped death from rabies due to anti-library (from Greech. "Rabies" - rabies) vaccinations. Pasteur vaccinations were recognized worldwide. France honored her great scientist. In 1888, the Pasteur Institute of Pastera opens at the funds collected by subscription (which became the international center after decades microbiological studies). Many countries have collected 2.5 million francs, thereby expressing a sense of deep respect for the scientist. The French newspapers were noted: "The Russian government donated 100,000 francs to the Institute of Pasteur, that is, at the rate of 40000 gold rubles." It was also reported about awarding L. Pasteur Order Anna I degree with diamonds.

The fate of the great Russian scientist I. Mechnikov is inextricably linked with the history of the Pastera Institute, and the fate of the great Russian scientist I. Mechnikov. He took the director of this institute after the death of L. Pasteur.

But back in 1888 knowing that his method should be the property of physicians around the world, L. Pister agreed to the creation of Pasteur stations in other countries, and above all in Russia - as a sign of gratitude to the trust rendered to him during persecution and slander. The second reason - many of his like-minded people lived here and decent successors.

The very first outside of Paris station vaccinations against rabies was created in Odessa. I.Deshnik, already then a peaceful scientist, organized her and worked, refusing a salary. June 11, 1886, the doctors of the Odessa Station began to make vaccinations. The first voluntarily agreed by the 28-year-old Deputy Station Director I. Barda.

But Russia is clearly lacked in Russia. And in Moscow, a Pasteur station opened in Moscow. In her organization and work, prominent Russian scientists - N. Unkovsky, S. Puchkov, A. Nerovyev, and others are the merit in the creation of this station and the chairman of the Moscow Surgical Society of Professor N. Sklifosovsky. Soon such stations appeared in St. Petersburg, Smolensk, Samara, Irkutsk, Kiev, Kharkov, Tiflis ....

French medical Academy reported in 1887, which is from 18 Pasteur stations organized in different countries of Europe and America, six - Russian.

Unfortunately, to say that rabies on the globe are eliminated, it is impossible today. Moreover, the intensity of rabies epizoty among animals continues to grow. Features of the evolution of rabies in the range recent years In particular, with the advent of a new environmental factor - hybrids of a wolf with dogs, which is not least due to the increase in the number of abandoned, wild dogs.

In Moscow, rabies among animals are recorded annually. Each unprecedented dog can potentially cause tragedy. Nature Mustrate for our cruelty. Let's remember the words L. Pasteur: "I am unshakably believe that science and the world will trust over ignorance and the war that the peoples will come to an agreement not for extermination, and the creation, and that the future belongs to those who will do for the suffering mankind."

Another 150 years ago, the man bite the man was doomed. Today, scientists are improving weapons in the war with an ancient and extremely dangerous enemy - rabies virus.

Know the enemy

Rabies causative agent ( Rabies Virus) belongs to the Rhabdoviridae family (Rhabdoviridae) containing a single-chain linear RNA molecule, family Lyssavirus.. In shape, it resembles a bullet with a length of about 180 and a diameter of 75 nm. Currently known seven genotypes.

Cusar virus

The rabies virus has tropiness (affinity) to the nervous tissue, as well as influenza viruses - to the epithelium respiratory tract. It penetrates the peripheral nerves and at a speed of about 3 mm / h moving into the central departments of the nervous system. Then the neurogenic means it applies to other organs, mainly on salivary glands.

The probability of the disease depends on the place and severity of the bites: when biteing with mad animals in the face and neck, rabies develop an average of 90% of cases, in the hand of hand - 63%, and in the hips and in the hands above the elbow - only in 23% of cases.

Sources of infection

The main wild animals - sources of infection - are wolves, foxes, jackals, raccoon dogs, badgers, skunks, bats. Among the domestic people are dangerous cats and dogs, and it is on the latter that a maximum of confirmed cases of rabies transfer to man. Most of the sick animals perish for 7-10 days, the only exception described is yellow, he is a foxid mangoste Cynictis Penicillata.capable of carrying a virus without the development of a clinical picture of infection for several years.

The most characteristic and reliable sign of the presence of a virus in a human or animal organism is the detection of the so-called non-neuro taurus, specific inclusions in the cytoplasm of neurons with a diameter of about 10 nm. However, in 20% of Taurus patients, Negri cannot find, so their absence does not exclude rabies diagnosis.

The first, but an extremely important step towards fighting rabies made a brilliant French chemist and microbiologist Louis Pasteur. He began the development of a vaccine against this disease in 1880, after he had to observe the agony of a five-year-old girl, branched with a mad dog.

Rabbits and dogs

Although for the first time rabies were described in the first century BC. Roman Cornelia Celsios, after almost 2,000 years old about this disease was known to be negligible. Only in 1903, eight years after the death of Pasteur, the French doctor Pierre Cembling found that rabies were caused by a submicroscopic form of life - with a filtered virus.

How viruses breed

To get into the cage, the rabies virus uses an endosomal transport system: the cell must grab it itself and draw the bubble-endosome from the cell shell - endosome, the "inner body" to the cytoplasm. The activation of this process occurs after binding the virus with special receptor proteins on the cell membrane. The resulting endosome disintegrates over time, the viral particle releases RNA, then everything goes according to the standard scenario.

Pasteur, having this information, nevertheless, was not going to give up: To create a vaccine, he chose a workaround - to find the reservoir "poison" and turn it into an antidote. It was reliably known that something transmitted from the sick animal to another animal or a person together with an infected saliva amazing nervous system. During the experiments, it was found that the disease has a very long incubation period, but it only spurred Pasteur and his colleagues, because he meant that physicians have the opportunity to influence a slowly developing pathological process, - "I needed" to get to the spinal out of the peripheral nerves and then brain.

Then began experiments on rabbits in order to get the most fatal "poison" of rabies in large quantities. After dozens of transfers of the brain fabric from a sick animal to the brain of healthy, from him - the next, etc. The scientist managed to ensure that the standard extract from the brain killed the rabbit exactly in seven days instead of the usual 16-21. Now it was necessary to find a way to loosen the pathogen of rabies (the method of creating vaccines - the weakening of the pathogen is also the opening of the passer). And the method found: a two-week drying with a fabric with a virus of a rabbit brain over absorbing moisture alkali.

After the introduction of the suspension from the resulting drug infected with rabies, the dog not only recovered, but also became absolutely unresponsible to rabies, whatever the number of "poison" was introduced.

Finally, making sure that the same seven-day laboratory "poison" does not work on vaccinated dogs, the researchers held a cruel experiment: their patients with rabies conifections launched. The branches are not sick!

40 injections in the belly

Then it was the turn of people. But where to find volunteers? Brought to despair, Paster was ready to sacrifice the sake of science, but fortunately, his majesty intervened.

On July 6, 1885, a glacious woman who kept the nine-year-old son - Josef Maisters appeared on the threshold of the Paris Laboratory Pasteur. Three days before that, the boy bit a mad dog, applying 14 open wounds. The consequences were quite predictable: at that time it was already known that death in such cases was almost inevitable. However, the boy's father was heard about the works of Pasteur and insisted on bringing a child from Alsace to Paris. After serious hesitation, Pasteur introduced a small patient an experimental drug, and Joseph became the first person in the history of a man saved from rabies.

From the laboratory diary Louis Pasteur, 1885

"The death of this child was inevitable, so I decided not without serious doubt and anxiety, which is well explained, to experience the method on Joseph Maister's method that I found successful in the treatment of dogs. As a result, 60 hours after bites, in the presence of Vilpo's doctors and Graysh, the young Mayster was vaccinated by half a syringe from the spinal cord of the rabbit, who deceased from rabies, in front of this drilled dry air for 15 days. In total, I made 13 injections, on one every next day, gradually introducing an increasingly deadly dose. Three months later I examined the boy and found it completely healthy. "

In Paris, people from all over the world reached out - Algerians, Australians, Americans, Russians, and often in French, they knew only one word: "Paster". Despite such success, the vaccine discoverer from mortal Disease I had to hear in my address and the word "killer". The fact is that not all bold survived after vaccination. In vain Pasteur tried to explain that they were treated too late - someone two weeks after the attack of the animal, and someone and a month and a half. In 1887, at the meeting of the Academy of Medicine, colleagues directly accused Pastera in the fact that he simply kills people with pieces of the brain of rabbits. A scientist who gave science all his strength could not stand - on October 23, he developed a second stroke, from which he did not recover until death in 1895.

But he was supported simple people. By subscription for a year and a half, residents of many countries have collected 2.5 million francs, which was created by the Pasteur Institute, officially open on November 14, 1888. On its territory there is a museum and a tomb of the researcher who saved humanity from death hazardous infection. The death date of Pasteur, September 28, is chosen by the World Health Organization (WHO) for the annual World Fighting Day against rabies.

For a long time, the vaccine was administered under the skin of the front abdominal wall, and up to 40 injections were required for the full course. The modern immunopreparation is introduced intramuscularly, in the shoulder, enough six visits to the trauma.

Miracle Milwaukee

During the 20th century, the situation with rabies was unambiguous: if the victim was not vaccinated on time or he did not receive a vaccine at all, it was tragically ended. According to WHO estimates, 50-55 thousand people die in the world after an attack, 95% of them fall into Africa and Asia.

The possibility of full-fledged treatment of infection was spoken only in the XXI century. This was due to the occasion of the American Giis GIS, which for the first time in the history of medicine did not receive a vaccine, but survived after the appearance of rabies symptoms. On September 12, 2004, 15-year-old Gina caught a bat, which bit her finger. Parents did not apply to the doctor, having counted the wound to be wounded, but after 37 days, the girl developed clinical picture INFECTION: temperature rise up to 39 ° C, tremor, bias in the eyes, the difficulty of speech is all signs of the lesion of the central nervous system. Gini sent Wisconsin to the children's hospital, and in the Laboratory of the Center for Control and Prevent Diseases ( CENTERS FOR DISEASE CONTROL AND PREVENTION, CDC) in Atlanta confirmed rabies.

Parents offered to try the experimental method of treatment on the girl. Having received consent, doctors with the help of Ketamine and Midazolam introduced a patient into an artificial to whom, actually turning off its brain. It also received antivirus therapy in the form of a combination of ribavirin and amantadine. In this state, the doctors kept it until the immune system began to produce a sufficient amount of antibodies to cope with the virus. It took this six days.

After a month, the tests confirmed: there is no virus in the body of the girl. Moreover, brain functions were violated minimally - she graduated from school, and a year later received driver's license. Currently, Gina graduated from college and intends to continue learning at the university. It is not surprising that she sees biology or veterinarian by his future profession, and it is planning to specialize in the field of rabies.

The protocol of treatment that was applied to the girl was called "Miloksky", or "Wisconsinsky". He was repeatedly tried to reproduce in other hospitals ... but, alas, without much success. The first version of the protocol was tested for 25 patients, only two were survived from them. The second version of which Ribavirin was excluded, but added preparations to prevent vascular spasms were applied to ten patients and prevented the death of two of them.

When conducting epidemiological investigations, it turned out that patients who managed to cure with the help of the Miluoka Protocol were biting bats. It was this fact that some scientists suggest that in fact the method of treatment here is nothing to do with it, but it is in these mammals, and more precisely that they are infected with another strain of a virus, less dangerous for a person.

Riddle of volatile mouse

In 2012, this assumption received the first confirmation. IN American Journal Of Tropical Medicine and Hygiene An article of the CDC expert group, American military virologists and epidemiologists of the Ministry of Health of the Peru are appeared. The results of their research produced the effect of a broken bomb: in the Peruvian jungle managed to detect people who have antibodies in the blood to the rabies virus. These people have never been injected by any vaccines, moreover, they don't even remember that they were sick anything serious. And this means that rabies are not 100% deadly!

"From this district of the Peruvian Amazon Jungle over the past 20 years, many reports have been received about contact with vampire mice and cases of rabies among people and domestic animals, - explains" PM "lead author of Dr. Amy Gilbert, working in CDC in a rabies learning program . - Villages and farms that we examined are in a very distance from civilization places - to the nearest hospital, for example, two days of the road, and in some areas the movement is possible exclusively on water boats. "

In the process of surveying inhabitants, 63 of 92 people told scientists about the bite of volatile mice. These people, as well as local vampires, blood samples were taken. The results of the tests were unexpected: antibodies, neutralizing rabies virus, found in seven samples.

The presence of antibodies could be explained by the introduction of anti-libtic (lat. rabies. - rabies) vaccines, but, as it turned out, only one of the seven people received such a vaccine. The rest have risen rabies not only without a deadly outcome, but even without any serious symptoms. In two Peruvian villages, they showed more survivors after this infection than described in all medical literature! It is not surprising that the Gilbert group has rehearsed the received data before you decide to publish them.

"Most likely, there is a unique set of circumstances, when the local population regularly contacts with a special non-fatty strain of rabies virus," says Dr. Gilbert. - The natural vaccination occurs, which is confirmed by highly high antibody titers. However, it still requires additional confirmations and clarifications. "

Her point of view is separated by Russian colleagues. Virologist Alexander Ivanov from the laboratory of the molecular basis of the actions of physiologically active compounds of the Institute of Molecular Biology. V. A. Engelgardta, whom "PM" asked to comment on the find of the CDC experts, stressed that these strange results at first glance may have a completely scientific explanation: "On the basis of available data, it can be assumed that the locals were infected with the variants of the virus, which for a number of available The reasons have a low replicative activity (ability to reproduce) and a low pathogeneity ("poisonousness"). In my opinion, this may be due to several factors. First, each virus has a huge number of options due to its relatively high variability. Infectiousons suggest that even for the successful transition from the bats to other species, the rabies virus must pass several certain mutations. If so, then many virus strains carrying with bats can be low enough for a person. Secondly, mutations in the genome of the virus affect its recognition by the immune system, as well as the possibility of the virus to block the immune response to the infection. At the same time, it is the variants of rabies virus that are capable of eluding the system of congenital immunity, have an increased pathogenicity. Thus, these facts actually suggest existence in a population of bats of such strains of rabies virus, which are on time and are destroyed by the immune system of a person without causing fatal consequences. "

But in no case - this is emphasized by all experts, including the authors of the study - it is impossible to abandon the introduction of an anti-libtic vaccine in the uncens of wild animals. First, it may indeed be that another variety of virus lives in bats, weaker, and the luck of the Peruvian peasants does not apply to strains transmitted with the bites of dogs or raccoons. Second, results and conclusions this study It may be erroneous, so once again, there is no point in the risk.

By the beginning of the 1870s, Louis Paster had already committed a lion's share of his medical discoveries. Over the past 30 years, he has made a significant contribution to the opening of the microbial theory with its works in the field of fermentation, pasteurization, the rescue of the silk-repulsive industry and the final debunation of the theory of spontaneous birth of life.

But at the end of the 1870s, Pasteur was waiting for another epochal discovery, the reason for which he served this time a rather sinister gift: Chicken head. No, it was not a threat and not a cruel joke. The chicken died from bird cholera - a serious infectious disease, whose rampant destroyed up to 90% of chicken livestock in the country.

The vet, who sent the paste the chicken head, believed that the disease was caused by a specific microbe. Soon the scientist confirmed his theory: taking a sample with a dead chicken head, he raised a similar microbial culture in a laboratory and introduced it to healthy helics. Those soon died from bird cholera. This was another confirmation of the consistency of the microbial theory, but the pathoral culture grown by the Pasteur soon played a much more important role in history. In this she was helped by the scattered science and a happy accident.

In the summer of 1879, Paster went to a long trip, completely forgetting about the Bird cholera culture left in an open test tube in the laboratory. Returning from the trip, he introduced this culture to several hen chits and found that the virus lost his deadly properties in many ways: birds, which introduced weakened, or attenuated, bacteria, got sick, but did not die .

However, after this, Pasteur was waiting for an even more important discovery. He waited when the chicken would be approaching the disease, introduced them to the deadly bacteria of bird cholera and found that now they are completely immune to the disease.

Pasteur immediately realized that he opened new method of manufacturing vaccines: Introduction of weakened bacteria emphasized the body with the ability to fight and with active fatal forms.

Discussing this discovery in 1881 in his article printed in the British Medical Journal magazine, Pastera wrote:

"We touched on the basic principle of vaccination. Having overdoned with a virus in a weakened form, the birds were then not affected and after infection with a virulent virus, and turned out to be reliably protected from bird cholera. "

Inspired by this discovery, Pasteur began to explore the possibilities of applying a new approach in the manufacture of vaccines from other diseases. His next success was associated with siberian ulcer.

This disease applied a serious damage to agriculture, lifting the life of 10-20% of the sheep's livestock. Previously, Robert Koh has already proved that the Siberian ulcers cause bacteria. Pasteur wanted to find out if it is possible to weaken them, make harmless, but so that they keep the ability to stimulate the protective forces of the body, which will be introduced in the form of a vaccine.

He achieved the desired result, growing bacteria when increased temperature. When some contemporaries doubted him in his finds, Pasteur decided to prove her right, putting a very spectacular public experiment.

On May 5, 1881, Pasteur introduced 25 sheep their vaccine - new related virus Siberian ulcers. On May 17, he again introduced them more virulent, but still weakened virus. Finally, on May 31, he introduced deadly bacteria of the Siberian ulcers with 25 graft sheeps and 25 more unvacked. Two days later, the crowd of viewers, among whom were members of parliament, scientists and reporters, gathered to see what the experiment end. The result spoke for himself for himself: only one pregnant sheep died from the graft group, from the unansion 23 died and two were close to death.

But perhaps the most famous pasteur achievement in this area was the opening of an anti-libtic vaccine (against rabies) - its first vaccine intended for a person. At that time, rabies were a terrible disease and consistently ended with death.

The cause of the disease was usually becoming a bite of a mad dog, and the treatment methods were one more terrible: the patient was offered to introduce a long hot needle into a wound or sprinkle a bite of powder and set fire. No one knew that it was rabily: the pathoral virus was too small for the then microscopes, and it was impossible to grow in the form of a separate culture.

But Paster was still convinced that the disease excites some microorganism, affecting the central nervous system. To create a vaccine, Pasteur cultivated an unknown pathogen in the brain of the rabbit, weakened it, drying the fragments of the fabric, and used them for the manufacture of a vaccine.

Initially, Paster was not intended to experience an experimental vaccine on a person, however, on July 6, 1885, he had to change his decision. On that day, Nine-year-old Joseph Maceer was delivered to him with 14 bites of a furious dog on the body. The mother of the boy begged Pastera about help, and, having surrendered under her pressure, he agreed to introduce a new vaccine to the child. The course of treatment (13 injections in 10 days) was successful, the boy survived.

After that, although the introduction of a death agent to a person and caused protests in society, another 1500 people received vaccination from rabies for 15 months.

So, in just eight years Louis Paster. not only performed the first major breakthrough in the history of vaccination since Jenner, opening Wiring Attenuation Methods, but and created effective vaccine against bird cholera, Siberian ulcers and rabies.

However, in his advanced work, another unexpected turn was hidden: it was not only in reducing viruses virulence.

How later understood Pasteur, viruses from which it consisted of an anti-executive vaccine was not simply weakened, but dead .

Louis Paster.born on September 18, 1822 in the small French town of Doyle. His father, a veteran of Napoleonic Wars, earned the fact that he kept a small leather workshop. The head of the family did not graduate from school and hardly able to read and write, but for his son he wanted another future. Kozhevannik did not regret money, and after graduating from school, the young Louis was sent to the college, where he continued his education. They say a more diligent student was difficult to find in all of France. Paster showed unprecedented perseverance, and in letters sisters reasoned how much success in the sciences depends on the "desire and labor". Nobody was surprised when, graduating from college, Louis decided to keep the exam in the Higher Normal School in Paris.

With success, passing the introductory tests, Pasteur became a student. The money that brought a leather workshop was lacking for education, so the young man had to work as a teacher. But neither work, nor passion for painting (Pasteur received a bachelor's degree in arts, wrote multiple-portraits who were highly appreciated by the artists of that time) could not distract a young man from passion to natural sciences.

Boy vaccination, branched with a mad dog. Photo: www.globallookpress.com.

Already at 26, Louis Paster received the title of professor of physics for its discoveries in the structure of the structure of wine-acid crystals. However, in the process of studying organic substances, a young scientist understood that his vocation was not at all physics, but chemistry and biology.

In 1826, Louis Paster received an invitation to work at Strasbourg University. Being visiting the rector of Lauren, Paster met his daughter Marie. And after a week after the acquaintance, the rector received a letter in which the young professor asked his daughter's hands. Pasteur saw Marie just once, but was completely confident in his choice. In the letter, he was also reported by the father of the bride that "except good health and the good heart," he has nothing to offer Marie. However, Mr. Laurent for some reason believed in the happy future of his daughter and gave permission to the wedding. Intuition did not fail - Spouse Pasteur lived in consent long years, And in the face of Marie, the scientist found not only his beloved wife, but also a faithful assistant.

Wine and chickens

One of the first works brought by Pasteer fame was a work dedicated to fermentation processes. In 1854, Louis Paster was appointed Dean of the Faculty of Natural Sciences at the University of Lille. There, he continued to study the wine acids, started in the highest normal school. Once in the house of Pastera knocked a rich winner and asked the scientist to help him. Local winemakers could not understand why wine and beer deteriorate. Paster enthusiastically began to solve an unusual task. Having considered the wort, the Paster found that in wine, in addition to yeast fungi, there are also microorganisms in the form of chopsticks. In the vessels where the sticks were present, the wine skeyal. And if the fungi was responsible for the process of alcohol fermentation, then the wands were the culprits of damage and beer. Thus, one of the greatest discoveries was made - Paster explained not only the nature of fermentation, but also made the assumption that the microbes would not be born by themselves, but fall into the body from the outside. Solving the problem of damage to Wine Pasteur began with the creation of the environment, clean from bacteria. The scientist heated the wort to a temperature of 60 degrees to died all microorganisms, and the wine and beer prepared on the basis of this. This reception to this day is used in industry and is called pasteurization in honor of its creator.

Louis Pasteur in his laboratory. Photo: www.globallookpress.com.

Despite the fact that this discovery brought Pasteer recognition, those times were severe for a scientist - three of the five daughters of Pastera died from abdominal typhoid. This tragedy pushed professors to the study of infectious diseases. Exploring the contents of ulneys, wounds and ulcers, Paster opened many infection pathogens, including Staphylococcus and Streptococcus.

Pasteur's laboratory at that time reminded the farm chicken - the scientist revealed the causative agent chicken cholera and tried to find a way to counter this disease. Professor helped the accident. Culture with cholera microbes was forgotten in a thermostat. After the dried virus was introduced to chickens, they, to the surprise of the scientist, did not die, and transferred only a light shape of the disease. And when the scientist infected them again with fresh culture, no symptom of cholera appeared at chickens. Pasteur understood that the introduction of weakened microbes into the body can prevent infection in the future. This was born vaccination. Pasteur called his discovery in memory of the scientist Edward Jenner, who for preventing smallpox injected patients the blood of cows infected with a safe form of this disease (the word "vaccine" comes from Latin VACCA - "Cow").

After a successful experiment with Kuras, Paster has developed a vaccine from Siberian ulcers. The prevention of this disease in cattle saved the Government of France huge money. Pasteer was appointed lifelong pension, he was elected to the French Academy of Sciences.

Mad Dogs

In 1881, the scientist witnessed the death of a five-year-old girl, branched with a mad dog. Seen so struck Pasteur that he with a huge zeal began to create a vaccine against this disease. Unlike most microorganisms, with whom they had to deal with a scientist before, the rabies virus could not exist in itself - the causative agent lived only in brain cells. How to get a weakened form of a virus - this question was worried about the scientist. Pasteurs and nights spent in the laboratory, infecting rabbits with rabies and then beyond their brain. He personally collected saliva of sick animals directly from the mouth.

Professor Personally collected saliva of mad animals directly from the grazing photo: www.globallookpress.com

Close seriously feared for the health of the professor - it also left much to be desired. Over 13 years before, when Pasteer was only 45, he had a heavy stroke, which turned into a disabled scientist. He never recovered after the illness - the hand remained paralyzed, and the leg was dragging. But it did not prevent pasteer to make the greatest discovery in his life. From the dried bunny brain, he created a vaccine against rabies.

The scientist did not risk testing on people until it turned to him a boy's mother, strongly bitten by a mad dog. The child had no chance to survive, and then the scientist decided to introduce him a vaccine. The child recovered. Then, thanks to the Pastener vaccine, it was possible to save 16 peasants skiing with a mad wolf. Since then, the effectiveness of vaccinations from rabies has not been questioned.

Pasteur died in 1895 aged 72 years. For his merits, he received about 200 orders. Pasteur had awards of almost all countries of the world.

Rabies (Rabies)

Historical information about rabies

Framing is known to mankind from ancient times. In the first century BC. Cornelius Celsis gave the disease the name, preserved to the present day, - hydrophobia, and proposed for the purpose of treatment to carry out cautherization (cauterization of the bitten gland site).

In 1804, the German doctor of Zinc proved that rabies can be transferred from one animal to another way of introducing into the blood or under the skin of the saliva of a mad animal.

Rawlistein in 1879 revealed to localize the rabies virus in the nervous tissue. He wrote: "If the saliva poison is infected with the nervous end, then it is satisfied, then will then give a poison along the sympathetic nerves of the spinal cord, and it will reach the brain from it."

Development of rabies vaccine has become a triumph of science and made Louis Pasteur (Pasteur L., 1822-1895) Worldwide famous person. During his lifetime, he was given a monument in Paris.

Louis Paster.

For several years, Pastera went to unsuccessful efforts to highlight the pathogen. We failed and attempts to reproduce rabies causative agent in vitro. By turning to the experiments in vivo, Pastere and its employees (E. Ru, Sh. Shambrlan, L. Perdrey) managed to get a "fixed virulent factor of rabies" by 1884. The next stage of the creation of the vaccine was the search for receptions weakening the rabies causative agent. And by 1885, vaccine against rabies was created and successfully prevented the development of the disease in laboratory animals.

The first tests of the anti-libtic vaccine on a person occurred unexpectedly: On July 4, 1885, a 9-year-old Joseph Meister was delivered to the paster's laboratory with multiple bite of a mad dog. The boy was doomed and therefore a scientist decided to apply his invention. Moreover, after vaccination, Pasteur has introduced a patient an even more virulent virus than the rabies virus of street dogs. According to the scientist, such a reception made it possible to test the immunity caused by vaccination, or significantly accelerate the deadly agony (if the rabies would not have been prevented). The boy did not get sick.

The successful beginning of the vaccination of people Paster reported at a meeting of the French Academy of Sciences and the Academy of Medical Sciences on October 27, 1885. Presiding at the meeting, the physiologist A. Vyulpian immediately raised the question of the immediate organization of the stations network for the treatment of rabies so that each person could take advantage of the opening of Pasteur.

Initially, Paster was convinced of the need to centralize anti-library activities in a single international center. Therefore, patients from around the world began to come to his institute in France, including from Russia. The first half of 1886 became the most severe for Pasteur, since patient mortality arrived in Paris from Russian provinces was depressing and reached up to 82%, despite the intensive course of vaccine therapy. The closest associates and pupils of Pasteur (E. Ru, S. Shambberlan, L. Perdrey) stopped their participation in the vaccination activities, believing that the vaccine against rabies was not yet sufficiently studied.

Pierre Paul Emil Ru

The lack of medical education at Pasteur made it at the slightest failures of the ruthless criticism. In addition, the vaccine against the rabies of Pasteur was in a contradiction with the ideas generally accepted in medicine: the doctors were incomprehensible as the vaccine introduced after infection could have an effect.

Great support (moral and scientific) Pasteer had a young Russian doctor who was sent to Paris to Paris by the Russian Doctors Society, Nikolai Fedorovich Gamaley.

He voluntarily exposed himself intensive course Vaccs against rabies, thereby confirming the safety of the vaccine for a person.

It is our compatriot that drew the pasteur attention that all deaths among vaccinated were statistically statized on the period after the 14th day from the moment of bite. Later Gamalei N.F. I wrote: "I suggested that safety vaccinations can destroy only a poison that did not reach the nervous centers, and powerless against the one that is already in the latter."

Pasteur saw that it was impossible to do with the world's weight by the Pastern Institute, so he agreed to the opening of Pasteur stations in other countries and first of all contributed to the institution Odessa (opened in May 1886)

Like any new biological agent, vaccinations against rabies were not deprived of some flaws and pastere himself had to face post-specific complications. Pasteur first pointed to the leading role of the human body itself (and not vaccine) in the post-specific complication, and also allocated a number of additional nonspecific stimuli: alcohol consumption against the background of vaccination, overwork, infectious diseases, etc.

Live Pasteur vaccine was used for many years. For example, in the USSR - until 1925, in France - until 1948, Paster himself did not consider the living vaccine committed and in 1887 in the "letter of rabies" addressed to the editor of Annala Pasteur Institute magazine, spoke about the prospects Development of an inactivated vaccine.

Frenzy is an infectious disease with a guaranteed fatal. The only opportunity to avoid death is vaccination.

Every year on planet, rabies takes lives more than 55 thousand people (mainly in Africa and Asia). In Russia, about 10 people die annually from rabies. And if atypical pneumonia, which was presented as a new world threat, was the cause of death in 2003 in China 348 patients, then rabies gathered his deadly harvest in 490 people.

Etiology and carriers

The rabies causative agent is a neurotropic virus of the Rabdarus family (Rabdoviridae), the genus of Lissevirus (Lyssavirus), contains RNA. The rabies virus causes degenerative damage to neurons and is accompanied by the formation of specific cellular inclusions (Babez-Negri Babes).

The rabies virus is unstable and just withstands only low temperatures. In a frozen state, about 4 months can be maintained, in the rotting material - 2-3 weeks. Boil kills rabies virus after 2 minutes. Therefore, the clothing churred as a result of the bite or the clothed animal needs to boil.

It is possible to infected with rabies from a sick animal. From a person to a person, the rabies virus is not transmitted, although in some cases the infection is possible (there are cases of infection with rabies during the corneal transplantation).

The rabies virus affects all types of warm-blooded animals, so the carrier can be any animal.

The most dangerous as carriers of wild animals are foxes (main infection reservoir), wolves, raccows, jackals, badgers, bats. From home - cats and dogs. Rodents (proteins, rabbits, mice, rats, guinea pigs) Present a smaller danger.

Pathogenesis

The rabies virus as a result of the bite or fascinating damaged skin with the patient animals enters the body. For a while (6-12 days), rabies virus is located at the injection site, then it moves along the nerve fibers to the spinal and brain. I am accumulating and breeding in neurons, the rabies virus causes fatal encephalitis.

The probability of fatal outcome (as well as the duration of the incubation period) depends on the place of bite. For example, when bites in the face, the probability of getting sick (and, it means, it is guaranteed to die of 90%), with bitees in hand brushes - 63%, with bites in the lower limbs - 23%. That is, the better the body of the body is inexpaning, where the bite occurred or stroke, the faster the virus enters the central nervous system.

• Dangerous localization bits: head, neck, brushes and fingers.
• Bitches of non-hazardous localization: torso, legs.

It is important to know that for 3-5 days before manifestation clinical symptoms Diseases The rabies virus falls into salivary glands. So, at the time of contact with the animal, it may be even externally healthy, but saliva will already be contagious.

Symptoms of rabies in humans

From the moment of infection (bite or stalk) to the first signs of rabies usually passes from 10 days to 2 months. The incubation period can be reduced to 5 days and lengthen up to 1 year. After the appearance of symptoms, the patient will not be able to save.

Freshness in humans is divided into 3 phases.

1. Promotional phase (forerunner). In 50-80% of patients, the first signs of rabies are always associated with the place of bite: pain and itching appears, the scar will drink again and blushes. Other Symptoms: Subfeper Body Temperature, General Havigation, headache, nausea, difficult to swallowing, lack of air. There may be an increase in visual and hearing sensitivity, unreasonable fear, sleep disorders (insomnia, nightmares).

2. Encephalitium phase (excitation). After 2-3 days, the excitation period is developing, for which periodic attacks of painful spasms (seizures) of all muscles arising from the slightest stimulus are characteristic: bright light (photophobia), noise (acoustofobia), air whiff (aerophobia). Sometimes in this stage, against the background of attacks, patients become aggressive, shouting, swarming, tear clothes, break the furniture, discovering inhuman "frantic" power. Between the attacks often comes nonsense, auditory and visual hallucinations.

The body temperature rises to 40-41 degrees, tachycardia is sharply expressed, the postural decrease in blood pressure, elevated tears, sweating and sowing (abundant separation of saliva). Difficulty swallowing saliva and foaming it with air when swallowing characteristic symptom rabies - "foam of mouth".

Following the acute encephalitis, stem symptoms develop. The corneal reflex disappears, the pharyngeal reflex disappears. Hydrophobia is developing - convulsive cuts of swallowing muscles at the sight of water or sounds of pouring water.

The appearance at an early stage of the disease symptoms of the brain stem dysfunction is a distinctive feature of rabies from other encephalitis.

3. Final phase (paralysis). If the patient did not died from the long spasm of the respiratory muscles, then after 2-3 days the disease passes into last stadium, which is characterized by the development of paralysis of the limbs and the increase in stem symptoms in the form of the defeat of the cranial brain nerves (diplopia, paralysis facial nerve, neuritis optic nerve), violation of the function of the pelvic organs (priapism, spontaneous ejaculation). Psychomotor arousal and convulsions weaken, the patient can drink and eat, breathing becomes more calm ("ominous soothing"). After 12-20 hours, death comes from the paralysis of the respiratory center or stop the heart, as a rule, suddenly, without agony.

The total duration of the disease does not exceed 5-7 days.

Freshness in a person can flow without expressed excitation phenomena, the so-called quiet rabies. This form is characterized by the development of paralysis usually by the type of Landry ascending paralysis. Most often, such symptoms of rabies in humans are found in South America in the bite of volatile mice. Bat, possessing thin and sharp teeth, Maybe a person is imperceptible to him (for example, during sleep) and it seems that rabies arose without any reason.

You should know that rabies leaves no chance of life to the victim. This is a deadly disease with a 100% warranty. Therefore, it is important to prevent the risk of its development by timely vaccination.

Diagnosis of rabies

Diagnosis confirmation methods

The diagnosis of "rabies" is raised clinically on the basis of anamnesis. Even in developed countries, it is very difficult to confirm the rabies to firmly. This is usually done posthumously:

• Detection Taurus Babez-Negri in the study of brain biopsy.

• Detection of rabies rabies virus antigen in cells using ELISA.

• The formulation of the biological test with infection of the newborn mice virus from the suspension of brain tissue or submandibular glands.

Work with infected material should be carried out in compliance with all the rules envisaged for pathogens of particularly dangerous infections.

Due to the lack of lifetime laboratory diagnostics The atypical paralytic form of rabies (when there is no hydrophobia and excitation, "quiet rabies") is almost not diagnosed. Contact with infected animals also detected to find out not always.

In 2008, the international team of scientists led by Dr. Laurent Dacheux from the Pasteur Institute in Paris proposed to explore the skin biopsy with the nest reverse transcriptase polymerase chain reaction for the prompt detection of rabies virus L-polymerase. For the study, biopsyttes of the rear-upper surface of the neck were used (precisely there, in the nerve endings surrounding hair follicles, there are nucleocapsides of the virus). This PCR method showed very high specificity (about 98%) and sensitivity (100%), and from the first day of the appearance of rabies and to death, regardless of the day of sampling. The authors believe that such a study should be carried out by all patients with encephalitis of unclear origin.

Differential diagnosis

Most often have to differentiate rabies from tetanus. The tetanus differs from the rabies anamnesis (injury, burn, criminal abortion, etc.), the lack of impaired psyche (consciousness during the tetanus is always preserved), excitation, sowing, hydrophobia. Patients with tetanus do not disappear corneal and pharyngeal reflexes.

Viral encephalitis differs from rabies on the clinic and an epidemiological history. Begins, as a rule, sharply high temperatures, intoxication. There is no hydrophobia, aerophobia. Never develop stem symptoms in the first week of the disease.

Other similar diseases: atropine poisoning, dissociative disorders.

First aid for busted wounds

The first medical assistance to persons who applied for bites, scratches, exploring any animals, as well as drone damage to the skin when opening the corpses of animals that fell from rabies, or the opening of the corpses of people who died from hydrophobia provide all therapeutic and preventive institutions (we are not talking about vaccination ).

Local processing of wounds

Local wound treatment is extremely important. The earlier and carefully after the damage will be cleaned by the bite wound, the greater the guarantees that the rabies virus will be "washed away" from the wound. Local processing of the wound in no way excludes subsequent immunization.

1. I immediately and rinse the wound, scratches and all the places that the animal saliva got, soapy solution (Soap partially inactivates the rabies virus), then with pure water water, followed by treatment with hydrogen peroxide solution. Urgent and thorough watering of wound with water with soap prevented rabies disease in 90% of experimental animals.

2. Processing the edges of the wound 5% of iodine tincture or diamond greenery solution. The wound itself is not causing any solutions.

3. After processing, a gulling aseptic bandage is superimposed. It is advisable to use modern gigroscopic materialswho do not stick to the wound.

Attention! The Alphabet of Rabiology prohibits the penetration into the bite wound with acute objects (surgical excision of the edge of the wound, any cuts, seams) during the first three days after the bite.

Because of particular purulent complications, the busted wound is not sewn, except for the cases of a large wound defect, (when the skin seams are applied) and head bites (this area is well suited). Firmating bleeding vessels in order to stop outdoor bleeding is permissible.

4. The question of the emergency prevention of the tetanus and the need to carry out the antimicrobial treatment of the busted wounds should be resolved.

5. To send the victim to the traumatology item to appoint an anti-executive vaccination course and the administration of immunoglobulin. Inform every patient about possible consequences Failure from vaccinations and risk to get rabies, watching animals. In the case of unreasonable behavior of the patient, make a refusal to provide anti-policy assistance in the form of a written receipt of a patient, certified by the signatures of two medical workers (about each case of refusal should notify local organs State-poidnadzor).

Complications of branched wounds

The busting wound is caught more often than the wound of another origin 2-4 times. In addition to entering flora from the environment, the busting wound always contains the microflora of the oral cavity of the animal. In the latter case, it is both aerobic (Staphylococcus Aureus, Streptococcus Viridans) and anaerobic microorganisms. By the way, punctures from teeth are more often infected and easier than tangible wounds.

The bite of a dog or cat is distinguished by a long healing. Bite Place Bounce Leads to Healing Wounds secondary tensionWhat contributes to the formation of coarse deforming scars.

Inflammation and wound suppuration occurs within 24-48 hours. Infectness can lead to abscess, osteomyelitis, septic arthritis and meningitis.

For the prevention of suppuration of busting wounds, an inhibitor-protected penicillins should be used in the shortest possible time since the bite. For example, amoxicillin / clavulanate with a course of 5 days for the purpose of prevention in the early circulation or 7-10 days for the purpose of treatment with late treatment. The purpose of such antibiotics even a very short course in most cases allows you to prevent the reproduction of all bacteria in the wound at the time of the bite, and thereby avoid inflammation and suppuration. True prophylactic should be considered the appointment of an antibiotic in the earliest time, namely within 2 hours from the moment of bite.

Vaccine against rabies

Frenzy is an incurable disease. After the appearance of the clinic to save the patient does not succeed. Specific therapy is absent. The patient is simply placed in a separate ward with protection from external stimuli and is carried out only symptomatic treatment (sleeping pills, anticonvulsant, morphine in large doses).

To date, only 3 reliable cases of recovery of people from rabies (laboratory confirmed) and 5 not confirmed by laboratory are known in the world. In the first three cases, the treatment was built on combinations of antiviral drugs, sedatives and injection anesthetics to create an artificial coma. This technique was named "Milwaukee Protocol" and was first applied to the United States in 2004 to treat 15-year-old American Gis (Jeanna Giese).

Post-contact vaccination

Primary anti-library assistance is provided by a surgeon (doctor-traumatologist) of the Center for Anti-Rubic Assistance (according to the order of the Ministry of Health No. 297 of October 7, 1997). The vaccine against rabies is introduced on the first day of appeal to the trauma art.

About courses from 20-30 vaccinations under the skin of the belly can be forgotten. Since 1993, in practice, a concentrated purified culture anti-liblate vaccine (COCA) has been used, which made it possible to reduce the vaccination rate and reduce a one-time vaccination dose.

The usual dose is 1.0 ml intramuscularly: adults and adolescent vaccine against rabies are introduced into the deltoid muscle, children - in the outer surface of the hip. Cannot be introduced into the buttock muscle!

The vaccination scheme includes five intramuscular injections: on the day of appeal (0th day), on the 3rd, 7th, 14th and 30th days from the start of the course. Some patients introduce additional sixth injection on the 90th day.

Vaccine against rabies warns the occurrence of the disease in 96-98% of cases. But vaccination is effective only at the beginning of the course no later than the 14th day from the moment of bite. Nevertheless, the immunization course is prescribed even a few months after contact with sick or suspicious animal rabies.

Antibodies appear 2 weeks after the start of vaccinations, reaching a maximum in 30-40 days. In this regard, where you can think about a short incubation period (Bends in the head, neck, brushes and fingers of hands, multiple bites) An anti-libric immunoglobulin is introduced (see below).

Immunity becomes an effective approximately 2 weeks after the end of the vaccination course. The duration of post permanent immunity is 1 year.

Only a full course of vaccination allows you to prevent an imminent deadly outcome. Paradoxically, but if you have effective tools (Vaccine against rabies, immunoglobulin) People continue to die. As a rule, many victims either do not know, or do not attach the values \u200b\u200bof danger, not addressing medical care or refusing to the proposed vaccination (approximately 75% of all those who died from rabies). About 12.5% \u200b\u200bof deaths arise through the fault of medical workers who incorrectly evaluate the testimony to appoint the vaccination course. And another 12.5% \u200b\u200bof deaths fall on patients who independently overeat the course of anti-policy immunization or violate the prescribed regime.

It should be remembered that during the entire course of vaccination and within 6 months after its end (totaling 7-9 months) strictly contraindicated: Reception alcoholic beverages, physical overwork, overheating in the sun or in a bath / sauna, supercooling. All these factors weaken the effect of the vaccine, reduce the production of antibodies and undermine immunity. In the case of vaccination against the background of recreation of corticosteroids and immunosuppressants, the determination of the level of antibodies is mandatory. In the absence of antibodies, an additional treatment is carried out.

The vaccine against rabies is moved well. Side effects are observed only in 0.02-0.03% of cases in the form of light allergic reactions (rash).

For post-contact vaccination there are no contraindications, since the disease is deadly. Therefore, despite the pregnancy or acute pathology, victims need to vaccinate.

WHO experts depending on the depth of skin damage and the number of bites allocate three categories of contact. In my opinion, tactical situations are advisable to modify as follows.

1. Infection is unlikely

The rabies vaccine is not introduced when the possibility of infection is excluded:

• touch and flashing animal intact skin;
• bite through a dense thick tissue without its end-to-end damage;
• the wound with the beak or cogs of the bird (in animals, in contrast to birds, saliva can remain on the paws);
• consumption of milk or meat of mad animals;
• bite with pets, grafted from rabies for 1 year and having any manifestations suspicious to rabies.

The last item concerns only non-hazardous leakage of bite. With dangerous localization (face, neck, brushes, fingers of the hands) or multiple bite, the course of 3 vaccinations is shown, because There are cases of rabies transfer by animals, even grafted from this disease.

After the bite, it is necessary to establish an animal observation. And if for 10 days it appears signs of rabies, it is necessary to start a vaccination rate, even if the attacker animal was vaccinated.

2. Infection is possible

The vaccine against rabies is introduced when an unqualified homemade or wild animal bitten, caused scratches, or his saliva fell on the damaged skin.

If the estate animal is known (home), then you should trace his further fate for 10 days. During this time, a person has time to get 3 preventive vaccines. Vaccinations against rabies stop if after 10 days the animal remains healthy or it died (for example, shot), and in the study of the animal's brain, the corresponding morphological picture of rabies was found.

The full course of vaccination is carried out:

• when to check the condition of the animal is impossible (convinced earlier 10 days);
• if there was a contact with wild animals. Wild animals (foxes, wolves, bats, etc.) are considered initially infected rabies.

At the same time, if a person has previously received a complete course of vaccination against rabies, from which no more than 1 year has passed, then there are three injections of 1 ml on the 0th, 3rd and 7th day. If 1 year passed and an incomplete vaccination course was conducted, then a full course is prescribed.

Anti-cancer immunoglobulin

Immunoglobulinotherapy is starting within 24 hours after possible infection (but no later than 3 days after contact and before the introduction of the third dose of the vaccine on the 7th day). The usual dose of homologous (human) immunoglobulin is 20 me / kg, one-time.

At the same time, one half of the dose is used to slip the tissues around the bite wound (possibly irrigation of the wound), the second half is injected intramuscularly in the front-outer surface of the upper third of the thigh (immunoglobulin can be administered to the buttock muscle).

You can not use the same syringe for the introduction of immunoglobulin and vaccines! Indications for a combination of rabies vaccine with immunoglobulin administration:

• deep bite (with bleeding),
• several bites,
• dangerous Localization of bites (head, neck, brushes and fingers hands).

Prevention of rabies

In the conditions of a dysfunctional epidemiological and epizootic situation, rabies increase the role of preventive vaccination of not only people professionally related to the risk of infection with rabies (veterinarians, dogs, huntsman, laboratory technicians, speleologists), but also the total population, especially in the spring-summer period, when the probability increases Contact with wild or stray animals.

Scheme of prophylactic immunization:

• primary immunization - three injections on the 0th, 7th and 30th day of 1 ml
• primary revaccination after 1 year - one injection in 1 ml
• subsequent revaccination every 3 years - one injection of 1 ml

Contraindications for preventive immunization:

• the intolerance of the antibiotics of the Aminoglycoside group,
• acute diseases (infectious and non-infectious),
• chronic diseases in the aggravation stage
• pregnancy.

Fully eliminate rabies (destroy the circulation of the virus in nature) is hardly possible. Therefore, so far there are carnivorous animals, the danger of infection with rabies of a person cannot be excluded. But it is possible to carry out preventive measures among animals:

• In natural foci of rabies, the density of the population of wild animals is envisaged, mainly by their extermination by hunters. It is believed that the optimal number of foxes or wolves should not exceed 1-2 individuals per 10 square kilometers.
• Communal services of settlements should be engaged in catching stray dogs and cats followed by euthanasia and cremation.
• Owners of animals should take care of the registration of their pets, labeling them with electronic devices or at least a toe on collar, as well as mandatory annual preventive vaccination against rabies.