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Rabies is an acute viral disease of warm-blooded animals, characterized by damage to the central nervous system, which is expressed by bouts of arousal and the development of paralysis.
Etiology. The causative agent of the disease is RNA-genomic, complexly bullet-shaped. It belongs to the Rhabdoviridae family, the genus Lysavirus. It reproduces in the cytoplasm of nerve cells, where Babesh-Negri inclusions are formed.
In the saliva secreted by sick animals, the virus lasts up to 24 hours, in a rotting corpse for 2 weeks, in soil for 2 months. Boiling destroys the virus instantly, at 60 ° C inactivation occurs after 5 minutes. The virus is not resistant to the action of disinfectants: 1-5% formalin solutions inactivate it in 5 minutes, 5% phenol solution in 5 minutes.
Epizootology. All kinds of domestic and wild animals, as well as humans, are susceptible to rabies. Young animals are more sensitive than adults.
There are two epizootic types of rabies: forest natural (sylvanic), supported and distributed by wild animals; urban (urban), observed among stray dogs, cats and other domestic animals, which is now almost eliminated. Leading is forest madness. Currently, rabies is considered as a natural focal disease of wild animals, periodically brought into the sphere of domestic animals.
The source of the causative agent of infection are sick animals, as well as virus carriers, which release the pathogen 2-10 days before the onset of clinical signs of the disease and within the 31st day after recovery. Foxes are the main reservoir of the virus. The transmission of the rabies virus occurs mainly through saliva during the bite (in the salivary glands, the virus is found in 54% of the dogs that died from rabies). The most dangerous are deep, extensive lacerated wounds, the front part of the head and body parts rich in nerve fibers. Infection is also possible if saliva enters the mucous membranes and the damaged surface of the skin.
A rather strict cyclical nature of epizootic upliftment was noted, which depends on the number of wild animals, the activity of their migration, the presence of mouse-like rodents and their number. The frequency of outbreaks is two, in some cases three years. The seasonality of the disease is related to the biology of wild carnivores. The incidence of foxes can be over 76% of cases, dogs up to 72%.
Pathogenesis. Once in the body, the virus along the nerve fibers, centripetally moves to the synapses of the spinal cord and brain, where it is reproduced, causing non-purulent encephalitis. After this, the centrifugal movement of the pathogen into the salivary glands begins.
Symptoms and course. The incubation period can vary from a few days to a year, but most often it is 3 weeks. Its duration is largely due to the proximity of the bite to the head, the size and depth of the wound, the amount of virus that has entered and the individual resistance of the organism.
The course of the disease is acute, lasting 3 - 11 days.
By the nature of the manifestation of the disease, there are two forms: violent and silent (paralytic). In addition, atypical and abortive and recurrent (remitting) forms of the disease are possible.
In the violent form, three stages of development of the disease are clearly expressed: prodromal (melancholic), arousal (manic) and paralysis (depressive).
The prodromal stage lasts for 1.5 days and is characterized by a change in the behavior of the dog, which is expressed in the following: it becomes less attentive to the owner, does not immediately respond to the call, hardly rises; often becomes unusually affectionate, begins to lick the hands and face of the person (owner); Her eyes are dull, indifferent, absent, her eyes are dull. In the process of disease progression, the animal tries to hide in a dark corner, grabs the air (catches flies); there is a perverted appetite (swallows stones, pieces of wood, paper, own feces, etc.). Sometimes an itch appears at the site of the bite, which is accompanied by fierce scratching. By the end of the second day, there is a disorder in the act of swallowing; the dog does not touch the feed, does not drink water, barks hoarsely, there is a heavy drooling.
The stage of excitement lasts for 3-4 days and is characterized by: pronounced bouts of violence; desire to break the chain and run away from home; rushes at other animals, aggression sharply increases, she attacks other dogs without barking and mercilessly bites them. A sick dog is very thirsty, but cannot drink, as a result of a convulsive contraction of swallowing muscles and sharp pain, at the sight of water, the dog becomes enraged and becomes very agitated.
The paralytic stage lasts 2 days and is characterized by the development of paralysis of the muscles of the hind limbs, trunk and tail.
She may return to the owner. Such an animal is highly emaciated, the hair is disheveled, the eyes are deeply sunken, the lower jaw is saggy, the tongue falls out, and saliva is plentifully flowing from the mouth. Gait becomes shaky, then the animal cannot rise at all. Death occurs on the 6-11th day from the onset of the disease.
With a quiet form in dogs with complete absence of aggressiveness, paralysis of the muscles of the lower jaw, pharynx, hind limbs quickly develops, there is a strong drooling, difficulty swallowing. The dog behaves calmly, does not respond to stimuli, to the call of the owner. Obstructed breathing and excessive salivation create an impression among unknowing people that the dog has choked with something. Attempts to help may cause infection. This form is more often observed during infection from foxes. The main symptoms of the disease are, in addition to the above, dilated pupils, a “meaningless” look, a shaky gait and a perverted appetite.
In cats, rabies is usually a violent form. At the onset of the disease, anxiety, distorted appetite, severe drooling, difficulty swallowing are noted. Cats, enclosed in cages, violently rush to the stimulus. Quiet form they are extremely rare.
In wild animals, the most characteristic signs are the loss of a sense of fear of people and aggressiveness. No hydrophobia. From the point of view of the danger of infection, the silent form of rabies is of particular importance.
Pathologic diagnosis. An autopsy reveals the following: the presence of ragged wounds and foreign objects in the stomach. Hemorrhages and erosion in the gastric mucosa, venous hyperemia of the liver, lungs and spleen.
Diagnosis. The preliminary diagnosis is established taking into account the epizootic situation and characteristic symptoms. The final diagnosis is established by the results of laboratory studies. To do this, a fresh corpse and an animal’s head or brain are sent to the laboratory. The diagnosis is considered established when receiving positive results in the FTA; if Babesh-Negri inclusions are detected in the light microscope; with a positive bioassay (set when receiving negative results of light and luminescent microscopy).
Rabies must be distinguished from Aujeszky's disease (scratching is detected, there is no aggressiveness and paralysis of the lower jaw, no Taurus Babesh-Negri), and plague (conjunctivitis, the absence of aggressiveness and paralysis of the lower jaw, the presence of pneumonia and enteritis).
Treatment. Sick animals are killed. The corpses are burned.
Prevention and control measures. Preventive measures against rabies include streamlining the maintenance of dogs and cats and regulating the number of wild predatory animals; preventive vaccination of dogs, cats, etc .; timely diagnosis in patients; identification and elimination of foci of the disease; Explaining to the public the nature of the disease and the rules for keeping animals.
All dogs, regardless of their affiliation, and in the necessary case and cats vaccinated against rabies rabies vaccine.
To prevent rabies, citizens are obliged to: follow the established rules for keeping dogs, cats, fur animals and predatory animals; deliver dogs and cats belonging to them to a veterinary institution for examination and safety vaccinations; Do not allow dogs, cats not vaccinated against rabies, fur farms, dog nurseries, hunting or other. Each case of dog bite by wild animals, dogs, cats or suspected of having a rabies disease should be reported immediately to the veterinary specialist, and animals suspected of being ill or bitten by stray dogs (cats) and wild predators, it is safe to isolate.
Dogs, cats and other animals that bit people or animals are IMMEDIATELY delivered by the owner to the nearest veterinary institution for examination and quarantine under the supervision of a specialist for 10 days, which are carefully inspected at least 3 times a day.
In the event of a diagnosis, the locality or part of it is declared unfavorable and is quarantined. Obviously sick dogs and cats, as well as animals suspicious of the disease are subject to destruction. Corpses are burned, skinning is prohibited.
The places where animals, sick and suspicious of rabies disease were found, items of care, overalls and other equipment contaminated with saliva and secretions of animals suffering from rabies, are disinfected.
Quarantine, removed after 2 months from the date of the last case of animal disease by rabies and the implementation of activities under the plan.
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Educational task: using the algorithm, determine the clinical stage of rabies, conduct a differential diagnosis; appoint therapeutic measures for emergency care and treatment at the hospital stage. The task for self-study. Using the textbook, "Guide to Infectious Diseases", lecture material and a list of recommended literature for acquiring the necessary basic
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Rabies. pathogenesis. symptoms and course. diagnosis and differential diagnosis. prevention. Rabies (rabies, lyssa, hydrophobia) is a viral disease that occurs with severe damage to the nervous system and is usually fatal. The disease is known to mankind for several millennia. First described by C. Celsus in the I century. n e. In 1885, L. Pasteur received and
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