Rabies

如何获得Rabies？

Rabies is transmitted to humans through close contact with the saliva of an infected animal. Most human infections result from the bite of an infected dog or cat. Several kinds of bats may also transmit rabies. It is very rare that humans become infected with rabies from wild monkeys, foxes, raccoons, skunks, jackals and wolves. Livestock, horses and deer can also become infected with rabies and potentially transmit the virus to other animals or people, however, this rarely occurs.

易感性和抗性

Humans are generally more resistant to infection with the rabies virus after exposure than some other mammals.  Nevertheless, all first aid and preventative measures should be followed since the illness, if acquired, is almost universally fatal.

症状是什么？

The initial symptoms of rabies are flu-like, including fever, headache, and fatigue. The disease then progresses to involve the respiratory, gastrointestinal and/or central nervous system. In the critical stage of rabies, signs of hyperactivity or paralysis occur. Partial paralysis can eventually progress to complete paralysis, followed by coma. Spasms of swallowing muscles can occur when stimulated by the sight, sound, or perception of water, resulting in hydrophobia (fear of water). Delirium and convulsions can also develop. If the symptoms of rabies are allowed to occur, the disease will be fatal in nearly 100 percent of all cases, usually due to breathing failure due to paralysis. Death will occur during the first seven days of illness if not properly treated.

预防措施

避免与动物直接接触，特别是不接触或喂养任何动物（包括狗和猫），并密切监管所有动物周围的儿童，可以有效地预防狂犬病。有一种有效的狂犬病疫苗。应当考虑进行狂犬病疫苗接种的人员包括：兽医，长期旅行者和居住在高暴露风险地区的人员；可能参与使其与蝙蝠，狗和其他哺乳动物直接接触的活动的野生动植物专业人士，研究人员或冒险旅行者。具体的预防措施包括：可能接触狂犬病后：最近的研究表明，4剂细胞源性疫苗（人二倍体细胞疫苗[HDCV]或纯化的鸡胚细胞疫苗[PCECV]组合使用）狂犬病免疫球蛋白（RIG）产生足够的免疫反应，并且第5剂疫苗不能增强免疫反应如果在狂犬病暴发前未接种疫苗：建议同时使用RIG和疫苗进行叮咬和非叮咬暴露。应通过以下方式肌肉注射HDCV或PCECV疫苗降低的疫苗接种时间表：·第一剂：暴露后尽快（第0天）；·第二剂：第3天；·第三剂：第7天；和·第四剂：第14天此外，应在伤口部位及其周围注射RIG小心，有力地清洁伤口是预防狂犬病的重要组成部分如果以前在狂犬病暴发前已接种疫苗。 s：建议采用2剂治疗方案，具体如下：·第一剂：第0天； ·第二剂：第3天。不需要使用RIG，也不应使用。仔细，剧烈地清洁伤口是预防狂犬病的重要组成部分。 在暴露于狂犬病之前： 对于暴露前疫苗接种，建议使用3剂方案，具体如下：·第一剂：第0天； ·第二剂：第7天； ·第三剂量：第21或28天。特别注意事项：对于免疫系统受损的人（例如，HIV，器官移植受者等），建议在接触后进行5剂量的疫苗接种，其中1剂量的RIG狂犬病。来源：http：//www.cdc.gov/rabies/resources/acip \ _recommendations.html动物疫苗接种，尤其是流浪狗的疫苗接种，可以消除狂犬病向人类和其他动物的传播。家畜和一些野生动植物的疫苗接种已导致在几个发达国家和发展中国家大大减少了该疾病的发生。

处理

Rabies can be avoided if the wound of the bite or scratch is cleansed quickly and vigorously and then followed by the injection of rabies immune globulin (a preparation containing antibodies against rabies), plus a series of rabies vaccine injections immediately after the contact with a rabid animal. (See Preventative Measures)

If these precautions are taken promptly, onset of the symptoms of the disease (and nearly certain death) can be prevented in virtually 100 percent of exposures.  Once symptoms have developed, only the most heroic supportive therapy has managed to save a few people.

疫苗接种

• 狂犬病疫苗

它常见于哪里？

狂犬病在世界每个大陆上都可以找到。很难预测狂犬病可能发生的地方。由于对家畜（如狗）和野生动物（如蝙蝠，浣熊等）进行了疫苗接种，许多国家没有狂犬病。已知以下地区没有狂犬病：加勒比群岛；香港;日本;科威特;卡塔尔新加坡;阿拉伯联合酋长国；大多数欧洲国家；和澳大利亚。南美以及非洲和亚洲部分地区最近人类狂犬病死亡人数的增加表明，狂犬病可能会作为一个严重的公共卫生问题重新出现。