Rabies

您如何獲得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.

易感性和抵抗力

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.

有哪些症狀？

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.

預防措施

避免與動物直接接觸，特別是不接觸或餵養任何動物（包括狗和貓），並密切監管所有動物周圍的兒童，可以有效地預防狂犬病。有一種有效的狂犬病疫苗。應當考慮進行狂犬病疫苗接種的人員包括：獸醫，長期旅行者和居住在高暴露地區的人；可能參與使其直接與蝙蝠，狗和其他哺乳動物直接接觸的活動的野生動植物專業人士，研究人員或冒險旅行者。具體的預防措施包括：可能接觸狂犬病後：最近的研究表明，4劑細胞源性疫苗（人二倍體細胞疫苗[HDCV]或純化的雞胚細胞疫苗[PCECV]組合使用）狂犬病免疫球蛋白（RIG）產生足夠的免疫反應，並且第5劑疫苗不能增強免疫反應如果在狂犬病暴發前未接種疫苗：建議同時使用RIG和疫苗進行叮咬和非叮咬暴露。應通過以下方式肌肉注射HDCV或PCECV疫苗降低的疫苗接種時間表：·第一劑：暴露後儘快（第0天）；·第二劑：第3天；·第三劑：第7天；和·第四劑：第14天此外，應在傷口部位及其周圍注射RIG小心，有力地清潔傷口是預防狂犬病的重要組成部分如果以前在狂犬病暴發前已接種疫苗。 s：建議採用2劑治療方案，具體如下：·首次給藥：第0天； ·第二劑：第3天。不需要使用RIG，也不應使用。仔細，劇烈地清潔傷口是預防狂犬病的重要組成部分。 在暴露於狂犬病之前： 對於暴露前疫苗接種，建議使用3劑方案，具體如下：·第一劑：第0天； ·第二劑：第7天； ·第三劑量：第21或28天。特別注意事項：對於免疫系統受損的人（例如，HIV，器官移植受者等），建議在接觸後進行5劑量的疫苗接種，其中1劑量的RIG狂犬病。來源：http：//www.cdc.gov/rabies/resources/acip \ _recommendations.html動物疫苗接種，尤其是流浪狗的疫苗接種，可以消除狂犬病向人類和其他動物的傳播。家畜和一些野生動植物的疫苗接種已導致在幾個發達國家和發展中國家大大減少了該疾病的發生。

治療

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.

疫苗接種

• 狂犬病疫苗

通常在哪裡發生？

狂犬病在世界每個大陸上都可以找到。很難預測狂犬病可能發生的地方。由於對家畜（如狗）和野生動物（如蝙蝠，浣熊等）進行了疫苗接種，許多國家沒有狂犬病。已知以下地區沒有狂犬病：加勒比群島；香港;日本;科威特;卡塔爾新加坡;阿拉伯聯合酋長國；大多數歐洲國家；和澳大利亞。南美以及非洲和亞洲部分地區最近人類狂犬病死亡人數的增加表明，狂犬病可能會作為一個嚴重的公共衛生問題重新出現。