Rabies vaccination for humans

Photo: simptomyinfo.ru
Victoria Mamaeva

Chief editor of Filzor. Specialist in the field of Pharmacy

Mikhail Lebedev

Leading expert of the Research Institute of Epidemiology of Rospotrebnadzor

Doctors say that every year on the planet the number of rabies victims among humans alone is more than 50 thousand. Almost half of the cases are children and adolescents. The disease is fatal, and the only way to escape from it is to receive an anti-rabies vaccine .

Rabies is a viral disease that affects the nervous system. Without adequate treatment, the probability of death is estimated at 100%. A person usually becomes infected through close contact with an infected animal. Immediately after the pathogen enters the body, an incubation period begins, lasting from a week to a year. Most often, the duration of the incubation stage is from a month to three, with the first signs usually visible by the eighth week of infection.

The suspected diagnosis is confirmed based on laboratory tests. True, they will find out how to vaccinate a person against rabies before the results are ready: they cannot delay.

Stereotypes say that you can become infected through contact with dogs, and sometimes cats and foxes. In fact, the list is much wider. Any mammal is a potential source of risk. The disease can be transmitted by livestock - cows, horses. Infection occurs through contact with the saliva of an infected individual. The virus is transmitted even if the incubation period is still ongoing, so rabies vaccinations after a bite are necessary even if the animal seemed completely healthy.

Rabies virus, rabavirus (Rabies lyssavirus). Photo: dotphoto.com

It has been established that the disease occurs in more than 160 countries. The virus exists on all continents except Antarctica. Preventive measures against it were first actively carried out in Australia and Europe, Japan and the UK. Some countries are considered particularly safe. These include Finland, Slovakia and Belgium. But cases of infection are consistently observed in our country, in Ukraine, in Belarus. The situation is considered unfavorable in both Croatia and Lithuania, where people also sometimes find themselves in quarantine after being vaccinated against rabies, if the doctor sees the need for it.

This is interesting: where are the most dangerous houses? In our country, both wild and domestic animals often suffer from rabies. In 2016 alone, more than 2,000 sick individuals were observed. The most dangerous regions were the capital and the areas around: Ivanovo, Kaluga, Smolensk, Voronezh, Belgorod. The disease is most often recorded in foxes, followed by dogs, and cats close the top three.

Prevention of rabies

To minimize risks, you need to follow simple rules of behavior. All pets must receive vaccinations, information about which is recorded in a personal card. When purchasing a new animal, you must obtain a certificate from a veterinarian. Any animal taken from the street is a potential source of danger, so it must be immediately shown to a specialist. Wild animals must be avoided both in the city and in nature. If potential contact occurs, you should immediately, without delay, consult a doctor in order to receive a course of rabies vaccinations.

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Animal rabies can be atypical, violent or silent. In humans, the disease after the incubation stage manifests itself with fever. The area of damage is itchy, and the condition is generally depressed. The patient becomes fearful, finds it difficult to breathe, and develops a fear of water. Then it gradually paralyzes the muscles: first of the face, then of the arms, legs and the whole body.

The state-level health insurance program requires citizens of our country to receive a certain set of vaccinations. This complex does not provide an injection that protects against rabies, but anyone can contact doctors privately to receive the procedure. Administration of the vaccine is indicated immediately after a bite from an infected and potentially dangerous individual. This event is considered therapeutic and preventive.

The doctor referring you for the procedure will tell you which rabies vaccination is needed (usually KOKAV ). Preventive vaccination is indicated for those who could potentially come into contact with an infected individual. Knowing how long the rabies vaccination lasts is necessary, for example, for foresters and veterinarians, shelter workers and hunters. Not everyone knows whether a person is contagious after a rabies vaccination, and therefore avoids preventive injections. In fact, this is a myth: the vaccinated person is completely safe.

COCAV vaccine against rabies. Photo: simptomyinfo.ru

Vaccinations must be done:

for all bites, scratches, salivation of the skin and mucous membranes caused by clearly rabid, suspected rabid or unknown animals
for all bites, scratches, salivation of the skin and mucous membranes caused by wild carnivores, birds of prey, wild rodents, bats
when injured by objects contaminated with saliva or brain of rabid or suspected rabid animals
when biting, salivating and scratching a healthy pet at the time of contact, if it became ill, died or disappeared within 10 days
for all bites, scratches, salivation of the skin and mucous membranes caused by small house rodents (mice, rats) in areas unfavorable for rabies
in case of obvious drooling or damage to the skin by a person with rabies

Rabies vaccination schedule

A therapeutic and prophylactic rabies vaccination is required for a person who has been bitten by a potentially dangerous animal. If you are injured, you should immediately go to the hospital. You should also visit a doctor if there are no injuries, but the animal’s saliva gets on the skin. The doctor will immediately direct you to the procedure for administering the first portion of the medicine. The next injection is given on the third day, then after a week and after two; a person receives another injection on the 30th day, and the last one on the 50th.

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Sometimes it is possible to keep an eye on a potentially dangerous individual. If she has no symptoms of the disease within ten days, it is enough to give three injections (in accordance with the beginning of the standard rabies vaccination regimen). If you cannot monitor the animal, you will have to go through the entire cycle.

The disease will not develop if the saliva of an infected individual comes into contact with a person’s skin, but a rabies vaccination was given after the bite (for a child or an adult, it doesn’t matter) within two weeks after that. If there has been a bite, doctors will recommend administration of a vaccine and rabies immunoglobulin. To continue the course, only a vaccine is enough. Immunoglobulin is effective if it is used in the first three days after injury. There are no contraindications for administering the drug, since such a vaccine is the only way to save a person.

Does a vaccinated dog need special care?

After the first immunization, the animal owner must monitor the condition of his pet for 21 days. If the drug was reintroduced, quarantine after vaccination is reduced to 14 days. At this time, the owner of the animal must follow these rules:

Protect your four-legged friend from contact with other animals.
Make sure that the pet does not become hypothermic, avoid bathing and long walks for a while, and do not get the injection site wet.
Limit physical activity; during this period, you cannot conduct long training sessions or learn new commands.
Monitor the puppy’s nutrition, give him proven balanced food, and do not introduce new foods into the diet.
Make sure that your pet does not lie in a draft.

Also, after the first or second vaccination, the animal cannot be transported from place to place. You need to wait a month for the animal to fully recover. Only after this will you be able to move to a new place of residence or go to another country.

Necessary actions after an animal bite

There is always some time between receiving a potentially dangerous injury and seeing a doctor - at a minimum, you need to get to the hospital. There should be no doubt about how long it takes to get a rabies vaccination: you should see a doctor immediately, but if you become a victim of an animal, you must first drive it away. Whenever possible, turn to others for help.

Bites can be superficial or deep. In the first case, the wound should be washed with running water using antibacterial soap, then dried and secured with a bandage. In case of a deep bite, you first need to stop the bleeding, then call an ambulance. Already in the hospital, the doctor will explain what kind of rabies vaccination is given to a person, what scheme is used to administer it, and what restrictions are associated with it.

Symptoms and vectors of rabies. Photo: yandex.ru

Preparing your pet for the procedure

In order for your dog to be vaccinated without complications, you must first perform a number of procedures. Among them:

Deworming. As part of this, your pet needs to be given special tablets or suspensions that will remove worms from the animal’s body. It is mandatory to carry out before each vaccination, regardless of whether you are injecting your puppy for the first time or repeatedly.
Reducing walking time. The dog breeder is recommended to take the pet out into the fresh air for a short time, visit well-known places near the house, and make sure that the four-legged friend does not become hypothermic. Before vaccination against rabies, you need to protect your puppy from contact with other animals, especially wild ones.
Maintaining your usual diet. During preparation for vaccination, you can give your pet its usual food. There is no need to offer new products. On the day the medication is administered, it is better not to feed the animal - this will allow the drug to act faster and give a better effect.
Temperature measurement before the procedure itself. It should not be high or low. If this indicator does not correspond to the norm, it is better to postpone visiting the doctor. You should also examine the dog to make sure that it is healthy and does not need emergency veterinary care. Your pet's body temperature should be monitored on the eve of vaccination.

It is also important to avoid all kinds of stress for your four-legged friend. They can negatively affect his health.

Where do you get the rabies vaccination?

The rabies vaccine triggers the production of antibodies from the virus. These are produced in the human body approximately two weeks after receiving the first injection (this explains the specific schedule of rabies vaccinations). The maximum concentration is achieved after a month or a little more. The standard dosage is 1 ml of medication per procedure. The drug is injected into the muscle. For patients under five years of age, it is recommended to inject the medicine into the front and side of the thigh, for older people - into the deltoid brachialis muscle. It is strictly prohibited to administer the drug into the gluteal region! It is also not worth giving injections yourself. The workers in the treatment room know best how rabies vaccinations are done - they should be trusted with this.

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This is interesting: an alternative insertion technique! At the discretion of the doctor, half the dose of the rabies vaccine is administered to the person around the injury area, irrigating it, and the other half - into the thigh muscles. Rabies immunoglobulin can be injected into the gluteal area.

Can you get sick after immunization?

Since rabies vaccines do not contain live rabies viruses, the risk of disease arising from the vaccine is reduced to zero.

History has recorded cases where a person fell ill, even after immunization, for the following reasons:

untimely vaccination;
alcoholism in the victim of the bite;
poor-quality vaccine (for example, stored under incorrect temperature conditions);
incorrect technique of drug administration;
deficiency of the immune system (both congenital and acquired);
long-term use of drugs that have a serious effect on the functioning of the immune system. Such medications include: glucocorticoids, immunosuppressants and some others;
careless attitude of the patient himself, for example, missing a vaccination schedule or other.

As a rule, if at least one of the listed factors is present, a person is recommended to undergo a special test to determine the level of rabies antibodies in the blood. Based on its results, corrective measures are prescribed.

Prevention by vaccination

As a preventive measure, the rabies vaccine is given in three doses: when visiting the clinic, on the third day and on the 30th day. If it is necessary to prolong immune protection, first the vaccination is repeated after a year, then the procedure is done every three years. This is how long the drug works. At each revaccination, the doctor will remind you how many rabies vaccinations are given for prevention, and indicate the exact days on which you will need to come for a repeat appointment.

When should you not be vaccinated against rabies for preventive purposes?

If the vaccine is prescribed as a therapeutic and preventive measure, there can be no exceptions. There is no doubt whether pregnant women are vaccinated against rabies: since there is no alternative, in case of suspected infection, vaccination is mandatory. But for preventive use there are certain restrictions. The drug should not be administered:

pregnant women;
those who have previously had a systemic allergy to rabies vaccine;
It is forbidden to give injections if there is an acute illness or an aggravated chronic one. In this case, wait a month or more, after which injections are prescribed.

How to avoid the negative consequences of vaccination?

To prevent rabies vaccination from causing harm to the body, doctors recommend adhering to a number of rules:

It is strictly prohibited to consume any alcohol-containing drinks. Alcohol puts a strain on the liver and the body as a whole, which makes it impossible to form an adequate immune response. The ban should last at least two months, or better yet, up to six months;
During the immunization period and for several days after it, it is better to refrain from visiting crowded places where it is easy to catch any infection. This is especially true in the autumn-winter period;
It is better to refrain from swimming in open water and public places (sauna, swimming pool, etc.). It is not prohibited to wet the graft at home, in your own bath or shower;
overheating or hypothermia of the body after administration of the vaccine should be excluded, therefore it is not recommended to walk for a long time under the scorching sun or in severe frost;
It is worth limiting heavy physical overload, including sports;
It is important to combat stress, which also seriously weakens the body.

You can avoid being vaccinated against rabies only in the only case - when the bite or injury is caused by a domestic animal that is vaccinated and undergoes annual revaccination.

Expert opinion on the need for rabies vaccination

Answered by Mikhail Yuryevich Lebedev, leading expert of the Center for Molecular Diagnostics CMD of the Central Research Institute of Epidemiology of Rospotrebnadzor.

One of the most dangerous infections for humans is rabies (rabies, hydrophobia). This acute infectious disease affects not only humans, but all warm-blooded animals. The causative agent of the disease is the rabies virus . The virus affects the central nervous system, resulting in irreversible pathological changes in the nerve cells of the cortex and other parts of the brain (polyencephalitis). If an infected person develops clinical manifestations of damage to the central nervous system, then death is inevitable. To date, no specific treatment for rabies has been developed, and symptomatic and pathogenetic treatment is ineffective.

Around the world, 30-70 thousand people die from rabies every year, which is approximately 150 deaths per day! These are the data of the World Health Organization (WHO).

Rabies is recorded in more than 150 countries around the world and on all continents (with the exception of Antarctica). The vast majority of cases of the disease occur in developing countries.

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Rospotrebnadzor data: in 2021, 2 cases of human rabies were recorded in our country, in January - July 2021 - 1 case. WHO classifies Russia as a country with a medium risk of human rabies infection.

All mammals can carry the rabies virus. But most often these are foxes, dogs, wolves, raccoons, cats, rats, mice, hedgehogs. Farm animals - cows, horses, goats, etc. - are less often infected.

Important! In 2021, Rosselkhoznadzor identified 2,273 outbreaks of rabies in our country, 2,566 animals fell ill and died. In the first quarter of 2021, the largest number of disadvantaged areas (27) were registered in the Moscow region.

How do animals and humans become infected with rabies? This requires direct contact with the saliva of an infected animal (not only one that is already sick, but also one that is in the incubation period). For the virus to penetrate the body, the integrity of the skin must be broken, which most often happens with a bite. But there is a possibility of infection if saliva gets on damaged areas of the skin (abrasions, scratches, wounds, etc.). This mechanism of infection is called “salivation.”

Important! Every year in Russia, about 400,000 people visit medical institutions due to bites from wild, stray and domestic animals. In Moscow, the number of people bitten by animals in 8 months of 2021 was 17,565 people (in 2021 - 21,921), of which 43 contacts were with animals infected with rabies (in 2021 - 100).

What to do after dangerous contact? Immediately after the incident, you need to wash the wound with any antiseptic, or, in extreme cases, with soap and water, apply a bandage and urgently seek help from the nearest medical facility! There should be no delay, because we are talking about mortal danger!

Immunoprophylaxis (administration of rabies vaccine) is the only possible way to treat rabies (and, accordingly, save lives). Moreover, the vaccine must be administered during the incubation period of the disease (that is, before symptoms develop).

In Russia, the post-exposure rabies vaccination scheme looks like this: the first vaccination is on the day of treatment, then on the 3rd day, 7th day, 14th day, 30th day and 90th day.

Are there any contraindications to rabies vaccination? Is it possible to use the vaccine in pregnant and lactating women?

Everything is clear - THERE ARE NO CONTRAINDICATIONS TO POST-CONTACT VACCINATION (and cannot be), because the development of the disease means 100% death. Therefore, the vaccine is administered to absolutely everyone, including pregnant and lactating women.

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Of course, it is highly advisable to provide specialists with the animal itself with which there was potentially dangerous contact (or information about its vaccination against rabies). But this is only possible if the animal is domestic, “familiar.” But if the bitten animal is wild or stray, there is no such option.

To protect yourself and your family, you must follow the following rules:

vaccinate your pets against rabies (especially those traveling out of town with you);
purchase animals only with a veterinary passport;
do not come into any contact with wild and stray animals (do not feed by hand, do not pet). And under no circumstances should children be allowed to do this!

But if dangerous contact does occur, seek medical help URGENTLY!

REMEMBER: EMERGENCY VACCINATION IS CRUCIAL AND CAN SAVE A LIFE!

Signs and routes of infection

The virus is transmitted by infected animals, both through a bite and saliva, and is carried from the wound along nerve conductors and reaches the nerve cells of the cerebral cortex.

The virus causes severe central nervous system disorders and inflammation of the brain in those infected. The salivary glands receive a high dose of the pathogen, which causes increased salivation. Excess saliva drains into the stomach, ensuring the rapid development of the disease and into the external environment, facilitating the spread of the virus.

Death of an infected person from the moment of infection can occur within 2-5 days due to suffocation and cardiac arrest.

This period varies for different animals. Death for most mammals occurs within 2-6 weeks, but there are representatives of the animal kingdom that can be asymptomatically infected for several years, such as the African yellow mongoose.

Potential distributors of Rabies lyssavirus in the animal world are most often foxes, wolves, badgers, raccoon and domestic dogs, bats, and cats.

Outside the body, the virus is unstable, sensitive to ultraviolet radiation, direct solar radiation and many disinfectants; it dies in 15 minutes when heated to more than 50°C, and in 2 minutes when boiled. At low temperatures, the pathogen retains its vital activity and is resistant to phenol, an antiseptic drug.

Based on behavioral and physiological characteristics, it is customary to distinguish 3 stages of infection.

The primary signs of infection at stage 1 include weakness, fever, lack of sleep, anxiety, and pain in the bitten area. The duration of symptoms is 1-3 days.

Stage 2 lasts about 4 days. An acute reaction to light and sounds appears, phobias, fear arise, and hallucinations appear. Patients produce a lot of saliva and become aggressive.

The 3rd stage is fleeting, characterized by multiple paralysis: eyes, cheekbones (jaw drops), legs. The patient may eat inedible and dangerous things. The person becomes asocial, his personality disappears, and rabies begins. Suffocation causes death.

If you suspect the possibility of illness, before arriving at the doctor, you need to treat the wounded surface with soapy water to reduce the degree of infection. The edges of the wound must be treated with iodine or alcohol.

Side effects of vaccination

The introduction of a vaccine may cause complications. The most common reactions to rabies vaccination are local side effects:

itching;
tissue swelling at the injection site;
enlarged lymph nodes near the injection site.

Also, vaccination can lead to fever and general weakness. Moderate pain and fever after rabies vaccination are considered a normal reaction. Others have headaches. A general state of malaise is possible. There is a risk of neurological symptoms and serum sickness. There are known cases of anaphylactic shock. Such complications after vaccination against rabies in humans require urgent assistance. In general, the incidence of side effects is estimated at 0.02-0.03%, mainly mild skin reactions and bumps after rabies vaccination.

What to do if the vaccination schedule is broken

A variety of reasons can provoke a violation of the drug administration schedule. Sometimes the time intervals are confused or medications are administered in the wrong sequence. Other specific points are also possible. In any such situation, the doctor’s task is to assess the immune status in order to develop a continuation of the course individually, taking into account the time frame for the rabies vaccination should have been received.

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If the next portion of the medicine was not administered or it was administered at the wrong time, this may cause the ineffectiveness of the course as a whole. The tests carried out have proven the effectiveness of the vaccine only if the deadlines are strictly followed. If temporary pauses are not observed, correction of the subsequent program is based on the specifics of the case.

Sometimes the situation develops in such a way that a person is obliged to leave. It is not advisable to receive vaccines in different cities, as this carries an increased risk of delays. The effectiveness of activities in general is reduced. Unable to cancel the trip, they visit the doctor to plan the further course, find out in advance where to get a rabies vaccination for a person in a new place. If possible, contact a highly qualified specialist - a radiobiologist .

This is interesting: I want some air! There is an opinion that you should not go for a walk after receiving a rabies vaccination. This is wrong. Usually the vaccinated person continues to lead a normal life.

When should my pet have its first vaccination?

Opinions differ regarding the timing of comprehensive immunization of dogs:

A number of experts believe that every animal over 40 days old should be given medication for the rabies virus, unless there are contraindications. This approach allows you to protect him from infection through contact with other animals.
Domestic veterinarians advise vaccinating a puppy for the first time at the age of three months. By this time, the pet should get stronger, gain the required weight and often walk outside. The risk of complications after administration of the drug in this case is reduced.

The final decision on immunizing an animal must be made for each pet individually, taking into account the duration of the vaccine, the general condition of the four-legged friend, and the presence of contraindications to the procedure.

Rabies vaccination and alcohol

It is believed that during vaccination and for at least the next six months, it is strictly forbidden to drink alcohol, as this will lead to a loss of the effectiveness of the drug. The instructions for the medicine actually mention a ban as a restriction after a person is vaccinated against rabies, but this is not associated with the loss of effectiveness of the medicine under the influence of alcohol: such a statement has no scientific basis.

Doctors say that after rabies vaccinations you should not drink for about six months, since alcohol negatively affects human health, weakening it in general. For the same reason, during treatment and for another six months after the cycle of injections, you should not overwork, hypothermia or overheating. You should avoid visiting the sauna or bathhouse.

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This is interesting: how did this happen? The explanation for where the myth about the interaction of the rabies vaccine and alcohol, about the drug’s loss of effectiveness, came from is quite simple. Previously, the only way to save yourself from rabies was medication administered in 30-40 portions. Every day a person received an injection in the stomach, this lasted at least a month. By missing at least one procedure, the patient risked not getting any effect from the course. Statistics show that most often patients miss doctor's appointments due to intoxication. These two factors have led to the stereotype that alcohol blocks reactions in the body.

Is it possible to vaccinate yourself?

People who do not have special education and experience working with animals are not recommended to immunize their dog on their own. There are a number of reasons for this:

A non-specialist may not be able to determine the presence of contraindications and may give an injection during estrus, stress, or at elevated temperatures. This will have a negative impact on the animal's health.
There are certain requirements for the storage and use of medications that are difficult to comply with at home. Their violation leads to the appearance of side effects after vaccination of animals.
The owner will not be able to provide proper assistance to the animal if he is allergic to the drug. This threatens the death of your four-legged friend.

In exceptional cases: if there is a high risk of infection, if there are no veterinary clinics in the area where you live, you can carry out the procedure yourself. To do this, you should study the instructions for the use of anti-rabies drugs and strictly follow their requirements.

Do I need to get a rabies vaccination?

Some ordinary people doubt the need for a vaccine. There should not be even the slightest doubt about whether to get a rabies vaccine. For example, there is a stereotype that a minor injury is completely safe if the area is disinfected. Doctors note: a vaccine is the only way to survive if a disease pathogen has entered the body. Even if it penetrates through a tiny scratch, a slight abrasion of the skin, it ends up inside, where it gradually affects the nervous system and brain, guaranteed to be fatal. The consequences will be much more severe than any reaction to the rabies vaccine.

There is a myth that the disease was cured. In fact, the story is somewhat distorted. Not a single officially documented case of cure has been established. If infection occurs, only a course of therapeutic and prophylactic vaccination against rabies helps save a person. This is the only reasonable and completely justified measure that has no alternative.

Important! Since 2007, World Rabies Day has been celebrated (September 28 every year). It was established at the initiative of the Global Alliance to Control Rabies with the aim of attracting the attention of people around the world to this problem and making them aware of the prevention of the disease.