Dog bites are the main mode of transmission of rabies virus, and the case fatality rate of rabies is almost 100%. All dog bites require a rabies exposure risk assessment, and an appropriate immunoprophylaxis treatment plan is selected based on the exposure classification.
The specific methods are as follows:
In short: If you are bitten The skin is not damaged, and local cleaning is sufficient; if the skin is damaged but does not bleed, the wound must be actively treated, and rabies vaccination must be administered at the same time; if the skin is damaged and bleeding, the wound must be actively debrided and at the same time injected locally Rabies immune globulin, and rabies vaccine at the same time.
02How to treat wounds?
Thorough and effective local wound washing is very critical. Through effective wound cleaning, immediate vaccination with rabies vaccine and completion of post-exposure prophylaxis, more than 99% of patients can survive.
1. Wound irrigation and cleaning:
① Use soapy water (or other weak alkaline cleaning agents) and running water to clean all bite wounds alternately for about 15 minutes;
② Use sterile gauze or absorbent cotton to absorb the residual fluid from the wound;
③ Use normal saline to rinse the wound to avoid leaving soapy water or other cleaning agents on the wound.
2. Disinfection treatment: After thorough washing, apply or clean the inside of the wound with dilute iodophor or other medical preparations with the ability to inactivate viruses.
3. Seek medical attention: If the wound is serious, go to the hospital immediately for debridement and wound expansion.
Prevent rabies
How to prevent rabies? Methods include active immunization and passive immunization. Let me introduce it to you below:
1. Active immunity: that is, vaccination with rabies vaccine. The human rabies vaccines currently used in our country are concentrated and purified cell culture vaccines. For those exposed for the first time, choose the "5-shot method" or the "2-1-1" procedure to complete the full vaccination program. 5-needle method: Essen method, one dose is injected intramuscularly on days 0, 3, 7, 14, and 28 respectively. 4-injection method: Zagreb method, 2-1-1 immune schedule, with 2 doses, 1 dose, and 1 dose injected intramuscularly on days 0, 7, and 21 respectively.
2. Passive immunity: that is, the local infiltration and injection of immune preparations into the wound to neutralize the virus remaining after the wound has been cleaned and disinfected to produce local immune protection. In fact, it is the local injection of rabies immune globulin into the wound. It is mainly targeted at rabies level III patients who have not been vaccinated against rabies before, level II exposed patients with severe immune deficiency, and areas with densely distributed wounds (head, face, perineum, hands, etc.).
Some students may ask, if you have already been vaccinated against rabies, do you still need to inject rabies immune globulin? The rabies virus usually replicates slowly in local muscle cells for a period of time before entering the nervous tissue. The human body cannot yet produce a high level of protective antibodies within a week after the initial injection of the rabies vaccine. Therefore, for patients with exposure level III, Within 7 days after the first dose of vaccine, the rabies passive immunity preparation should be injected as soon as possible. my country's rabies immune globulin includes: human-derived rabies immune globulin (rabies immune globulin) (no skin test required) and equine-derived rabies F (ab') 2 fragment preparation (anti-rabies serum) (skin test required).
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