Oct 239 mins read

How to use the "10 -day observation method" for rabies? Don't let the error understand delay treatment time

Although the prevalence of rabies is not high, it is frightened because of the mortality of the disease. Regarding rabies, there is a "ten -day observation method". Many people have heard of it, but they do not know their details. Some people think that this is an unreliable soil method.

In fact, the "Ten Day Observation Law" is a way to judge whether animal injuries to spread rabies virus when judging animal injuries. (Frequently Asked Questions on Rabies "(hereinafter referred to as the" Handbook "), which mentioned the ten -day observation method.

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What is the "Ten Day Observation"?

The official statement of the World Health Organization in the "Ten Day Observation Law" in the "Handbook" is:

Stop the treatment if the animal remains healthy during an observation period of 10 days or has been shown to be negative for rabies of a reliable laboratory using suitable diagnostic techniques.

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Translation: If the animals are still healthy during the 10 -day observation period (after the bite), it still maintains a healthy [limited to cats and dogs], or reliable laboratory uses correct diagnostic technologies to prove that animals are negative of rabies, then disposal can be terminated (That is, no longer continue to vaccinate the remaining vaccines).

What do you need to pay attention to when the "Ten Day Observation Law"?

1. The correct understanding of the ten -day observation method is "After the wounds are completely cleaned with soapy water and iodine, the vaccine is vaccinated as soon as possible. If the animals that hurt people are still healthy after ten days, you do not have to continue in vaccination. Vaccine, not "waiting for ten days, if the animals die, then vaccine."

2. On the ten -day observation method, it is only applicable to dogs and cats. For other animals, there is enough data support. However, all mammals may be infected and spread rabies virus through saliva (although the chances of spreading rabies such as grass and livestock such as horses, donkeys, etc., there is still a report). People) Bite still need to be vaccinated first, and then try to determine whether animals (or people) are carried by rabies virus through blood drawing tests, and then decide whether to continue in vaccination.

3. It is unclear whether the mammalian of the vaccine is slightly grabbed. Even if the wound has no bleeding, the wounded should be vaccinated. If the human animal is a cat raising, the animal can be observed for ten days, and the animals are healthy ten days later, but no vaccination is not necessary.

4. It is not clear whether the animals that vaccinate the vaccine licked the mucosa parts such as eyes, oral cavity, or licking the skin wounds, and the above 3 treatment.

How is the correct prevention of rabies?

In the Chinese version of the World Health Organization, the recommended disposal method is clearly given:

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Note that stray cats and dogs and wild bats, foxes, crickets, wolves, mice, rats, racons, and skunk are all sensitive animals, which are highly dangerous. If they are bitten, they must be able to capture animal tests. Inocular vaccines, antibumatology is needed when the wound is severe.

If the cats and dogs who have been vaccinated on time each year, the cats and dogs who have been vaccinated more than 2 times, or the wounded person has been completely inoculated for a round of rabies vaccine within 3 months, as long as the wound is properly dealt with Essence Licking the entire skin by animals without having to vaccinate rabies.

What is the theoretical basis of the "Ten Day Observation Law"?

After cats and dogs are infected with rabies virus, early infection, their saliva does not contain rabies virus. At this time, even if the cat or dog is bitten, there will be no rabies virus into the human body.

Only when the sick cat/sick dog's body goes up to the brain, and it will enter the saliva glands after copying and being proliferated in a certain amount in the brain. At this time, the cat and dog saliva will have rabies virus. Cats and dogs with rabies with rabies in saliva may be infected with rabies virus.

But at this stage, cats and dogs have actually been "ill." Even if a temporary cat/sick dog cannot see obvious rabies disease signs, it will definitely develop within 3 to 5 days, and quickly fail to die within a few days after the onset. Rabies are very urgent. Cats and dogs who are onset can clearly see one or more of the symptoms of mental deficiency or mania, alien food, light, saliva, weak hind limbs, and weak hind limbs.

When the "Ten Day Observation Law" was initially proposed, it was recommended to observe for 5 days to see if cats and dogs developed, but considering that ordinary people may not be able to accurately judge the symptoms of animals, for the premium of insurance, the World Health Organization will extend it to 10 days to 10 days Essence It can be said that from cats and dog saliva with rabies virus, even if the cat/sick dog has not died in 10 days, the symptoms have been seriously known to the level of seeing.

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Why do WHO recommend the "Ten Day Observation Law"?

On the one hand, any vaccine or drugs have a certain degree of adverse reactions and side effects. Although the rate of severe adverse reactions of rabies vaccine is small with the continuous improvement of vaccine preparation technology, the incidence of adverse reactions Local redness and shortness of adverse reactions such as local redness and pain, joint pain, fatigue and fatigue, have the incidence of 0.3 to 10%.

In the case of whether the injured animal is not able to spread the rabies virus, in order to ensure the safety of life, it is worth the risk of inoculation of rabies vaccine and bear the risk of adverse reactions. However, once it is determined that animals do not spread rabies virus when they are injured, and then vaccinated, they are in vain to bear risks. At the same time, in the case of unnecessary cases, the remaining several needle vaccines are also a waste of public health resources.

On the other hand, many people are panicked about rabies. Some people still can't let go even if they have been vaccinated and injected with serum; some people think of being bitten by cats and dogs, but they have not been uneasy for various reasons, but they have not been vaccinated.

Mammals that are most likely to hurt people are cats and dogs. It is clear that the cats and dogs are still healthy ten days after the injury, which means that they do not spread rabies virus when hurting people. Essence

In addition, it is worth mentioning that although the incubation period of rabies can last for more than one year (the longest case of the latent period recognized by the World Health Organization is 6 years), in most cases, the incubation period is 1 to 3 months. Has been bitten by a dog, it has been more than ten years, and you can relax your mindset without having to worry too much.

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"Ten Day Observation Law" is also effective for cats and dogs that have not been vaccinated?

On the Chinese network, there is also a saying: "Cats and dogs must have a record of at least two clear rabies vaccination in order to implement the ten -day observation method." This statement is wrong.

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(Screenshots on the Internet, the orange line pointed out the error, the red box is the original in the screenshot)

The reason for this error may be due to the error translation and interpretation of the "WHO Expert Consultation on Rabies" (hereinafter referred to as the "Report").

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(World Health Organization "Who Expert Consultation on Rabies" cover)

According to the "Report", animals have at least twice clear rabies vaccination records, not the prerequisite for implementing the 10 -day observation method, but whether the judgment basis that needs to be vaccinated as soon as it is bitten.

The original text in the "Report" of the WHO is:

Factors that should be taken into account when deciding to initiate prophylaxis after exposure include the epidemiological probability that the implicated animal was rabid, the severity of exposure (see section 8.3.2), the animal's clinical properties, its vaccination status (especially for dogs and cats) and its accessibility for observation and laboratory tests. All exposures that are determined to represent a risk of rabies require prophylaxis after exposure.

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Translation: Whether to prevent it after exposure (that is, vaccination), there are several factors that should be considered: the possibility of epidemiological possibilities of human animals suffering from rabies, the severity of exposure (see 8. 3. 2), the clinical clinical of animals The characteristics and its immune vaccination (especially the dogs and cats), as well as the feasibility of observation and laboratory detection. All the exposure to the risk of rabies needs to be exposed after exposure.

It can be seen that the status of animals' immunization is the basis for "whether to prevent it after exposure (that is, whether to vaccinate the vaccine immediately)", rather than the judgment basis of "whether the 10 -day observation method".

In fact, cats and dogs who vaccinated vaccines do not infected rabies virus; and within three months after the entire process of inoculation of rabies vaccine, the antibody concentration in the blood can definitely reach the level that can prevent rabies virus infection. Therefore, the WHO believes that cats and dogs who have been vaccinated on time and have been vaccinated twice of rabies vaccine to bite, or the injured person has been vaccinated in the whole process within three months. As long as the wound is properly treated to avoid other problems such as other infections.

Cats and dogs that have never been vaccinated, and cats and dogs who have been vaccinated no matter how many vaccines can be closed for ten days, and they are applicable to the "Ten Day Observation Law".