Experts call for rabies prevention and control to be further strengthened

Source: Guangming Daily client Yang Shu

September 28 is the 15th World Rabies Day, with the theme of "knowing the truth and not being crazy". Rabies is a zoonotic infectious disease caused by rabies virus, and the mortality rate is as high as 100. At present, there are many misunderstandings in the public's cognition of rabies prevention and control, and authoritative and scientific health science popularization is particularly important. To this end, recently, the Health Times has planned and organized the implementation of "knowing the truth without fear"-a popular science and media exchange meeting on rabies prevention and control knowledge, in order to improve the public's awareness and ability to prevent rabies. This activity is supported by Liaoning Chengda Biological Co., Ltd.

"Know the truth but not fear madness" -- popular science and media exchange meeting on rabies prevention and control knowledge

Zhang Lingli, deputy secretary-general of the Chinese Preventive Medicine Association, pointed out at the meeting that although rabies is terrible, it is also preventable. In recent years, with the great attention of the party and the government, the prevention and control of rabies in my country has achieved remarkable results. The number of rabies cases has dropped year by year, from 3300 cases at the peak in 2007 to 202 cases in 2020, a drop of 94%. However, due to the high mortality rate of rabies and the increasing number of people raising pet cats and dogs in the society, the prevention and control of rabies is still an important task at present.

Although rabies is extremely harmful, many people think that they are far away from rabies. Yin Wenwu, chief physician of the Infectious Disease Management Office of the Chinese Center for Disease Control and Prevention and head of the rabies vaccine working group of the National Immunization Program Technical Working Group, pointed out that the vast majority of rabies cases in China are caused by dog bites and scratches, and a small number are cats. At present, rabies in most areas of our country has been distributed at a low level, and some areas have reached a state of regional elimination. But at the same time, the number of infectious sources (dogs) in my country is large and widely distributed, and the immunization rate of dogs is not high; some people have a weak awareness of civilized dog raising, and they do not register, do not immunize, and abandon dogs at will; rabies is prevalent in rural areas, Especially in poor areas. He pointed out that as an individual, we must raise dogs in accordance with the law, raise dogs in a civilized manner, and know how to prevent rabies. The ''Healthy China Action (2019-2030) ''pointed out that breeders should vaccinate dogs and cats with veterinary rabies vaccine; when taking dogs out, use a dog chain or put a cage on the dog to prevent biting others; after being scratched or bitten by a dog or cat, the wound should be washed immediately, and anti-rabies immunoglobulin (or serum) and human rabies vaccine should be injected as soon as possible under the guidance of a doctor.

After being bitten or scratched by an animal, timely, scientific and standardized wound treatment is one of the keys to prevent rabies. According to the nature and severity of exposure, rabies exposure is divided into three levels: Level I: contact or feeding animals, or licking of intact skin. Grade II: bare skin is lightly bitten, or minor scratches or abrasions without bleeding. Grade III: Single or multiple penetrating skin bites or scratches, or damaged skin is licked, or open wounds, mucous membranes are contaminated. Zuo Yongbo, director of emergency surgery in Haidian Hospital of Peking University Third Hospital, taught everyone a simple way to distinguish grade I and grade II exposure by themselves, which is to see the reaction of the wound after alcohol is applied. If only the skin is cool, it is grade I exposure. Feeling pain proves that the skin is damaged, which is grade ii exposure.

Cheng Hongbin, deputy director of the emergency department of Tianjin Fourth Central Hospital, reminded that there are two important steps when families deal with wounds: washing and disinfection. The shortest time to rinse is 15 minutes. You can rinse with running water for 5 minutes first, and then scrub with soapy water. This cycle lasts for 3 processes. Iodophor is recommended for disinfection. If the wound is deep and blood vessels, tendons and nerves are injured, towel can be used to compress hemostasis and seek medical treatment as soon as possible. It is not recommended to use hemostatic powder by oneself, which will bring difficulties to debridement.

Dong Guanmu, a member of the National Pharmacopoeia Committee and former director of the Vaccine Office of the China Institute for Food and Drug Control, introduced that there are two procedures for vaccination after rabies exposure: one is the traditional five-needle method, that is, 0, 3, 7, 14, and 28 days. One shot, a total of 5 visits and 5 shots of vaccine; there is also a "2-1-1 procedure", that is, one shot on the upper arm on the 0th day, one shot on the 7th and 21st days, a total of 3 visits and 4 shots of vaccine. Both procedures are safe and effective.

Chen Qiulan, director of the Animal and Vector Infectious Diseases Department of the Infectious Diseases Management Office of the Chinese Center for Disease Control and Prevention, and deputy head of the Rabies Vaccine Working Group of the National Immunization Program Technical Working Group, reminded that children's physical functions are relatively poor, but due to their playful and curious nature, I prefer to tease dogs and cats. Parents should remind their children that if they are scratched, bitten, or licked by stray dogs and cats, they should tell their parents and teachers as soon as possible. In addition, there has been a popular saying that the incubation period of rabies is as long as 10 years or even 20 years. In this regard, Chen Qiulan emphasized that this is misleading. The incubation period of rabies is generally 1 to 3 months, and the shortest is 5 days, but the extremely short incubation period is rare and rarely exceeds 1 year. (Guangming Daily full-media reporter Yang Shu)