Doctors told about the danger of rabies

In the Canadian province of Ontario, an 11-year-old boy died of rabies after he woke up and found a bat on his face. The parents did not notice the bite marks and did not seek medical help, and the first symptoms appeared only a few weeks later. This case has once again drawn the attention of doctors to a disease that remains virtually incurable after the onset of clinical signs, but is almost always prevented by timely vaccination.

Why even imperceptible contact with a bat can be dangerous and how humanity has learned to protect itself from one of the deadliest viruses — in the Izvestia article.

One unnoticeable bite that proved fatal

The tragic case became known on June 30. According to Canadian doctors, an 11-year-old boy from Ontario province died of rabies after coming into contact with a bat that appeared on his face at night. The parents found no bite marks or scratches, so they decided not to go to the doctors. A few weeks later, the child showed the first symptoms of the disease, after which he was hospitalized, but it was not possible to save the patient.

According to experts, such cases are extremely rare, but bats remain one of the main causes of rabies infection in North America. The main danger lies in the fact that their teeth are so small and sharp that the bite site may leave almost no noticeable marks on the skin. It is especially difficult to detect such injuries in young children or in a person who was asleep at the time of contact with an animal.

That is why doctors recommend seeking medical help after any direct contact with a bat, even if a person is not sure if they have been bitten. A similar recommendation applies in cases where bats are found in a room with a sleeping person, a small child, or a person who cannot tell you exactly what happened. Doctors explain this by saying that the consequences of a missed infection may be irreversible.

This factor is said to make rabies one of the most insidious infections. As long as a person feels healthy, doctors still have the opportunity to completely prevent the development of the disease. However, after the first symptoms appear, the situation changes almost irreversibly.

Why rabies almost always ends in death

The causative agent of the disease is rabies virus (Rabies lyssavirus), which is found in the saliva of an infected animal and usually enters the body through a bite or damaged skin. Unlike many other viruses, it does not spread through the body through the blood. Instead, the pathogen gradually penetrates into the ends of the peripheral nerves and begins to slowly move along them towards the brain. It is this feature that determines the development of the disease and at the same time gives doctors a chance to stop the infection before symptoms appear.

The rate of virus advance depends on the bite site: the closer the lesion is to the head or neck, the faster the pathogen reaches the central nervous system. That is why the incubation period can vary significantly: for most people, it ranges from one to three months, but in some cases the first symptoms appear after a few days or, conversely, many months after infection. All this time, a person can feel perfectly healthy and not suspect that the virus is already in the body.

When the virus reaches the brain, an inflammation of the nervous tissue begins — encephalitis. It is from this moment that the first signs of the disease appear: fever, weakness, headache, anxiety and unusual sensations at the bite site, even if the wound itself has long since healed.

As the nervous system is affected, confusion, muscle spasms, hallucinations, and behavioral disorders occur. Many patients develop the characteristic hydrophobia of rabies — painful cramps of the pharyngeal muscles when trying to take a sip of water or even at the sight of it. Despite the widespread popularity of this symptom, it does not appear immediately and indicates severe brain damage.

It is after the appearance of clinical symptoms that medicine practically loses the opportunity to help the patient. The World Health Organization emphasizes that rabies is one of the diseases with almost one hundred percent mortality after the onset of the clinical stage. Only a few cases of survival have been described throughout history, but they remain an exception and do not allow us to talk about the existence of a reliable treatment method.

The most famous is the so—called Milwaukee Protocol, an experimental method proposed in 2004 after an American patient, Gina Gis, was able to survive after developing rabies symptoms. Doctors put her into an artificial coma, hoping to gain time for the immune system. However, subsequent attempts to repeat this approach have failed in most cases. Today, experts believe that the protocol cannot be considered as a universal treatment, and the main way to combat the disease is still prevention before the first symptoms appear.

A disease that humanity learned to prevent more than a century ago

Although rabies remains one of the deadliest infections, it was one of the first diseases that humanity learned to effectively defend itself against. The turning point occurred at the end of the 19th century thanks to the French scientist Louis Pasteur. In 1885, he successfully used the vaccine he had developed for the first time to save nine-year-old Joseph Meister, who had been bitten repeatedly by a rabid dog shortly before. Without treatment, the child would almost certainly have died, but the course of vaccination prevented the development of the disease. This case is considered one of the most important events in the history of medicine and marked the beginning of modern rabies prevention.

Since then, the approach to prevention has changed significantly. Modern vaccines do not contain live virus and are highly safe. If a person seeks medical help immediately after contact with a potentially infected animal, they are prescribed a course of post-exposure prophylaxis. Depending on the situation, it includes wound treatment, the administration of rabies immunoglobulin and several doses of vaccine according to the established scheme. The World Health Organization emphasizes that with timely treatment, such prevention almost completely prevents the development of the disease.

That is why experts constantly remind you that in case of possible infection, you should not wait for symptoms to appear. Unlike most infections, in rabies, the vaccine is applied after contact with the virus and manages to form an immune response before the pathogen reaches the brain. It is this feature that makes the disease both one of the most dangerous and one of the most preventable.

Degree of risk: Russians refuse to get vaccinated against rabies

In some regions, the number of "draft dodgers" reaches 34% — they do not want to follow a diet and forget about alcohol.

According to WHO estimates, about 59,000 people die from rabies worldwide every year, with almost all cases occurring in Asia and Africa, where access to medical care and vaccines remains limited. At the same time, experts note that most of these deaths could have been prevented thanks to timely prevention after an animal bite.

Why do doctors take bats so seriously?

In many countries, people associate rabies primarily with stray dogs, and this is true: according to WHO, about 99% of cases of transmission of the virus to humans in the world occur through the bites of infected dogs.

However, the epidemiological situation differs depending on the region. In North America, due to the mass vaccination of pets, cases of infection from dogs have become extremely rare, while bats remain the main natural reservoir of the virus.

At the same time, experts emphasize that not every bat is infected with rabies. Most of these animals do not pose a danger to humans and play an important role in ecosystems, destroying insects and participating in the spread of plant seeds.

The problem lies in another way: it is impossible to determine from the appearance whether an animal is infected or not. That is why any direct contact with a bat is considered a potential risk requiring medical advice.

Experts recommend being especially careful in situations where a bat finds itself in a room with a sleeping person, a small child, or a person who is unable to accurately describe what happened. Even if the bite is not visible, doctors recommend that you do not try to assess the risk yourself, but contact a medical institution as soon as possible. The decision on the need for vaccination is made after an assessment of the specific situation by specialists.

It is this principle that underlies the recommendations that are currently in force in many countries around the world. The story of a Canadian schoolboy has shown how easy it is to underestimate the danger if you focus only on visible bite marks or well-being after contact with an animal.

Rabies remains one of the few infections in which modern medicine is almost always powerless after the first symptoms appear. However, at the same time, this disease is among the most preventable: timely post-exposure prophylaxis almost completely eliminates the development of the disease.

Therefore, experts once again recall the rule that has saved millions of lives over the past decades: if you suspect contact with a potentially infected animal, it is better to consult a doctor immediately than to miss the only moment when the virus can still be stopped.