Polio-About Polio:
Polio is caused by the polio virus, an acute infectious disease. Clinical manifestations of polio-bed fever, sore throat and body pain, some patients with flaccid paralysis may occur. Prevalence of infection and when to conceal non-paralyzed for many, the high morbidity in children than in adults, particularly before general vaccination of infants and young children more sick.
Polio - Data
Alias disease: polio, polio current sexual activity
Respective parts: the body
Treatment sections: Pediatric Infectious Diseases
Signs and symptoms: diarrhea, fever, cough, cyanosis, coma, paralysis of abdominal pain, nausea and vomiting
Polio - Overview
Polio (poliomyelitis hereinafter referred to as polio), also known as poliomyelitis, is caused by the polio virus, an acute infectious disease. The main clinical manifestations are fever, sore throat and body pain, some patients may occur flaccid paralysis. Prevalence of infection and when to conceal non-paralyzed for many, the high morbidity in children than in adults, particularly before general vaccination of infants and young children sick more, it is also called poliomyelitis (Infantile paralysis), the main lesions in the spinal cord gray matter, damage can have serious paralysis sequelae.
Polio - causes
Polio virus, polio virus from the oropharynx or intestinal mucosa into the human body can be reached within one day of local lymphoid tissue such as tonsils, pharyngeal wall lymphoid tissue, intestinal growth and reproduction of a collection of lymphoid tissue, etc., to the partial discharge of the virus, If this time the body produces large amounts of specific antibodies, the virus can be controlled locally. The formation of latent infection; otherwise the virus further invade the bloodstream (the first viremia) throughout the first 3 days to reach non-neural tissues, such as respiratory, intestinal, skin and mucous membranes, heart, kidney, liver, pancreas, adrenal, etc. breeding In particular, multi-systemic lymphoid tissues, and in the first 4 to 7, again poured into the blood circulation (second viremia) If the time-specific antibodies in the blood circulation is adequate and the virus, the development of the disease at this point to form a frustrated type polio. Only the upper respiratory and intestinal symptoms, without neurological disease, some patients may be less toxic due to strong virus or antibodies in the blood and not the one, the virus can be violated with the blood-brain barrier via the central nervous system, a serious disease paralysis may occur, and occasionally the virus can spread along peripheral nerves to the central nervous system, specific neutralizing antibodies is not easy to reach the central nervous system and gut, so the virus within the cerebrospinal fluid and feces retained longer. Therefore, if blood circulation in the body-specific antibodies appear sooner or later and their number is to determine whether the violation of the virus an important factor in the central nervous system.
A variety of factors can affect the disease outcome, such as cold, fatigue, local irritation, injury, surgery (such as vaccination, tonsils amputated patients, dial teeth, etc.) and the immunocompromised, etc., are likely to promote the occurrence of paralysis, pregnant women such as disease prone to paralysis, older children and adults with serious condition, the occurrence of paralysis and more. Children susceptible to severe in boys than girls, more common in paralysis.
The most prominent pathological changes of polio in the central nervous system (the virus with neurotropic toxic) scattered lesions and multiple asymmetrical features may involve the brain, midbrain, medulla oblongata, cerebellum and spinal cord, the main damage to the spinal cord, brain dry times, especially in the motor nerve cells in the lesions of the most significant. Cervical and lumbar segments of the spinal cord to anterior horn cell damage is more gray matter, it is a common clinical quadriplegic. Most of central and brain stem motor nucleus can be damaged to the network structure, vestibular nuclei and cerebellar nuclear lesions is more common cover, the cerebral cortex are rare lesions, even if the motor area lesions were mostly minor. Occasionally sympathetic ganglia and peripheral ganglia lesions, scattered on the leptomeningeal inflammatory lesions, arachnoid little affected, inflammatory changes appear in cerebrospinal fluid. No paralysis type of nervous system lesions are mostly minor. Polio virus enters the body through the mouth, throat and intestinal tract that invade lymphatic tissue, the formation of latent infection; antibodies into the blood circulation is low virus caused viremia, if the body's lack of immunity, the virus with blood blood brain barrier to invade the central nervous system, and spread along the nerve fibers, causing paralysis period without symptoms; if badly damaged motor neurons, the muscle paralysis, causing paralysis of symptoms.
Polio - symptoms
Polio patients season if susceptible patients after exposure to excessive sweating, irritability, hypersensitivity, sore throat, neck and back limb pain, stiffness, tendon reflexes, and so on, and the disease should be suspected. Prodromal period should be the general upper respiratory infection, influenza, gastroenteritis and other identification. Patients should be a variety of pre-paralysis virus encephalitis, purulent meningitis, tuberculous meningitis and encephalitis phase identification. Flaccid paralysis occurs in the diagnosis.
3 to 35 day incubation period, usually 7 to 14, according to the severity of symptoms and the presence of paralysis can be divided into latent infection, frustrated type, no type of paralysis and paralysis type.
Polio incubation period is 5 to 14 days, clinically manifested a variety of types: ① latent infection; ② frustrated type; ③ no paralysis type; ④ paralysis type.
(A) the precursor of the main symptoms are fever, loss of appetite, sweating, irritability and systemic hypersensitivity; also visible nausea. Vomiting, headache, sore throat, constipation, diffuse abdominal pain, rhinitis, cough, pharyngeal exudate, diarrhea, 1 to 4 days. If the condition does not develop, is frustrated type.
(B) the period of paralysis early prodromal symptoms disappeared after the l ~ 6 days, the temperature rose again, headache, nausea, severe vomiting, skin redness, transient bladder sphincter disorders, neck muscles, trunk and limb rigidity burning, often constipation. Examination shows that: ① tripod sign: the need to use both hands when the patient sat up in bed after a support such as tripod, to support the position; ② kiss knee test positive, that is, patients sit, bend the neck when the lips can not touch the knee; ③ appear head drooping levy, set about to hand under the patient shoulder, lift the torso, the head and torso parallel to the normal. So far, such as illness, 3 to 5 days after the heat back, is no paralysis type, such as the disease continues to develop, is often paralysis appeared 12 to 24 hours before the key reflex, light reflex initially, after the suppression of deep tendon reflexes Therefore early detection of reflex has important diagnostic value.
(C) paralysis paralysis of the early period from the third and fourth day, the temperature started to decline in most of paralysis, and gradually increased, when the body temperature normal to retreat, to stop the development of paralysis, no sensory disturbances. Can be divided into the following types:
1, the spinal cord of this type is most common. Showed flaccid paralysis, asymmetry, tendon reflexes, muscle hypotonia, lower limbs and large muscles and small muscles more than upper limb involvement, but there may be only a single muscle group involved, or are paralyzed limbs, such as involving the neck muscle, diaphragm, intercostal muscles, then a vertical head and sat up difficulties, breathing movement disorders, breathing contradiction performance.
2, also known as medullary type ball, Department of cranial nerve motor nucleus and the medullary respiratory, circulatory center due to violations. This type accounts for 5% ~ paralysis type 10%, damage to the respiratory center when irregular breathing, apnea; impaired vasomotor center may have changes in blood pressure and pulse rate, both of which are fatal diseases. Cranial nerve damage occurs when the corresponding nerve palsy symptoms and signs, to the facial nerve and Part X of the cranial nerve injury common.
3, this type of rare brain-type; high fever, irritability, convulsions, coma or lethargy, with upper motor neuron spastic paralysis performance.
4, mixed over the performance of several types exist.
(D) recovery from paralysis of the distal limbs began to recover, for several weeks to several months, usually within 8 months of cases can be fully restored, serious need 6 to 18 months or longer.
(E) sequelae of severe involvement of muscle contraction, nerve function can not be restored, resulting in affected limb deformities. Part of the paralysis-type cases for decades after infection, the occurrence of progressive neuromuscular weakness, pain, paralysis of limbs increased involvement, known as the "post-polio muscular atrophy syndrome." Of unknown etiology.
Complications: As of peripheral or central respiratory paralysis may be secondary to aspiration pneumonia, atelectasis, purulent bronchitis, and respiratory failure caused by severe bleeding; prolonged bed rest can lead to bedsores and nitrogen, calcium negative balance, the performance of osteoporosis , urinary tract stones and renal failure.
1, the latent infection (asymptomatic): 90 total infections to 95%, symptoms appear after infection, virus propagation only stay in the digestive tract, does not produce viremia, not immersed in the central nervous system, but the pharyngeal separable from the Ministry and feces can be found in vivo virus-specific neutralizing antibodies.
2, frustrated type (light): about 4 ~ 8% of virus attacks the body non-neural tissues, the lack of specificity of clinical symptoms can appear ① symptoms of upper respiratory tract inflammation, such as varying degrees of fever, throat discomfort, pharyngeal congestion and pharyngeal lymphoid tissue, tonsils, etc.; ② gastrointestinal symptoms, nausea, vomiting, diarrhea or constipation, abdominal discomfort; ③ flu-like symptoms, joint, muscle pain and other symptoms for 1 to 3, self-healing.
3, no paralysis type: polio virus invades the central nervous system and nerve fibers spread systemic circulation, can occur at the beginning of this period, the incidence of symptoms, but most patients in the prodromal period of 1 to 6 days after symptom or symptom relief , then enter this period.
4, paralysis type: about infection of 1 to 2%, characterized by paralysis in the absence of clinical manifestations, based on the combined gray matter involving the anterior horn of the spinal cord, brain and brain lesions, resulting in muscle paralysis.
Polio - Check
1, brain fluid: Most abnormalities in paralysis before. Slightly turbid appearance, the pressure increased slightly, the number of cells increased slightly (25 ~ 500/mm3), early in neutrophils as many places after the single-core-based, rapid heat back to normal, may be a slight increase in sugar, most of the normal chloride, protein slightly increased, and last longer, a small number of patients with spinal cord fluid can be always normal.
2, peripheral blood: the majority of normal white blood cells in early and secondary infection can be increased, mainly by neutrophils, acute phase ESR.
3, virus isolation or antigen detection: onset 1 week, and from the nasopharynx to isolate the virus in feces, feces can hold 2 to 3 weeks following the positive, early blood or cerebrospinal fluid from the isolated virus even greater significance, general separation method using tissue culture, in recent years, the use of PCR, detection of enterovirus RNA than the tissue culture and rapid sensitive.
4 polio patients, serological tests: type-specific antibody titers reached a peak in the first week can be, especially in specific IgM rose faster than IgG, and testing available in the complement fixation test and ELISA methods such as detection of specific antibodies, and experiments in which the more commonly used, because of persistent positive longer, double titer four times and 4 times more growth can be confirmed by the complement fixation test was negative and rapid, while in the negative on schedule and test positive, and often prompts past infection; both of which are positive, you are prompted recent infection, recent detection of antigen by immunofluorescence and specific IgM monoclonal antibody ELISA method for detecting early diagnosis.
Poliomyelitis - diagnosis
Whether the child is infected with polio, the need for testing stool taken, because the virus will appear in the human excrement of two to three weeks long, so samples from feces, easier to isolate the virus.
Prodromal period should be the general upper respiratory infection, influenza, gastroenteritis and other identification. Patients should be a variety of pre-paralysis virus encephalitis, purulent meningitis, tuberculous meningitis and encephalitis phase identification. Flaccid paralysis occurs in the diagnosis. Need to identify patients with the following:
(A) infection or inflammation of multiple nerve root known as Green - Bell Composite (Guillain-Barre's syndrome) more common in older children, distribution of onset, no heat or fever, with mild symptoms of upper respiratory tract inflammation, the gradual emergence of flaccid paralysis, goes to the line, symmetry, often accompanied by sensory disturbances. Increased cerebrospinal fluid protein and cells have less of its features. Recovered rapidly and completely paralyzed, with few side effects.
(B) rare familial periodic paralysis, no heat, sudden paralysis, symmetry, the rapid, throughout the body. Attack of low blood potassium, potassium quickly restored, but can recur. Often a family history.
(C) by peripheral neuritis neuritis after diphtheria, intramuscular injection injury, lead poisoning, vitamin B1 deficiency, caused by herpes zoster infection. History, physical examination can be identified, no change in cerebrospinal fluid.
(D) caused by paresis of other viral infections such as Coxsackie, ECHO virus infection, clinical difficult to identify, such as chest pain, rash and other typical symptoms, help to identify. Diagnosis depends on virus isolation and serology.
(E) encephalitis should be identified with this type of brain disease. Encephalitis occurs mainly in summer and autumn, rapid onset, often accompanied by consciousness disorder. Peripheral blood and cerebrospinal fluid are mainly an increase in neutrophils.
(F) pseudo-paralysis of infants and young children because of injuries, fractures, arthritis, vitamin C deficiency subperiosteal hematoma, physical activity may be limited, should be carefully examined to identify.
Polio - treatment:
Treatment of patients with acute polio
1, the general treatment: bed rest, isolation, at least until 40 days after onset, to avoid fatigue, muscle pain can be localized at the moist heat to relieve pain, paralysis of limb function should be placed in position to prevent hand, foot drop and other deformities. Attention to nutrition and fluid balance, can be taken orally a lot of vitamin C and B group, high fever, poisoning symptoms and patients with early, consider intramuscular injection of gamma globulin preparations, 3 ~ 6ml per day for 2 to 3 days, critically ill patients may be strong The loose oral or intravenous hydrocortisone. Usually with 3 to 5 days, secondary infection plus antibiotics.
2, respiratory disorders treatment: patients often severe respiratory disorders, caused by lack of oxygen and carbon dioxide retention, the main cause of death is often caused, we must first distinguish the cause of respiratory disorders, active rescue, to keep the airway open, hypoxia and irritability sedatives with caution, so as not to increase the breathing and swallowing difficulties early use of antimicrobial drugs to prevent secondary infection of the lungs, blood gas changes and close attention to the dielectric disorder, at any time be corrected.
Promote the recovery of paralysis
1, the patient should be lying on a hard mattress Banchuang, pay attention to paralyzed limbs of care, to avoid injury pressure, in a comfortable position functions, to prevent the pedal produces the phenomenon of vertical wrist, constipation and urinary retention, to provide appropriate enema and catheterization.
2, Chinese medicine treatment, the choice of DUHUOJISHENG Decoction.
3, difficulty breathing and swallowing disorders treatment, prevention and treatment of circulatory failure.
4, to promote the recovery of nerve conduction
Promote the function of nerve conduction drugs such as methimazole, such as the blue he was sensitive, the effect is not significant, now rarely used, in the heat back to do, when no longer paralyzed, early selection of the following treatments.
(1) acupuncture treatment: for younger age, short duration, body atrophy were not obvious. According to the paralyzed parts of the acupoints, neck and upper limb often take Jiaji, shoulder Chen, Ojo, hand three years, a small sea, the customs, Hegu, after the river, 2 to 3 points each election, the lower limbs often choose to open next lumbar 1 inch at, jump ring, rank edge, jumping, Yu Shu, thigh clearance, Yin Lian, the semi-finals, V rabbit, Cheng Fu, Yin gate, season, Yanglingquan, Zusanli, Xie River, the river too, must bone, the wind market, Cheng-shan, paralysis of limbs under the floor and other major muscle groups involved in the election for three or four points, each can be replaced alternately, 1 day, 10 to 15 times for a course, two courses are between 3 to 5 days, starting treatment after treatment with a strong stimulation to achieve change in the stimulus, the consolidation effect with weak stimulation, the needle can be electric or water needle, every election 1 to 2 point injection of vitamin B1 γ or blood of GABA Angelica fluid stasis of Chinese herbal compound (angelica, safflower, Chuanxiong preparation) per hole 0.5 ~ 1.0ml.
(2) Massage Therapy: The paralysis of limbs on the rolling method to roll back 8 to 10 minutes, rubbing loose joints 3 to 5 minutes, rub the spine and limbs 5 to 6 times, and local laws to rub rub hot day or every other day, families can be taught at home.
(3) functional exercise: weight is not in paralyzed limbs can be the first massage, massage, promote limb blood circulation, improve muscular and neural regulation, and enhance muscle strength, limb movement and muscle strength can be very poor for a minor who can help its for flexion, abduction, adduction and so passive action, physical activity and muscle strength has been able to remain poor, encourage patients to make automatic movement, the physical therapy, physical therapy tool training with muscle strength and correct deformities.
(4) therapy: to use hydrotherapy, electrotherapy, paraffin, light therapy, contributing to the disease, muscle relaxation, improve blood flow and absorption of inflammation.
(5) Other: Available cupping (cupping tank cylinders) and herbal fumigation, external application to promote the recovery of paralyzed limbs, and another reported application of acupuncture to stimulate the ligation therapy for longer paralyzed limbs to enhance muscle strength, limb deformities of wood can be used or cast immobilization, as well as with surgical correction.
Poliomyelitis - prevention measures
Polio patients
1, taking the polio vaccine.
2, the patient has been disease, isolated from the date of onset less than 40 days. At the same time, the patient excretions, secretions and contaminated equipment should be promptly disinfected.
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Tuesday, January 31, 2012
Monday, January 30, 2012
Rabies-What is rabies
Rabies-What is rabies?
Rabies, also known as hydrophobia. Rabies is a zoonotic infectious disease pathogens as the rabies virus is a zoonotic central nervous. Acute infectious disease of rabies through the system. Rabies causes acute encephalitis in mammals and peripheral nerve inflammation, did not receive vaccine in infection, when the nerve is almost inevitable death after onset of symptoms, the usual cause of death are due to central nervous system (brain - spinal cord) damage by the virus, the final died of organ failure caused by autonomic damage.
Rabies - Overview
Rabies mammals, primates, Carnivora, Chiroptera and other animals can become the purpose of rabies patients, such as people, cats, dogs, ferrets, raccoons, skunks, foxes, wolves, bears, bats have horses; and rodents (except beavers outside) very few infections, such as squirrels, chipmunks, rabbits, etc., but to be safe, be bitten by rodents such as mice or rabies vaccine should be injected.
Rabies - etiology:
Rabies vaccine rabies virus RNA-type rhabdovirus, one end of the round convex; end of the concave, shaped like a bullet diameter of 65 ~ 80nm, about 130 ~ 240nm. Virus is easy to sunlight, ultraviolet radiation, formaldehyde, mercuric chloride quaternary ammonium compounds (such as benzalkonium bromide), lipid solvents, 50% to 70% alcohol inactivated, the suspension by 56 ℃ 30 ~ 60 minutes or 100 ℃ 2 分钟 Jimie live. Virus or freeze-dried at -70 ℃ 0 ~ 4 ℃ after the home can remain viable for several years. Infected tissue can be stored in 50% glycerol incoming inspection.
Rabies virus containing five proteins, namely, glycoprotein (G), nucleoprotein (N), dimeric enzyme (L), phosphoprotein (NS) and matrix (M) and so on. The latter two for the small proteins. G can lead to the formation of neutralizing antibodies in vivo can be against virus attacks. N caused by antibodies and not with the force, can detect intracytoplasmic inclusion bodies.
Rabies - Pathogenesis:
Animal experiments show that the majority of rabies, the incubation period and does not appear during the onset of viremia, the incidence of rabies can be divided into three stages.
(A) the local organization from the breeding site of the bite viral invasion, after the wound of the striated muscle spindle receptors at nerve fibers gathered reproduction, later invaded the nearby peripheral nerves. From a local wound to invade peripheral nerves interval is generally less than 3 days, but also that the virus can stay in the invasion at 2 weeks old, or even longer (accounting for most of the incubation period).
(B) the period of the virus invade the central nervous around the nerve axon along concentric spread to the pulp, the hourly rate of about 3mm. Reach the dorsal root ganglia Festival, a large number of virus that is in their breeding, and then invade the central nervous system and spinal cord, cerebellum, etc. mainly affects the brain and neurons.
(C) the period of the virus spread to various organs of the central nervous system from the eccentric to the proliferation of peripheral nerves, invade the tissues and organs, especially in the saliva nucleus, glossopharyngeal nucleus and hypoglossal nucleus damage, there may be fear of the clinical water, breathing difficulties, swallowing difficulties and other symptoms. Saliva secretion, and increased sweating is caused by sympathetic stimulation, vagal ganglia, sympathetic ganglia and cardiac ganglion can cause damage to the patient cardiovascular dysfunction or sudden death.
Rabies - pathology
Congestion of brain and spinal cord of rabies. Microscope, showing diffuse changes in acute transverse myelitis. Nerve cell degeneration, necrosis, perivascular lymphocytes, plasma cells, the formation of blood vessel sleeves phenomenon. Occur within nerve cells characteristic of the Negri body, with a pathological diagnosis. Which appeared in the cytoplasm of nerve cells containing the body, were round or oval, clear boundary, eosinophilic, more common in hippocampal pyramidal cells and pyramidal cells in the brain. The number of cytoplasmic bodies from one to several months, but in the serious parts of the small number of this body.
The main pathological changes of acute diffuse encephalomyelitis, especially with the very site of the bite of the dorsal root ganglion and spinal cord segments, the brain's hippocampus, and medulla oblongata, pons, cerebellum, etc. as the most important, usually without meningeal disease. Brain parenchyma showed congestion, edema and minor bleeding, microscope, non-specific degeneration and inflammatory changes, such as nerve cells, vacuolization, hyaline degeneration and chromatin breakdown, perivascular mononuclear cell infiltration.
These lesions are non-specific, while 80% of patients in the cytoplasm of nerve cells, can be found a specific and a diagnosis of eosinophilic inclusion bodies, as in the base's body (Negribody). Lanes within the base's small round or oval diameter of about 3 ~ 10nm, neat edge, there are one or two seemed to be the nucleus of a small point, the most common in the hippocampus and cerebellar Purkinje cells in the nervous tissue; also The cone cells in the cortex layer of the spinal cord neurons, dorsal horn ganglion cell layer of retinal nerve, sympathetic ganglia, etc. detected. Within the base's body is actually set off the virus, electron microscope, a small body with baculovirus particles.
Salivary gland swelling, soft, clear degeneration of acinar cells, glandular tissue surrounded by mononuclear cell infiltration. And pancreatic acinar epithelium, gastric parietal cells, adrenal medullary cells, renal tubular epithelial cells can be acute degeneration.
Rabies - Rabies features:
Rabies can correctly identify the rabies, rabies is extremely important for the timely elimination. Rabies incidence of disease is generally divided into three phases: pre-behavior change usually only contact with dogs more easy to find talent. As usual, and you become very close to the dog back, or find a place to hide, and some even went very far away, but people usually do not move closer to the dog might become very affectionate with people, lick people close to it body and hands.
At this time the dog's saliva (saliva) already contains a virus, so there is the risk of contagious, sick dogs at this time to moderate fever, Eat or not eat, but also may be biting the soil, the surface blocks, rags and other debris, Dai Li sometimes stare or look empty flutter bite, often encountered stimulate terrified. For 2 days or so early into the exciting period. In the excitement, sick dogs performance was not stable, will stimulate the whole body vibrations encountered, and often attack people or other animals. Usually drooling, tail firmly between legs caught in the two later, bolted down, eye redness, barking mad bite, stiff neck or rotate not working and other symptoms. This period will last 2-3 days, maximum harm on the people; into the paralysis period, the performance of swing into action, scattered hairs, sagging chin, mouth Shenshe, last seen the trunk and limbs, paralysis and other symptoms, ultimately due to respiratory center paralysis or heart failure and death.
Rabies - Epidemiology
Rabies virus of the disease exists in 60 countries, including Southeast Asian countries, the incidence of particularly high. The incidence of domestic 0.4 / 100,000 to 1.58 / one hundred thousand dollars. Were significantly increased. Deaths in the status of legal infectious diseases ranks first or second place.
The mode of transmission is concerned, rabies can be divided into the city, and from non-immune dogs, cats spread; forest type is determined by skunks, foxes, raccoons, mongoose, wolves and bats cause.
Dogs, sick cats and other animals, more saliva containing the virus, the virus through the bite wound was immersed in the body. Mucous membrane is invaded portal, people can be sick because of conjunctival staining liquid animal to sleep, touch the dogs licking the anus and other mucous membranes were acquired infections. In addition, even by stripping sick animal skins, and the incidence of eating infected meat, there are clusters due to inhalation of bat caves in aerosols containing the virus become ill person.
People are generally susceptible to rabies virus, hunters, veterinarians and animal feed are more vulnerable to infection. Rural young people with opportunities for contact and more sick animals, so the incidence were also more. Tropical and subtropical regions are Benbingfasheng any season, spring and summer places in Northeast China is more common.
After people have been bitten by dogs, the average incidence rate of 15% to 20%, after being sick wolf bite is 50% to 60% (refer to those who have not been vaccinated). Disease or with the following factors: ① the bite site, head, face, neck, fingers, etc. The higher incidence; ② degree of trauma, wound deep and big to the high incidence of head and face up to the incidence of deep-injured 80%; ③ local handle the situation quickly and thoroughly cleaned after the bite of those less incidence; ④ clothing thickness, thick winter clothing, infected fewer opportunities; ⑤ Note vaccines, timely, full, full dose of rabies vaccine are The low incidence. Throughout the country report the incidence of injection was 0.15% (0.016% of foreign 0.48%), those who did not note the entire distance of 13.93%.
Rabies - clinical manifestations
Rabies incubation period of varying lengths, mostly in three months or less, an average of 66.9 days of domestic reports. 4 to 10% of patients more than half of the incubation period, 1% more than 1 year, an example of the literature up to 19 years. The length of incubation period and age (children shorter), the wound site (the incidence of head and facial bites earlier, an average of 39 days, the average incubation period of lower extremity bites 90 days), wound depth (deep by a short incubation period), the number of virus and intrusion virulence (toxic and strong by a short incubation period) and other factors, others such as debridement is not complete, trauma, exposure to cold, excessive fatigue, etc., can make the disease occurred earlier.
Rabies - clinical course can be divided into the following three.
(A) the prodromal period or invasion period before the onset of the excited state, most patients have fever, loss of appetite, nausea, headache (mostly in the occipital), fatigue, aches and discomfort, etc., exactly like the "cold"; followed by fear, anxiety, for sound, light, wind, and other more sensitive to pain, and throat tightness. More diagnostic significance of early symptoms of paresthesia and around the wound, there is numbness, itching, pain and formication, etc., which was caused by virus propagation neural stimulation, seen in 80% of cases. Current for 2 to 4 days.
(B) the excited patients gradually into a highly excited state, its outstanding performance as extreme terror, fear of water, afraid of the wind, seizure pharyngeal muscle spasms, difficulty breathing, sweating, salivation, urination and bowel problems, etc.
Fear of water is the specific symptoms of the disease, is caused by pharyngeal muscle spasm, but not necessarily each case are not necessarily in the early stage. Patients typically see the water, heard the sound of water, drinking water, or only mentioned in drinking water, can cause severe throat muscle spasms. Although most patients do not dare to drink thirsty, even after drinking can not swallow. Often accompanied by hoarseness and dehydration.
Wind is also a common symptom of fear, though the breeze can cause pharyngeal muscle spasm. Other stimuli such as light, sound, touch, etc., can lead to the same attack, serious attack, the body can still occur painful convulsions. Due to the presence of respiratory muscle spasm, it can lead to breathing difficulties and cyanosis.
Common sympathetic hyperactivity, manifested as an increase in saliva secretion, sweating, heart rate, blood pressure and body temperature and so on. Due to sphincter dysfunction and urination defecation difficulties were also quite common.
Most patients with a clear mind, though extreme fear and irritability, but rarely intrusive behavior. As the excited state of growth, some patients may suffer from mental disorders, delirium, hallucination, auditory hallucination, collision howling and so on. Disease progressed very quickly, many patients died of respiratory failure in the attack or circulatory failure. Period for 1 to 3 days.
(C) the paralysis period cramps stop, the patient becoming quiet, but there flaccid paralysis, especially in the limbs flaccid paralysis is most common. Ocular, facial muscles and masticatory muscles may also be involved, expressed as strabismus, eye movement disorders, jaw falling, I can not be closed, lack of facial expression and so on.
Patients becoming weak or irregular breathing, and tidal breathing occurs; breakdown pulse, blood pressure, reflex, mydriasis, may be due to respiratory and circulatory failure and rapid death. Before death than patients into a coma. Period for 6 to 18 hours. Throughout the course of rabies not more than 6, and occasionally exceed 10 persons.
In addition to these typical cases, there to a standstill as the main manifestation of the "paralytic" or "quiet type", also known as "dumb rabies" (dumb rabies), about 20%. This type of excitement and fear in patients with non-water phenomenon, with high fever, headache, vomiting, pain at the bite started, followed by limb weakness, abdominal distension, ataxia, muscle paralysis, incontinence, etc., showing transverse myelitis or ascending spinal paralysis and other symptoms. The lesions confined to the spinal cord and medulla oblongata, without involving the brainstem or higher parts of the central nervous system. Duration of up to 10 days due to respiratory muscle paralysis and eventually paralysis and death ball. Vampire bat rabies bite often is caused by this type.
Complications of rabies
May be inappropriate antidiuretic hormone secretion, may be complicated by pneumonia, pneumothorax, mediastinal emphysema, heart rate is not agent, heart failure, venous thrombosis, superior vena cava obstruction, upper gastrointestinal bleeding, acute renal failure.
Rabies - first aid measures
1 animal bites should immediately wash the wound. The key is to wash methods. Because the wound is closed as the valve, as with most, it is necessary to wash the wound broke. Rinse the wound with tap water though a bit against the pain, but we have reluctantly rinse carefully, so as to prevent infection. After washing use a clean gauze to the wound covered, speed to the hospital for treatment.
(2) after animal bites, even the smallest wound, but also the possibility of rabies infection, while infected with tetanus, wounds fester easily. Patients should ask the doctor rabies vaccine and tetanus antitoxin vaccination.
Dog bite dog bites and rabies sub-normal bite (the latter also known as rabies or hydrophobia), the former is no more danger, which is often stored in so mad (or healthy infected dog) rabies virus in saliva, along the bite, wound licking wounds or scratches to invade the nervous system within the brain multiply, causing severe symptoms. In addition to the dog, the infected cat, wolf bites can also occur in this disease. Bitten by infected animals without making the incidence of anti-injecting rate of 10% to 70% or more.
Rabies - a cure
Rabies (a) single-chamber strict isolation, hand care, quiet bed rest to prevent all sound, light, wind stimulation. Large venous catheter line of high nutritional therapy, Cong would be required to wear masks, gowns and gloves. The patient's secretions, excretions and pollutants, must be strictly disinfected. Installed bed rails to prevent seizures in patients injured.
(B) do a good job symptomatic treatment, prevention and treatment of complications
1 the phenomenon of the nervous system should have fear of water to drink fasting to minimize a variety of stimuli. Seizures may be phenytoin, diazepam, etc. Cerebral edema may be dehydrating agent such as mannitol and furosemide, may be invalid lateral drainage.
(2) anti-diuretic hormone pituitary dysfunction should be limited too much water intake, diabetes insipidus were to intravenous rehydration, with the posterior pituitary vasopressin (Pitressin).
3 Respiratory difficulties were to tracheostomy breathing, cyanosis, hypoxia, atelectasis atelectasis by oxygen, artificial respiration, complicated by pneumonia, to physical therapy and anti-bacterial drugs. Pneumothorax were, the implementation of lung recruitment technique. Taken to prevent aspiration pneumonia.
4 most of the cardiovascular system arrhythmia supraventricular, and hypoxemia should be oxygen, and viral myocarditis were handled by myocarditis. To vasoconstrictor agents and hypotension expansion rehydration. Heart failure, water restrictions, the application of Di digoxin and other cardiac stimulant. Arterial or venous thrombosis, venous catheter exchangeable; if the superior vena cava obstruction, should be allocated in addition to intravenous cannulation. Cardiac arrest and resuscitation were implemented.
5 Other anemia blood transfusion, gastrointestinal bleeding blood transfusion, rehydration. Cold mattress with high fever, hypothermia, heat blankets to those in blood volume is too low or too high, should be adjusted promptly.
Rabies - Prevention
In view of the disease of rabies no effective treatment, it should strengthen preventive measures to control the spread of the disease. Vaccination to prevent the onset of a positive value, strict implementation of dog management, can significantly reduce the incidence.
(A) the management of the source of infection to kill all the wild dogs on the need for keeping dogs, police dogs and experimental dogs, should be registered, and preventive vaccination. The sick cats, dogs found and killed immediately, to avoid wounding. Extraordinary dog bite, domestic cats should seek to capture, and isolated for observation for 10 days. Animals are still alive who can be identified as non-rabies quarantine can be lifted. Whichever of the brain tissue of dead animals should be checked, and burned or buried, must not peeling or eating.
(B) early wound treatment wound management is extremely important. Time after people have been bitten by 20% soapy water to fully clean the wound and keep clean. Those who still need to use the catheter wound deeper stretching, continuous perfusion with soapy water for cleaning. If serum for skin test negative, you can into the bottom and around the wound, the wound should not be sutured or bandaged.
(C) vaccination vaccination as follows: ① the wolf, fox and other wild animals that bite are; ② is the incidence of subsequent death (including the observation period) or a missing dog, cat bites are; ③ to have been killed and brain tissue The animal has been bitten by corruption; ④ skin wound is contaminated by the saliva of rabies; ⑤ wound in the head, neck, or large and deep wounds were such as biting animals (refer to non-endemic areas is concerned) and will remain the safety of 5 unharmed, injection can be discontinued; ⑥ medical staff broken skin contamination, etc. for the rabies patients. In recent years, China has found a number of bites and rabies disease death row, while the dog is safe, proven carriers of the virus within the dog's saliva, so endemic areas are bitten by dogs should be vaccinated. Table 11-8 shows the indications of rabies vaccination. Currently the use of rabies vaccine over the world in Table 11-9.
Rabies, also known as hydrophobia. Rabies is a zoonotic infectious disease pathogens as the rabies virus is a zoonotic central nervous. Acute infectious disease of rabies through the system. Rabies causes acute encephalitis in mammals and peripheral nerve inflammation, did not receive vaccine in infection, when the nerve is almost inevitable death after onset of symptoms, the usual cause of death are due to central nervous system (brain - spinal cord) damage by the virus, the final died of organ failure caused by autonomic damage.
Rabies - Overview
Rabies mammals, primates, Carnivora, Chiroptera and other animals can become the purpose of rabies patients, such as people, cats, dogs, ferrets, raccoons, skunks, foxes, wolves, bears, bats have horses; and rodents (except beavers outside) very few infections, such as squirrels, chipmunks, rabbits, etc., but to be safe, be bitten by rodents such as mice or rabies vaccine should be injected.
Rabies - etiology:
Rabies vaccine rabies virus RNA-type rhabdovirus, one end of the round convex; end of the concave, shaped like a bullet diameter of 65 ~ 80nm, about 130 ~ 240nm. Virus is easy to sunlight, ultraviolet radiation, formaldehyde, mercuric chloride quaternary ammonium compounds (such as benzalkonium bromide), lipid solvents, 50% to 70% alcohol inactivated, the suspension by 56 ℃ 30 ~ 60 minutes or 100 ℃ 2 分钟 Jimie live. Virus or freeze-dried at -70 ℃ 0 ~ 4 ℃ after the home can remain viable for several years. Infected tissue can be stored in 50% glycerol incoming inspection.
Rabies virus containing five proteins, namely, glycoprotein (G), nucleoprotein (N), dimeric enzyme (L), phosphoprotein (NS) and matrix (M) and so on. The latter two for the small proteins. G can lead to the formation of neutralizing antibodies in vivo can be against virus attacks. N caused by antibodies and not with the force, can detect intracytoplasmic inclusion bodies.
Rabies - Pathogenesis:
Animal experiments show that the majority of rabies, the incubation period and does not appear during the onset of viremia, the incidence of rabies can be divided into three stages.
(A) the local organization from the breeding site of the bite viral invasion, after the wound of the striated muscle spindle receptors at nerve fibers gathered reproduction, later invaded the nearby peripheral nerves. From a local wound to invade peripheral nerves interval is generally less than 3 days, but also that the virus can stay in the invasion at 2 weeks old, or even longer (accounting for most of the incubation period).
(B) the period of the virus invade the central nervous around the nerve axon along concentric spread to the pulp, the hourly rate of about 3mm. Reach the dorsal root ganglia Festival, a large number of virus that is in their breeding, and then invade the central nervous system and spinal cord, cerebellum, etc. mainly affects the brain and neurons.
(C) the period of the virus spread to various organs of the central nervous system from the eccentric to the proliferation of peripheral nerves, invade the tissues and organs, especially in the saliva nucleus, glossopharyngeal nucleus and hypoglossal nucleus damage, there may be fear of the clinical water, breathing difficulties, swallowing difficulties and other symptoms. Saliva secretion, and increased sweating is caused by sympathetic stimulation, vagal ganglia, sympathetic ganglia and cardiac ganglion can cause damage to the patient cardiovascular dysfunction or sudden death.
Rabies - pathology
Congestion of brain and spinal cord of rabies. Microscope, showing diffuse changes in acute transverse myelitis. Nerve cell degeneration, necrosis, perivascular lymphocytes, plasma cells, the formation of blood vessel sleeves phenomenon. Occur within nerve cells characteristic of the Negri body, with a pathological diagnosis. Which appeared in the cytoplasm of nerve cells containing the body, were round or oval, clear boundary, eosinophilic, more common in hippocampal pyramidal cells and pyramidal cells in the brain. The number of cytoplasmic bodies from one to several months, but in the serious parts of the small number of this body.
The main pathological changes of acute diffuse encephalomyelitis, especially with the very site of the bite of the dorsal root ganglion and spinal cord segments, the brain's hippocampus, and medulla oblongata, pons, cerebellum, etc. as the most important, usually without meningeal disease. Brain parenchyma showed congestion, edema and minor bleeding, microscope, non-specific degeneration and inflammatory changes, such as nerve cells, vacuolization, hyaline degeneration and chromatin breakdown, perivascular mononuclear cell infiltration.
These lesions are non-specific, while 80% of patients in the cytoplasm of nerve cells, can be found a specific and a diagnosis of eosinophilic inclusion bodies, as in the base's body (Negribody). Lanes within the base's small round or oval diameter of about 3 ~ 10nm, neat edge, there are one or two seemed to be the nucleus of a small point, the most common in the hippocampus and cerebellar Purkinje cells in the nervous tissue; also The cone cells in the cortex layer of the spinal cord neurons, dorsal horn ganglion cell layer of retinal nerve, sympathetic ganglia, etc. detected. Within the base's body is actually set off the virus, electron microscope, a small body with baculovirus particles.
Salivary gland swelling, soft, clear degeneration of acinar cells, glandular tissue surrounded by mononuclear cell infiltration. And pancreatic acinar epithelium, gastric parietal cells, adrenal medullary cells, renal tubular epithelial cells can be acute degeneration.
Rabies - Rabies features:
Rabies can correctly identify the rabies, rabies is extremely important for the timely elimination. Rabies incidence of disease is generally divided into three phases: pre-behavior change usually only contact with dogs more easy to find talent. As usual, and you become very close to the dog back, or find a place to hide, and some even went very far away, but people usually do not move closer to the dog might become very affectionate with people, lick people close to it body and hands.
At this time the dog's saliva (saliva) already contains a virus, so there is the risk of contagious, sick dogs at this time to moderate fever, Eat or not eat, but also may be biting the soil, the surface blocks, rags and other debris, Dai Li sometimes stare or look empty flutter bite, often encountered stimulate terrified. For 2 days or so early into the exciting period. In the excitement, sick dogs performance was not stable, will stimulate the whole body vibrations encountered, and often attack people or other animals. Usually drooling, tail firmly between legs caught in the two later, bolted down, eye redness, barking mad bite, stiff neck or rotate not working and other symptoms. This period will last 2-3 days, maximum harm on the people; into the paralysis period, the performance of swing into action, scattered hairs, sagging chin, mouth Shenshe, last seen the trunk and limbs, paralysis and other symptoms, ultimately due to respiratory center paralysis or heart failure and death.
Rabies - Epidemiology
Rabies virus of the disease exists in 60 countries, including Southeast Asian countries, the incidence of particularly high. The incidence of domestic 0.4 / 100,000 to 1.58 / one hundred thousand dollars. Were significantly increased. Deaths in the status of legal infectious diseases ranks first or second place.
The mode of transmission is concerned, rabies can be divided into the city, and from non-immune dogs, cats spread; forest type is determined by skunks, foxes, raccoons, mongoose, wolves and bats cause.
Dogs, sick cats and other animals, more saliva containing the virus, the virus through the bite wound was immersed in the body. Mucous membrane is invaded portal, people can be sick because of conjunctival staining liquid animal to sleep, touch the dogs licking the anus and other mucous membranes were acquired infections. In addition, even by stripping sick animal skins, and the incidence of eating infected meat, there are clusters due to inhalation of bat caves in aerosols containing the virus become ill person.
People are generally susceptible to rabies virus, hunters, veterinarians and animal feed are more vulnerable to infection. Rural young people with opportunities for contact and more sick animals, so the incidence were also more. Tropical and subtropical regions are Benbingfasheng any season, spring and summer places in Northeast China is more common.
After people have been bitten by dogs, the average incidence rate of 15% to 20%, after being sick wolf bite is 50% to 60% (refer to those who have not been vaccinated). Disease or with the following factors: ① the bite site, head, face, neck, fingers, etc. The higher incidence; ② degree of trauma, wound deep and big to the high incidence of head and face up to the incidence of deep-injured 80%; ③ local handle the situation quickly and thoroughly cleaned after the bite of those less incidence; ④ clothing thickness, thick winter clothing, infected fewer opportunities; ⑤ Note vaccines, timely, full, full dose of rabies vaccine are The low incidence. Throughout the country report the incidence of injection was 0.15% (0.016% of foreign 0.48%), those who did not note the entire distance of 13.93%.
Rabies - clinical manifestations
Rabies incubation period of varying lengths, mostly in three months or less, an average of 66.9 days of domestic reports. 4 to 10% of patients more than half of the incubation period, 1% more than 1 year, an example of the literature up to 19 years. The length of incubation period and age (children shorter), the wound site (the incidence of head and facial bites earlier, an average of 39 days, the average incubation period of lower extremity bites 90 days), wound depth (deep by a short incubation period), the number of virus and intrusion virulence (toxic and strong by a short incubation period) and other factors, others such as debridement is not complete, trauma, exposure to cold, excessive fatigue, etc., can make the disease occurred earlier.
Rabies - clinical course can be divided into the following three.
(A) the prodromal period or invasion period before the onset of the excited state, most patients have fever, loss of appetite, nausea, headache (mostly in the occipital), fatigue, aches and discomfort, etc., exactly like the "cold"; followed by fear, anxiety, for sound, light, wind, and other more sensitive to pain, and throat tightness. More diagnostic significance of early symptoms of paresthesia and around the wound, there is numbness, itching, pain and formication, etc., which was caused by virus propagation neural stimulation, seen in 80% of cases. Current for 2 to 4 days.
(B) the excited patients gradually into a highly excited state, its outstanding performance as extreme terror, fear of water, afraid of the wind, seizure pharyngeal muscle spasms, difficulty breathing, sweating, salivation, urination and bowel problems, etc.
Fear of water is the specific symptoms of the disease, is caused by pharyngeal muscle spasm, but not necessarily each case are not necessarily in the early stage. Patients typically see the water, heard the sound of water, drinking water, or only mentioned in drinking water, can cause severe throat muscle spasms. Although most patients do not dare to drink thirsty, even after drinking can not swallow. Often accompanied by hoarseness and dehydration.
Wind is also a common symptom of fear, though the breeze can cause pharyngeal muscle spasm. Other stimuli such as light, sound, touch, etc., can lead to the same attack, serious attack, the body can still occur painful convulsions. Due to the presence of respiratory muscle spasm, it can lead to breathing difficulties and cyanosis.
Common sympathetic hyperactivity, manifested as an increase in saliva secretion, sweating, heart rate, blood pressure and body temperature and so on. Due to sphincter dysfunction and urination defecation difficulties were also quite common.
Most patients with a clear mind, though extreme fear and irritability, but rarely intrusive behavior. As the excited state of growth, some patients may suffer from mental disorders, delirium, hallucination, auditory hallucination, collision howling and so on. Disease progressed very quickly, many patients died of respiratory failure in the attack or circulatory failure. Period for 1 to 3 days.
(C) the paralysis period cramps stop, the patient becoming quiet, but there flaccid paralysis, especially in the limbs flaccid paralysis is most common. Ocular, facial muscles and masticatory muscles may also be involved, expressed as strabismus, eye movement disorders, jaw falling, I can not be closed, lack of facial expression and so on.
Patients becoming weak or irregular breathing, and tidal breathing occurs; breakdown pulse, blood pressure, reflex, mydriasis, may be due to respiratory and circulatory failure and rapid death. Before death than patients into a coma. Period for 6 to 18 hours. Throughout the course of rabies not more than 6, and occasionally exceed 10 persons.
In addition to these typical cases, there to a standstill as the main manifestation of the "paralytic" or "quiet type", also known as "dumb rabies" (dumb rabies), about 20%. This type of excitement and fear in patients with non-water phenomenon, with high fever, headache, vomiting, pain at the bite started, followed by limb weakness, abdominal distension, ataxia, muscle paralysis, incontinence, etc., showing transverse myelitis or ascending spinal paralysis and other symptoms. The lesions confined to the spinal cord and medulla oblongata, without involving the brainstem or higher parts of the central nervous system. Duration of up to 10 days due to respiratory muscle paralysis and eventually paralysis and death ball. Vampire bat rabies bite often is caused by this type.
Complications of rabies
May be inappropriate antidiuretic hormone secretion, may be complicated by pneumonia, pneumothorax, mediastinal emphysema, heart rate is not agent, heart failure, venous thrombosis, superior vena cava obstruction, upper gastrointestinal bleeding, acute renal failure.
Rabies - first aid measures
1 animal bites should immediately wash the wound. The key is to wash methods. Because the wound is closed as the valve, as with most, it is necessary to wash the wound broke. Rinse the wound with tap water though a bit against the pain, but we have reluctantly rinse carefully, so as to prevent infection. After washing use a clean gauze to the wound covered, speed to the hospital for treatment.
(2) after animal bites, even the smallest wound, but also the possibility of rabies infection, while infected with tetanus, wounds fester easily. Patients should ask the doctor rabies vaccine and tetanus antitoxin vaccination.
Dog bite dog bites and rabies sub-normal bite (the latter also known as rabies or hydrophobia), the former is no more danger, which is often stored in so mad (or healthy infected dog) rabies virus in saliva, along the bite, wound licking wounds or scratches to invade the nervous system within the brain multiply, causing severe symptoms. In addition to the dog, the infected cat, wolf bites can also occur in this disease. Bitten by infected animals without making the incidence of anti-injecting rate of 10% to 70% or more.
Rabies - a cure
Rabies (a) single-chamber strict isolation, hand care, quiet bed rest to prevent all sound, light, wind stimulation. Large venous catheter line of high nutritional therapy, Cong would be required to wear masks, gowns and gloves. The patient's secretions, excretions and pollutants, must be strictly disinfected. Installed bed rails to prevent seizures in patients injured.
(B) do a good job symptomatic treatment, prevention and treatment of complications
1 the phenomenon of the nervous system should have fear of water to drink fasting to minimize a variety of stimuli. Seizures may be phenytoin, diazepam, etc. Cerebral edema may be dehydrating agent such as mannitol and furosemide, may be invalid lateral drainage.
(2) anti-diuretic hormone pituitary dysfunction should be limited too much water intake, diabetes insipidus were to intravenous rehydration, with the posterior pituitary vasopressin (Pitressin).
3 Respiratory difficulties were to tracheostomy breathing, cyanosis, hypoxia, atelectasis atelectasis by oxygen, artificial respiration, complicated by pneumonia, to physical therapy and anti-bacterial drugs. Pneumothorax were, the implementation of lung recruitment technique. Taken to prevent aspiration pneumonia.
4 most of the cardiovascular system arrhythmia supraventricular, and hypoxemia should be oxygen, and viral myocarditis were handled by myocarditis. To vasoconstrictor agents and hypotension expansion rehydration. Heart failure, water restrictions, the application of Di digoxin and other cardiac stimulant. Arterial or venous thrombosis, venous catheter exchangeable; if the superior vena cava obstruction, should be allocated in addition to intravenous cannulation. Cardiac arrest and resuscitation were implemented.
5 Other anemia blood transfusion, gastrointestinal bleeding blood transfusion, rehydration. Cold mattress with high fever, hypothermia, heat blankets to those in blood volume is too low or too high, should be adjusted promptly.
Rabies - Prevention
In view of the disease of rabies no effective treatment, it should strengthen preventive measures to control the spread of the disease. Vaccination to prevent the onset of a positive value, strict implementation of dog management, can significantly reduce the incidence.
(A) the management of the source of infection to kill all the wild dogs on the need for keeping dogs, police dogs and experimental dogs, should be registered, and preventive vaccination. The sick cats, dogs found and killed immediately, to avoid wounding. Extraordinary dog bite, domestic cats should seek to capture, and isolated for observation for 10 days. Animals are still alive who can be identified as non-rabies quarantine can be lifted. Whichever of the brain tissue of dead animals should be checked, and burned or buried, must not peeling or eating.
(B) early wound treatment wound management is extremely important. Time after people have been bitten by 20% soapy water to fully clean the wound and keep clean. Those who still need to use the catheter wound deeper stretching, continuous perfusion with soapy water for cleaning. If serum for skin test negative, you can into the bottom and around the wound, the wound should not be sutured or bandaged.
(C) vaccination vaccination as follows: ① the wolf, fox and other wild animals that bite are; ② is the incidence of subsequent death (including the observation period) or a missing dog, cat bites are; ③ to have been killed and brain tissue The animal has been bitten by corruption; ④ skin wound is contaminated by the saliva of rabies; ⑤ wound in the head, neck, or large and deep wounds were such as biting animals (refer to non-endemic areas is concerned) and will remain the safety of 5 unharmed, injection can be discontinued; ⑥ medical staff broken skin contamination, etc. for the rabies patients. In recent years, China has found a number of bites and rabies disease death row, while the dog is safe, proven carriers of the virus within the dog's saliva, so endemic areas are bitten by dogs should be vaccinated. Table 11-8 shows the indications of rabies vaccination. Currently the use of rabies vaccine over the world in Table 11-9.
Onychomycosis Treatment
Onychomycosis-Onychomycosis disease:
Onychomycosis, also known as onychomycosis. Onychomycosis is a large class of micro-organisms called fungi infection. Onychomycosis lesions began in a remote, side fold edge or a department, the performance of a color and shape abnormalities. Generally 1-2 (toe) A onset, severe all means (toe) may suffer. Sick deck dull, brittle and damaged falling off the deck. Easy to relapse, summer and autumn and more ease. Onychomycosis mostly gray, and dull; significant thickening of the deck surface uneven. The quality of loose debris, and subungual keratin debris is often deposited. Sometimes the deck with a separate bed.
Onychomycosis - Category
1, proximal subungual type onychomycosis: rare, most secondary to paronychia. First crack at the deck near the nail fold (ie, the proximal end of the deck) white, and later gradually expanded into a spot, missing the final partial deck, extended to the whole armor. Only this type of Trichophyton rubrum and Trichophyton rose due.
2, distal subungual type onychomycosis: a first performance of the remote (lateral edge) deck irregular small pieces of white, then become a dull gray leaf spot, and gradually becomes yellow-brown up to black. Soon the deck deterioration, subungual horny debris accumulation, thickening of the nail bed. Finally, the deck becomes atrophy, occasional bleeding. This type often by the red, gypsum-like, or Epidermophyton floccosum cause.
3, Superficial white onychomycosis: common refers to the nail. Performance of the deck surface with white spots or white 1 mm diameter the size of the plaques, a disease brittle and scraping off. This type of plaster-like only by Trichophyton or mold-like bacteria, caused by Fusarium and Aspergillus.
4, all dystrophic onychomycosis A: This is rare, and often more than the final result of the development of various types. A dull for the whole performance, deterioration, thickening or fragmentation, abnormal thickening of the left off the nail bed.
5, chronic mucocutaneous candidiasis Influenza (or true Candida onychomycosis) onychomycosis: a bad performance for the whole, swelling, crisp, verrucous surface, uneven.
6, chronic paronychia type of onychomycosis: a performance of the lateral and proximal nail fold folds, cuticle deterioration or change the skin brown. The most important feature is the existence of a paronychia, a week of swelling and not a fold under the hyperkeratosis may be a small amount of exudate but no pus. This type resembles caused by the candida.
7, fungal alpha-onychomycosis: a strong performance for the athlete's foot (known as "athlete's foot") toe trench rot, water rash.
Onychomycosis - Clinical manifestations
1. Onychomycosis of the most common pathogen was Trichophyton rubrum.
2 There are two types of onychomycosis. A manifestation of white armor, and often start with a root, white point of the deck surface, and gradually expand, causing the deck soft subsidence.
3 Another injury to start a free edge and sidewalls started to make a small depression or a deck there Yokomizo, and gradually developed to the deck brittle, fragile, thickened, was in brown. Accumulation of subungual debris often easy to make a empty, tilt and separation of the nail bed, the deck surface uneven, rough dull.
4 decks of onychomycosis usually uneven, black, the deck often mild atrophy, without thickening, often accompanied by paronychia.
Onychomycosis - the diagnosis of onychomycosis
Turbid
Onychomycosis, or nail bed fungal invasion of the deck, due to a large number of hyphae and spores multiply rapidly, making a bed, a lot of horny material accumulation, the naked eye view, the deck becomes cloudy, opaque, so a fungal disease known as ash (toe ) A.
Thickening
Fungi invade the nail bed or deck, the deck by the fungi in the horny material of the role of a high degree of proliferation, accumulation of the horny material of the deck thickness. Thickening of the deck also deepened nail bed turbidity, generally it can be thicker than a normal deck of 1 to 3 times.
Uneven surface
As the deck or under deck skin loads, while the deck has been destroyed, so that the deck surface of the rough, uneven and dull. This rugged for both vertical and horizontal can also. Can also understand a disease of the main lesion in the deck.
Deck brittle friable
As the deck and nail bed fungal invasion, the role of the enzyme dissolved in the skin, the skin but white is dissolved to form a small skin particles, damaged deck lack of flexibility and toughness and become brittle, skin particles in powder form easy to fall off, become loose and complex was broken.
A hierarchical
Onychomycosis thickening of the skin to dry matter, clastic, brittle, it easily from between the deck and fell off a bed, making the meat refers to the original bond with the surface of the nail, the phenomenon appears hollow, that the nail is divided into 2 layers , refers to the meat surface and separated from the other isolated thin layer of a stick refers to the quality of meat.
Color
Deck or under deck fungi accumulate different fungal hyphae or spores themselves can have a color. Lesions, thickening of the deck can also be present colors. A skin disease under the deck at the things off, can enter the dirt, dirt showing color. Deck damage, debris off the deck after that show color. It was a dirty gray, brown, white, yellow, black.
Tilt deck
Fungi and hyperplasia of the skin under a lot of things stacked the deck so the deck's remote tilt was significantly higher than the state, this time a disease becomes hypertrophic, more cloudy, color and more obvious. Affected toenail tilt deck shoes, seriously affecting the quality of life.
Shrinkage of the deck
Deck smaller, thinner, shorter length, the deck is called atrophy. Deck may have furrows and crevices, ridges, irregular spots, dull or dark brown, was insect-like, a poor flexibility, easily broken, sometimes leaving only a parent material of nearly half of the deck, deck of a small number of patients completely disappeared. Shrinkage of the deck is divided into congenital and acquired deck deck atrophy atrophy.
Off deck
Deck of onychomycosis fungal mycelium and spores of damage, brittle, clastic, proliferation, accumulation of the skin surface, especially from the deck off, and finally completely off the deck, only able to save and root. At this point the deck feature lost.
Onychomycosis - the cause
Onychomycosis 1) Environmental factors: high temperature, humidity is an important ringworm disease-prone conditions. Therefore, the summer rainy season of psoriasis patients than in winter, dry season and more important. The patient's working and living environment should not be ignored. Well-ventilated place than closed, place the wet low incidence of nausea. High incidence of people crowded places, where the incidence of low contrast. In the high temperature, high humidity plant, in particular, to wear heavy clothes and poor ventilation can produce an environment susceptible to ringworm, without equipment or failure to take a bath shower, the incidence of psoriasis patients will be significantly improved.
2) personal factors: men and women can get ringworm. In general, young men and women more susceptible; love sports, good actors are easy to suffer. Ringworm is not genetic, it is not clear there is no familial predisposition. Personal hygiene and directly related to psoriasis patients. Ground Huanyi, people often bathe less ringworm; in a public bathroom wash basin ponds and poor sanitary conditions in the swimming pool of people infected with ringworm is easy. Keeping cats, dogs and other pets who easily pets of dermatophytes infection. Sweating more people susceptible to ringworm. Certain chronic diseases such as malnutrition, hyperthyroidism, diabetes, many see ringworm disease, symptoms tend to emphasize. Some severe, such as AIDS patients with advanced cancer, not only a high incidence of fungal disease ringworm, but ringworm disease widely distributed, the performance of strange, very stubborn skin ulcers. Ringworm is a fungal genetic disease may be continued healing of another factor. Recently reported the foreign skin disease psoriasis, a chronic syndrome, caused by the Trichophyton rubrum. Patients are also suffering from hand, foot and ringworm, (toe) tinea, jock itch, tinea, and multiple follicular psoriasis. Course of a long, stubborn intractable. According to the survey associated with autosomal dominant inheritance. Easily induced when too thick tight underwear jock itch, ringworm hip. Often than not take the toilet seat are susceptible to hip ringworm. Shower after swimming were not timely and susceptible to tinea versicolor (Hanban). In addition, bathing too frequently, like people are more susceptible to scratching the ringworm disease, it is because excessive bathing, damage the epidermis layer of protection; frequent scratching caused not only scratched, but also easy to be implanted in the affected area with fungal dander or spread elsewhere.
Jiufu certain drugs such as anti-cancer drugs, glucocorticoid drugs, the chance of ringworm may increase, will expand the existing psoriasis, heavier, which is the skin immune dysfunction.
Onychomycosis - Treatment
The treatment of onychomycosis can be summarized as the following:
The treatment of onychomycosis therapy in addition to use:
General topical treatment of onychomycosis should be selected according to different agents, there are soaking, cut local applicator and packet treatment and other methods. Need to remove the disease, treatment with A, it is generally not convenient oral law, but safe, no pain, no side effects. As long as the selection of appropriate agents, the effect is more ideal. Pure Chinese medicine bath therapy (topical) treatment of onychomycosis (hands, athlete's foot) main ingredients include: Smilax glabra, flavescens, white moss skin, silkworm, all insects, centipedes, nosed pit viper and other herbs, the use of large doses, large concentration of each wash, soak twenty minutes or more. Take the whole hand, foot and partial immersion method of treatment (usually need to soak the entire deck) in order to achieve strong penetration of drug to the stratum corneum and skin deep deck, the deck thoroughly to kill parasites in the skin and the skin around the cuticle in all the fungi, the Gray (toe) A general treatment has been radical, to prevent recurrence of the produce. In the treatment of patients suffering from onychomycosis fifteen days to twenty days grow new roots in a mean, a whole continued to grow after the new drug, a disease all cut off, the patient received radical elimination of the treatment process will not no side effects.
The treatment of onychomycosis pulling a method
This law applies to a single hair of onychomycosis. Surgeons can for the patients under local anesthesia means the removal of their disease (toe). In addition, removal of chemical substances can be applied to a disease. If using 40% urea ointment wrapped a disease, once daily medication, usually dressing 5-7 times, illness can be softened with a deck bed separation, this time can be a disease removal. The advantage of this method is more thorough treatment of onychomycosis; The disadvantage is that the larger the patient's pain, and may cause inconvenience to the patient's daily life. Therefore, very few applications of this method is currently only in serious condition, the use of ineffective treatments before considering other uses.
Surgical treatment of onychomycosis pulling a:
Under local anesthesia, the risk of a removal. This approach wounds, bleeding, easy to cause infection. Surgery generally feel more pain, due to "temporary solution", generally less than ideal, easy to re-infection recurrence. And heart disease, hypertension, diabetes patients, not surgery.
Onychomycosis is a common skin disease Hand, now, the vast majority of onychomycosis can be cured. Commonly used methods include patients with a small knife scrape a crisp, thin or fell a thickening of the disease, and then coated with 10% or 30% acetic acid solution of iodine, the disease can also be immersed in 10% iodine, or a goose Zhang Feng cure in a few months to adhere to treatment, you can give birth to a new armor. Treatment of severe onychomycosis, oral griseofulvin even a few months.
Onychomycosis - susceptible people
Fingernails or toenails turned white, it is often called "onychomycosis," modern medicine known as onychomycosis. Onychomycosis by dermatophytes, yeasts and fungi to invade the deck and the deck under the nail bed occurs a chronic infectious disease. Dermatology A fungal disease is the common disease, but also a relatively cumbersome treatment of the disease.
The performance of a fingernail onychomycosis cloudy and dull, nail hypertrophy, a surface is uneven, a separation, discoloration, shrinking the deck, off deck, the deck tilt or a hook, or the performance of paronychia.
The elderly, diabetes, immune function is relatively low, or nail trauma, easy sweating, wearing tight shoes and socks for a long time who are the potential of onychomycosis-prone population.
1, a fungal disease in the elderly the most
Onychomycosis in the elderly the most, and older, the incidence rate, 60 years old or older high incidence of onychomycosis, a fungal disease, and some elderly people suffering long as 50-60 years. Generally more common in men than women, toenail fungus disease than the common nail.
2, pregnant women more prone to suffer from onychomycosis
Pregnant women because of fetal intra-abdominal, all aspects of life is not easy, feet sweat more, bent and feet is more difficult, life and more lazy, and prone to a fungal disease, and rapid development. Toenail onychomycosis is more common than fingernail. Pregnancy or lactation should not be found in onychomycosis treated with oral antifungal agents, or give the fetus or infant adverse reactions, should be treated with topical antifungal cream as well.
3, onychomycosis in diabetic patients is three times the normal.
Onychomycosis, also known as onychomycosis. Onychomycosis is a large class of micro-organisms called fungi infection. Onychomycosis lesions began in a remote, side fold edge or a department, the performance of a color and shape abnormalities. Generally 1-2 (toe) A onset, severe all means (toe) may suffer. Sick deck dull, brittle and damaged falling off the deck. Easy to relapse, summer and autumn and more ease. Onychomycosis mostly gray, and dull; significant thickening of the deck surface uneven. The quality of loose debris, and subungual keratin debris is often deposited. Sometimes the deck with a separate bed.
Onychomycosis - Category
1, proximal subungual type onychomycosis: rare, most secondary to paronychia. First crack at the deck near the nail fold (ie, the proximal end of the deck) white, and later gradually expanded into a spot, missing the final partial deck, extended to the whole armor. Only this type of Trichophyton rubrum and Trichophyton rose due.
2, distal subungual type onychomycosis: a first performance of the remote (lateral edge) deck irregular small pieces of white, then become a dull gray leaf spot, and gradually becomes yellow-brown up to black. Soon the deck deterioration, subungual horny debris accumulation, thickening of the nail bed. Finally, the deck becomes atrophy, occasional bleeding. This type often by the red, gypsum-like, or Epidermophyton floccosum cause.
3, Superficial white onychomycosis: common refers to the nail. Performance of the deck surface with white spots or white 1 mm diameter the size of the plaques, a disease brittle and scraping off. This type of plaster-like only by Trichophyton or mold-like bacteria, caused by Fusarium and Aspergillus.
4, all dystrophic onychomycosis A: This is rare, and often more than the final result of the development of various types. A dull for the whole performance, deterioration, thickening or fragmentation, abnormal thickening of the left off the nail bed.
5, chronic mucocutaneous candidiasis Influenza (or true Candida onychomycosis) onychomycosis: a bad performance for the whole, swelling, crisp, verrucous surface, uneven.
6, chronic paronychia type of onychomycosis: a performance of the lateral and proximal nail fold folds, cuticle deterioration or change the skin brown. The most important feature is the existence of a paronychia, a week of swelling and not a fold under the hyperkeratosis may be a small amount of exudate but no pus. This type resembles caused by the candida.
7, fungal alpha-onychomycosis: a strong performance for the athlete's foot (known as "athlete's foot") toe trench rot, water rash.
Onychomycosis - Clinical manifestations
1. Onychomycosis of the most common pathogen was Trichophyton rubrum.
2 There are two types of onychomycosis. A manifestation of white armor, and often start with a root, white point of the deck surface, and gradually expand, causing the deck soft subsidence.
3 Another injury to start a free edge and sidewalls started to make a small depression or a deck there Yokomizo, and gradually developed to the deck brittle, fragile, thickened, was in brown. Accumulation of subungual debris often easy to make a empty, tilt and separation of the nail bed, the deck surface uneven, rough dull.
4 decks of onychomycosis usually uneven, black, the deck often mild atrophy, without thickening, often accompanied by paronychia.
Onychomycosis - the diagnosis of onychomycosis
Turbid
Onychomycosis, or nail bed fungal invasion of the deck, due to a large number of hyphae and spores multiply rapidly, making a bed, a lot of horny material accumulation, the naked eye view, the deck becomes cloudy, opaque, so a fungal disease known as ash (toe ) A.
Thickening
Fungi invade the nail bed or deck, the deck by the fungi in the horny material of the role of a high degree of proliferation, accumulation of the horny material of the deck thickness. Thickening of the deck also deepened nail bed turbidity, generally it can be thicker than a normal deck of 1 to 3 times.
Uneven surface
As the deck or under deck skin loads, while the deck has been destroyed, so that the deck surface of the rough, uneven and dull. This rugged for both vertical and horizontal can also. Can also understand a disease of the main lesion in the deck.
Deck brittle friable
As the deck and nail bed fungal invasion, the role of the enzyme dissolved in the skin, the skin but white is dissolved to form a small skin particles, damaged deck lack of flexibility and toughness and become brittle, skin particles in powder form easy to fall off, become loose and complex was broken.
A hierarchical
Onychomycosis thickening of the skin to dry matter, clastic, brittle, it easily from between the deck and fell off a bed, making the meat refers to the original bond with the surface of the nail, the phenomenon appears hollow, that the nail is divided into 2 layers , refers to the meat surface and separated from the other isolated thin layer of a stick refers to the quality of meat.
Color
Deck or under deck fungi accumulate different fungal hyphae or spores themselves can have a color. Lesions, thickening of the deck can also be present colors. A skin disease under the deck at the things off, can enter the dirt, dirt showing color. Deck damage, debris off the deck after that show color. It was a dirty gray, brown, white, yellow, black.
Tilt deck
Fungi and hyperplasia of the skin under a lot of things stacked the deck so the deck's remote tilt was significantly higher than the state, this time a disease becomes hypertrophic, more cloudy, color and more obvious. Affected toenail tilt deck shoes, seriously affecting the quality of life.
Shrinkage of the deck
Deck smaller, thinner, shorter length, the deck is called atrophy. Deck may have furrows and crevices, ridges, irregular spots, dull or dark brown, was insect-like, a poor flexibility, easily broken, sometimes leaving only a parent material of nearly half of the deck, deck of a small number of patients completely disappeared. Shrinkage of the deck is divided into congenital and acquired deck deck atrophy atrophy.
Off deck
Deck of onychomycosis fungal mycelium and spores of damage, brittle, clastic, proliferation, accumulation of the skin surface, especially from the deck off, and finally completely off the deck, only able to save and root. At this point the deck feature lost.
Onychomycosis - the cause
Onychomycosis 1) Environmental factors: high temperature, humidity is an important ringworm disease-prone conditions. Therefore, the summer rainy season of psoriasis patients than in winter, dry season and more important. The patient's working and living environment should not be ignored. Well-ventilated place than closed, place the wet low incidence of nausea. High incidence of people crowded places, where the incidence of low contrast. In the high temperature, high humidity plant, in particular, to wear heavy clothes and poor ventilation can produce an environment susceptible to ringworm, without equipment or failure to take a bath shower, the incidence of psoriasis patients will be significantly improved.
2) personal factors: men and women can get ringworm. In general, young men and women more susceptible; love sports, good actors are easy to suffer. Ringworm is not genetic, it is not clear there is no familial predisposition. Personal hygiene and directly related to psoriasis patients. Ground Huanyi, people often bathe less ringworm; in a public bathroom wash basin ponds and poor sanitary conditions in the swimming pool of people infected with ringworm is easy. Keeping cats, dogs and other pets who easily pets of dermatophytes infection. Sweating more people susceptible to ringworm. Certain chronic diseases such as malnutrition, hyperthyroidism, diabetes, many see ringworm disease, symptoms tend to emphasize. Some severe, such as AIDS patients with advanced cancer, not only a high incidence of fungal disease ringworm, but ringworm disease widely distributed, the performance of strange, very stubborn skin ulcers. Ringworm is a fungal genetic disease may be continued healing of another factor. Recently reported the foreign skin disease psoriasis, a chronic syndrome, caused by the Trichophyton rubrum. Patients are also suffering from hand, foot and ringworm, (toe) tinea, jock itch, tinea, and multiple follicular psoriasis. Course of a long, stubborn intractable. According to the survey associated with autosomal dominant inheritance. Easily induced when too thick tight underwear jock itch, ringworm hip. Often than not take the toilet seat are susceptible to hip ringworm. Shower after swimming were not timely and susceptible to tinea versicolor (Hanban). In addition, bathing too frequently, like people are more susceptible to scratching the ringworm disease, it is because excessive bathing, damage the epidermis layer of protection; frequent scratching caused not only scratched, but also easy to be implanted in the affected area with fungal dander or spread elsewhere.
Jiufu certain drugs such as anti-cancer drugs, glucocorticoid drugs, the chance of ringworm may increase, will expand the existing psoriasis, heavier, which is the skin immune dysfunction.
Onychomycosis - Treatment
The treatment of onychomycosis can be summarized as the following:
The treatment of onychomycosis therapy in addition to use:
General topical treatment of onychomycosis should be selected according to different agents, there are soaking, cut local applicator and packet treatment and other methods. Need to remove the disease, treatment with A, it is generally not convenient oral law, but safe, no pain, no side effects. As long as the selection of appropriate agents, the effect is more ideal. Pure Chinese medicine bath therapy (topical) treatment of onychomycosis (hands, athlete's foot) main ingredients include: Smilax glabra, flavescens, white moss skin, silkworm, all insects, centipedes, nosed pit viper and other herbs, the use of large doses, large concentration of each wash, soak twenty minutes or more. Take the whole hand, foot and partial immersion method of treatment (usually need to soak the entire deck) in order to achieve strong penetration of drug to the stratum corneum and skin deep deck, the deck thoroughly to kill parasites in the skin and the skin around the cuticle in all the fungi, the Gray (toe) A general treatment has been radical, to prevent recurrence of the produce. In the treatment of patients suffering from onychomycosis fifteen days to twenty days grow new roots in a mean, a whole continued to grow after the new drug, a disease all cut off, the patient received radical elimination of the treatment process will not no side effects.
The treatment of onychomycosis pulling a method
This law applies to a single hair of onychomycosis. Surgeons can for the patients under local anesthesia means the removal of their disease (toe). In addition, removal of chemical substances can be applied to a disease. If using 40% urea ointment wrapped a disease, once daily medication, usually dressing 5-7 times, illness can be softened with a deck bed separation, this time can be a disease removal. The advantage of this method is more thorough treatment of onychomycosis; The disadvantage is that the larger the patient's pain, and may cause inconvenience to the patient's daily life. Therefore, very few applications of this method is currently only in serious condition, the use of ineffective treatments before considering other uses.
Surgical treatment of onychomycosis pulling a:
Under local anesthesia, the risk of a removal. This approach wounds, bleeding, easy to cause infection. Surgery generally feel more pain, due to "temporary solution", generally less than ideal, easy to re-infection recurrence. And heart disease, hypertension, diabetes patients, not surgery.
Onychomycosis is a common skin disease Hand, now, the vast majority of onychomycosis can be cured. Commonly used methods include patients with a small knife scrape a crisp, thin or fell a thickening of the disease, and then coated with 10% or 30% acetic acid solution of iodine, the disease can also be immersed in 10% iodine, or a goose Zhang Feng cure in a few months to adhere to treatment, you can give birth to a new armor. Treatment of severe onychomycosis, oral griseofulvin even a few months.
Onychomycosis - susceptible people
Fingernails or toenails turned white, it is often called "onychomycosis," modern medicine known as onychomycosis. Onychomycosis by dermatophytes, yeasts and fungi to invade the deck and the deck under the nail bed occurs a chronic infectious disease. Dermatology A fungal disease is the common disease, but also a relatively cumbersome treatment of the disease.
The performance of a fingernail onychomycosis cloudy and dull, nail hypertrophy, a surface is uneven, a separation, discoloration, shrinking the deck, off deck, the deck tilt or a hook, or the performance of paronychia.
The elderly, diabetes, immune function is relatively low, or nail trauma, easy sweating, wearing tight shoes and socks for a long time who are the potential of onychomycosis-prone population.
1, a fungal disease in the elderly the most
Onychomycosis in the elderly the most, and older, the incidence rate, 60 years old or older high incidence of onychomycosis, a fungal disease, and some elderly people suffering long as 50-60 years. Generally more common in men than women, toenail fungus disease than the common nail.
2, pregnant women more prone to suffer from onychomycosis
Pregnant women because of fetal intra-abdominal, all aspects of life is not easy, feet sweat more, bent and feet is more difficult, life and more lazy, and prone to a fungal disease, and rapid development. Toenail onychomycosis is more common than fingernail. Pregnancy or lactation should not be found in onychomycosis treated with oral antifungal agents, or give the fetus or infant adverse reactions, should be treated with topical antifungal cream as well.
3, onychomycosis in diabetic patients is three times the normal.
Vaccine
Vaccine-What is the vaccine?
What is the vaccine?
Vaccine is bacteria, viruses, tumor cells made of the body can produce specific immune biological agents. The term originated from the vaccine by Edward Jenner used cowpox ("vacca" the Latin, meaning cow). When humans after vaccinia vaccination, smallpox can produce antibodies. Vaccinia as Pasteur and others continue to study. The process of distributing and receiving the vaccine is called immunization. Vaccine can prevent pathogens from natural or wild, drug or treatment of infections caused by the impact.
Vaccine History:
In 1796, the history of the first dose of vaccine, the nature of the vaccinia vaccine against smallpox to
In 1879, the first anti-cholera vaccines branch
In 1881, the first anti-anthrax vaccine support
In 1882, the first anti-rabies vaccine support
In 1890, the first anchorage tetanus, diphtheria vaccine
In 1896, the first anchorage typhoid fever vaccine (typhoid fever)
In 1897, the first anti-plague vaccine support
In 1921, the first branch of anti-tuberculosis vaccine (BCG)
In 1926, the first team against whooping cough vaccine
In 1927, the first branch of anti-TB vaccine
In 1932, the first anchorage of yellow fever vaccine
In 1937, the first anchorage typhoid fever (typhus) vaccine
In 1945, the first anti-influenza vaccine support
In 1952, the first anti-polio vaccination teams
In 1954, the first anchorage Japanese encephalitis vaccine
In 1957, the first anchorage adenovirus vaccine
In 1962, the first oral polio vaccine anchorage
In 1964, the first anchorage German measles (Rubella)
In 1967, the first anchorage mumps vaccine (Mumps)
In 1970, the first anchorage roseola vaccine (roséole)
In 1974, the first anchorage varicella vaccine
In 1977, the first anchorage pneumonia vaccine (pneumococcal)
In 1978, the first anchorage meningitis vaccine (meningococcal)
In 1981, the first support anti-hepatitis B vaccine
In 1985, the first team against Haemophilus influenzae type B vaccine
In 1992, the first anti-hepatitis vaccines branch
In 1998, the first team against Lyme disease, rotavirus vaccine
In 2006, the first anchorage cervical cancer (HPV) vaccine
April 23, 2009, China announced the successful development of recombinant Helicobacter pylori vaccine export service
Vaccines - Category:
Vaccination with the biological products including vaccines, vaccine and toxoid. One, made by bacteria as vaccine; by a virus, rickettsia, spiral structure into the vaccine, sometimes referred to as vaccine.
Artificial active immunization agents
1 dead vaccine
Immunogenicity of a good selection of bacteria, viruses, rickettsia, snails and other times the body by artificial culture, and then the physical or chemical methods to kill is made. Loss of reproductive capacity of this vaccine, but retained immunogenicity. Vaccine into the body after death can not be growth and reproduction of the body to stimulate the short time required to obtain long-lasting immunity to repeated vaccination.
2 live attenuated vaccine
Directional variation of artificial methods, or screened from natural or non-toxic reduced virulence of live attenuated vaccine made of live microorganisms. Used live BCG vaccine (BCG), measles vaccine, polio vaccine. After vaccination with in vivo growth and reproduction ability, close to natural infection, pathogens can stimulate the body lasting immunity. Small amount of live vaccine, the immune longer duration. Live vaccine is better than dead vaccine.
3 subunit vaccine (vaccine component)
Remove pathogens unprotected immune function and even harmful ingredients, to retain its original composition after the effective immunization, the vaccine is made. Available chemical reagents cracking influenza virus, made its hemagglutinin, neuraminidase made; with meningococcal capsular polysaccharide made of subunit vaccines.
4 recombinant vaccine
Made the application of genetic engineering techniques, such as the genes encoding HBSAg into yeast genome, made of recombinant hepatitis B vaccine. Recombinant method can also be made more species, more affordable, safer and more effective vaccines or multivalent vaccine.
5.DNA vaccine
DNA vaccines is the pathogen or tumor antigen in whole or part of the protein cloned in the eukaryotic expression vector injected directly into the body, after it stimulating antigen expression in vivo body to produce immune response. The production method is simple, safe and effective. From 1992 to now there have been two DNA vaccines market.
6 toxoid
Extracellular toxin by formaldehyde treatment, loss of toxicity, immunogenicity remains for toxoid. Which increases the amount of aluminum phosphate and aluminum hydroxide adsorption Serve refined toxoid. Slow absorption of the body, can stimulate the body a long time, resulting in higher titers of antibodies to enhance the immune effect. There used toxoid diphtheria toxoid, tetanus toxoid and so on.
Passive immunization agents
1 antitoxin
(2) anti-bacterial and anti-virus serum serum
3 globulin
4-specific immunoglobulin
5 immune RNA
6 transfer factor
7 thymosin
8 of interferon
Artificial active immunization and passive immunization are artificial body can increase resistance to disease, but the latter's short duration, mainly with the treatment and emergency prevention.
Vaccination - inoculation time:
To provide the best protection, children grow to their immune system can react to some of the vaccine, they should receive the vaccine. In general, children need to receive booster to achieve full resistance of the resulting disease. Resulting in a complex vaccination schedule. In the United States, the Advisory Committee on Immunization to the U.S. Centers for Disease Control and Prevention (CDC) recommended immunization schedule increases. The Committee recommends that all children should receive hepatitis A, hepatitis B, polio, mumps, measles, German measles, diphtheria, pertussis, tetanus, influenza B, varicella, rotavirus, influenza, meningitis inflammatory disease and bacterial pneumonia vaccine is recommended in large amounts of vaccine and booster doses (up to twenty-four injections required to undergo two years of age) vaccinated all the vaccine can cause problems. To address the completion of all immunization rates fall, the Administration set up a different notification system. Market also provides a different combination vaccines (eg: Prevnar and [[ProQuad]), to provide a wide range of single inoculation resistance to disease.
Inoculation of the vaccine may be given admission to the conditions of different grades. This is only possible through the school to reduce the number of infectious diseases, and age is not a list of vaccines for children. Therefore, in order to avoid an outbreak may lead to influence, the school may need to immunize children against the highly contagious disease vaccines, such as: influenza B and varicella. And if the pathogen can only exist in which the patient's blood or body fluids; will not be transmitted through social activities, general classrooms, such as: Hepatitis B, the school requires students to vaccination of these diseases lower the chance of vaccine. Individual states in the United States, the Government will put forward by parents, religious, moral or medical reasons, to set the mandatory vaccination of all kinds of exemptions.
In addition to recommending booster immunization of infants, the experts suggest that certain vaccines vaccination should be repeated regularly - usually measles, tetanus, influenza and pneumonia. Pregnant women, the continued resistance of German measles is often filtered. In 2006, the shingles vaccine available. Shingles is caused by the varicella-zoster virus disease, usually affecting older people. The elders because of pneumonia and influenza vaccine primarily because of its greater impact on the elderly.
Miao - Dispute
Vaccine is widely recognized as reducing the prevalence and impact of many diseases. National and international public health organizations as vaccination for their resistance to disease, the strategic focus. The consensus of health care organizations and doctors through the large-scale vaccination campaigns to achieve personal and herd immunity to eradicate or control the deadly disease is a fundamental and effective components.
When the overwhelming majority of the medical profession to support vaccination as preventing the spread of infectious diseases and reduce the impact of an effective and safe means, and most public health advocates believe that mandatory vaccination program more good than harm to the public, the anti-vaccination people think that in the absence of the adverse effects of the vaccine study, the vaccine's effectiveness and safety is questionable.
Staff continue to study for a range of diseases and the development of new vaccines have been widely used vaccine effectiveness and safety.
Since the initial vaccination campaigns: there, there have been many different criticisms made against vaccination.
Some vaccines, including giving young children, contains a body will be metabolized into ethyl mercury antimicrobial agent thimerosal.
Potential side effects of vaccines:
The typical vaccine needle ingredients are: mercury, aluminum, formaldehyde, phenol, antibiotics, ethylene glycol, inactivated bacteria / virus. The injection into the bloodstream, but it will permanently remain in the body tissue, the brain's immune system continued to make continuous state of tension and release free radicals, may damage brain tissue, causing a language barrier, abnormal behavior, thought disorder, temperament changes . Meanwhile, the head outside of the normal immune function and so on.
From the June 2006-July 2007, more than 3,461 cases of cervical cancer vaccine to fight the anti-Gardasil adverse side effects after the Adverse Report, of which eight died, 31 intensive care, 1,385 a need emergency treatment, 451 long-term sequelae, 51 disability. (The Great HPV Vaccine Hoax Exposed.)
Vaccine - Save method
Extend the expiration date for the vaccine and reduce the production and storage costs, in the past was extensive use of ethyl mercury (ethylmercury) used as thimerosal (thimerosal). However, many children who use the relevant vaccine, leading to neurological abnormalities and heart disease, in addition to a small number of influenza vaccines, thimerosal in the United States, Denmark and other countries in phasing out, but may be used in the manufacturing process.
Vaccine - immunization:
Vaccine immunization consists of two programs: one is the whole basis of adequate immunity, that is 1 year old to complete the initial inoculation; Second, after the booster immunization, the vaccine according to population persistence and prevalence of immunity and disease timely manner cropping.
What is the vaccine?
Vaccine is bacteria, viruses, tumor cells made of the body can produce specific immune biological agents. The term originated from the vaccine by Edward Jenner used cowpox ("vacca" the Latin, meaning cow). When humans after vaccinia vaccination, smallpox can produce antibodies. Vaccinia as Pasteur and others continue to study. The process of distributing and receiving the vaccine is called immunization. Vaccine can prevent pathogens from natural or wild, drug or treatment of infections caused by the impact.
Vaccine History:
In 1796, the history of the first dose of vaccine, the nature of the vaccinia vaccine against smallpox to
In 1879, the first anti-cholera vaccines branch
In 1881, the first anti-anthrax vaccine support
In 1882, the first anti-rabies vaccine support
In 1890, the first anchorage tetanus, diphtheria vaccine
In 1896, the first anchorage typhoid fever vaccine (typhoid fever)
In 1897, the first anti-plague vaccine support
In 1921, the first branch of anti-tuberculosis vaccine (BCG)
In 1926, the first team against whooping cough vaccine
In 1927, the first branch of anti-TB vaccine
In 1932, the first anchorage of yellow fever vaccine
In 1937, the first anchorage typhoid fever (typhus) vaccine
In 1945, the first anti-influenza vaccine support
In 1952, the first anti-polio vaccination teams
In 1954, the first anchorage Japanese encephalitis vaccine
In 1957, the first anchorage adenovirus vaccine
In 1962, the first oral polio vaccine anchorage
In 1964, the first anchorage German measles (Rubella)
In 1967, the first anchorage mumps vaccine (Mumps)
In 1970, the first anchorage roseola vaccine (roséole)
In 1974, the first anchorage varicella vaccine
In 1977, the first anchorage pneumonia vaccine (pneumococcal)
In 1978, the first anchorage meningitis vaccine (meningococcal)
In 1981, the first support anti-hepatitis B vaccine
In 1985, the first team against Haemophilus influenzae type B vaccine
In 1992, the first anti-hepatitis vaccines branch
In 1998, the first team against Lyme disease, rotavirus vaccine
In 2006, the first anchorage cervical cancer (HPV) vaccine
April 23, 2009, China announced the successful development of recombinant Helicobacter pylori vaccine export service
Vaccines - Category:
Vaccination with the biological products including vaccines, vaccine and toxoid. One, made by bacteria as vaccine; by a virus, rickettsia, spiral structure into the vaccine, sometimes referred to as vaccine.
Artificial active immunization agents
1 dead vaccine
Immunogenicity of a good selection of bacteria, viruses, rickettsia, snails and other times the body by artificial culture, and then the physical or chemical methods to kill is made. Loss of reproductive capacity of this vaccine, but retained immunogenicity. Vaccine into the body after death can not be growth and reproduction of the body to stimulate the short time required to obtain long-lasting immunity to repeated vaccination.
2 live attenuated vaccine
Directional variation of artificial methods, or screened from natural or non-toxic reduced virulence of live attenuated vaccine made of live microorganisms. Used live BCG vaccine (BCG), measles vaccine, polio vaccine. After vaccination with in vivo growth and reproduction ability, close to natural infection, pathogens can stimulate the body lasting immunity. Small amount of live vaccine, the immune longer duration. Live vaccine is better than dead vaccine.
3 subunit vaccine (vaccine component)
Remove pathogens unprotected immune function and even harmful ingredients, to retain its original composition after the effective immunization, the vaccine is made. Available chemical reagents cracking influenza virus, made its hemagglutinin, neuraminidase made; with meningococcal capsular polysaccharide made of subunit vaccines.
4 recombinant vaccine
Made the application of genetic engineering techniques, such as the genes encoding HBSAg into yeast genome, made of recombinant hepatitis B vaccine. Recombinant method can also be made more species, more affordable, safer and more effective vaccines or multivalent vaccine.
5.DNA vaccine
DNA vaccines is the pathogen or tumor antigen in whole or part of the protein cloned in the eukaryotic expression vector injected directly into the body, after it stimulating antigen expression in vivo body to produce immune response. The production method is simple, safe and effective. From 1992 to now there have been two DNA vaccines market.
6 toxoid
Extracellular toxin by formaldehyde treatment, loss of toxicity, immunogenicity remains for toxoid. Which increases the amount of aluminum phosphate and aluminum hydroxide adsorption Serve refined toxoid. Slow absorption of the body, can stimulate the body a long time, resulting in higher titers of antibodies to enhance the immune effect. There used toxoid diphtheria toxoid, tetanus toxoid and so on.
Passive immunization agents
1 antitoxin
(2) anti-bacterial and anti-virus serum serum
3 globulin
4-specific immunoglobulin
5 immune RNA
6 transfer factor
7 thymosin
8 of interferon
Artificial active immunization and passive immunization are artificial body can increase resistance to disease, but the latter's short duration, mainly with the treatment and emergency prevention.
Vaccination - inoculation time:
To provide the best protection, children grow to their immune system can react to some of the vaccine, they should receive the vaccine. In general, children need to receive booster to achieve full resistance of the resulting disease. Resulting in a complex vaccination schedule. In the United States, the Advisory Committee on Immunization to the U.S. Centers for Disease Control and Prevention (CDC) recommended immunization schedule increases. The Committee recommends that all children should receive hepatitis A, hepatitis B, polio, mumps, measles, German measles, diphtheria, pertussis, tetanus, influenza B, varicella, rotavirus, influenza, meningitis inflammatory disease and bacterial pneumonia vaccine is recommended in large amounts of vaccine and booster doses (up to twenty-four injections required to undergo two years of age) vaccinated all the vaccine can cause problems. To address the completion of all immunization rates fall, the Administration set up a different notification system. Market also provides a different combination vaccines (eg: Prevnar and [[ProQuad]), to provide a wide range of single inoculation resistance to disease.
Inoculation of the vaccine may be given admission to the conditions of different grades. This is only possible through the school to reduce the number of infectious diseases, and age is not a list of vaccines for children. Therefore, in order to avoid an outbreak may lead to influence, the school may need to immunize children against the highly contagious disease vaccines, such as: influenza B and varicella. And if the pathogen can only exist in which the patient's blood or body fluids; will not be transmitted through social activities, general classrooms, such as: Hepatitis B, the school requires students to vaccination of these diseases lower the chance of vaccine. Individual states in the United States, the Government will put forward by parents, religious, moral or medical reasons, to set the mandatory vaccination of all kinds of exemptions.
In addition to recommending booster immunization of infants, the experts suggest that certain vaccines vaccination should be repeated regularly - usually measles, tetanus, influenza and pneumonia. Pregnant women, the continued resistance of German measles is often filtered. In 2006, the shingles vaccine available. Shingles is caused by the varicella-zoster virus disease, usually affecting older people. The elders because of pneumonia and influenza vaccine primarily because of its greater impact on the elderly.
Miao - Dispute
Vaccine is widely recognized as reducing the prevalence and impact of many diseases. National and international public health organizations as vaccination for their resistance to disease, the strategic focus. The consensus of health care organizations and doctors through the large-scale vaccination campaigns to achieve personal and herd immunity to eradicate or control the deadly disease is a fundamental and effective components.
When the overwhelming majority of the medical profession to support vaccination as preventing the spread of infectious diseases and reduce the impact of an effective and safe means, and most public health advocates believe that mandatory vaccination program more good than harm to the public, the anti-vaccination people think that in the absence of the adverse effects of the vaccine study, the vaccine's effectiveness and safety is questionable.
Staff continue to study for a range of diseases and the development of new vaccines have been widely used vaccine effectiveness and safety.
Since the initial vaccination campaigns: there, there have been many different criticisms made against vaccination.
Some vaccines, including giving young children, contains a body will be metabolized into ethyl mercury antimicrobial agent thimerosal.
Potential side effects of vaccines:
The typical vaccine needle ingredients are: mercury, aluminum, formaldehyde, phenol, antibiotics, ethylene glycol, inactivated bacteria / virus. The injection into the bloodstream, but it will permanently remain in the body tissue, the brain's immune system continued to make continuous state of tension and release free radicals, may damage brain tissue, causing a language barrier, abnormal behavior, thought disorder, temperament changes . Meanwhile, the head outside of the normal immune function and so on.
From the June 2006-July 2007, more than 3,461 cases of cervical cancer vaccine to fight the anti-Gardasil adverse side effects after the Adverse Report, of which eight died, 31 intensive care, 1,385 a need emergency treatment, 451 long-term sequelae, 51 disability. (The Great HPV Vaccine Hoax Exposed.)
Vaccine - Save method
Extend the expiration date for the vaccine and reduce the production and storage costs, in the past was extensive use of ethyl mercury (ethylmercury) used as thimerosal (thimerosal). However, many children who use the relevant vaccine, leading to neurological abnormalities and heart disease, in addition to a small number of influenza vaccines, thimerosal in the United States, Denmark and other countries in phasing out, but may be used in the manufacturing process.
Vaccine - immunization:
Vaccine immunization consists of two programs: one is the whole basis of adequate immunity, that is 1 year old to complete the initial inoculation; Second, after the booster immunization, the vaccine according to population persistence and prevalence of immunity and disease timely manner cropping.
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