狂犬病病毒狂犬病.ppt

狂犬病病毒 狂犬病rabies,狂犬病是人和动物共患疾病，一旦发病，病死率极高。 “狂犬病，八天命” 我国是世界上狂犬病发病较多的国家。也是记载本病最早的国家。,2,Despite being 100% preventable, one person dies from rabies every ten minutes. It is estimated that 55,000 people die worldwide from rabies each year.,-流行情况-,3,2007年统计：,中国狂犬病发病数全球第2，死亡率近100% 疫情最严重的5个省份分别是广西、贵州、四川、湖南和广东,-流行情况-,生物学性状,病毒形态：似子弹状 是嗜神经病毒：可在神经细胞中增殖，并在胞浆中形成卵园形的嗜酸性包涵体（内基体Negri-body）,生物学性状,6,Electron micrograph of rabies virus in brain cells at 64,000x magnification. The bullets surrounding the smoothe gray circle are rabies. The circle itself is the negri body, which can be seen with a light microscope.,7,helical nucleocapsid (RNA plus N protein),G glycoprotein SPIKES,lipid bilayer membrane,M protein,RHABDOVIRUSES,8,抵抗力,56。C 30min灭活 100。C 2min全部死亡 常温 脑组织存活710d 1%甲醛、新洁而灭 灭活,9,易感动物,致病性,传染源： 狂犬（主） 带病毒的动物 感染途径： 带病毒的动物 咬伤,11,A rabid dog, with saliva dripping out of the mouth,12,13,Rabies is known to have been transmitted between humans by transplant surgery.,14,Case,In October 2004 a female brown bear killed one human and injured several others near the city of Braov in Central Romania. The bear was killed by human hunters and diagnosed with rabies. More than one hundred humans were vaccinated afterwards.,15,致病性,潜伏期：数天数年（10d，20年或更长）通常2060d 与多种因素有关： 咬伤部位 感染年龄 接触病毒的数量,16,Rabies attacks the Central Nervous System,Watch as the rabies virus from an exposure on the leg spreads up the spinal cord to the brain and throughout the rest of the body.,Rabies virus entering the body.,17,18,狂犬病常见症状,早期症状：发热、乏力、头痛、伤口四周及传入神经通路相应皮肤麻木、发痒、疼痛或蚁爬感 中枢神经症状：烦躁不安、焦虑、郁抑 吞咽或饮水时咽部肌肉痉挛（又名恐水症）,19,恐水症 渴极畏饮，饮而不能下咽,恐水是本病的特殊症状，但不一定每例均有，亦不一定早期出现。 典型表现在饮水、见水、流水声或谈及饮水时，可引起严重咽喉肌痉挛。故患者渴极畏饮，饮而不能下咽，常伴有声嘶和脱水。,20,怕风亦本病常见的症状，微风、吹风、穿堂风等可引起咽肌痉挛。 其他如音响、光亮、触动等，也可引起同样发作。,21,惊厥、发作性全身肌肉痛性抽搐，精神异常、嚎叫、咬人、 麻痹、昏迷、呼吸衰竭而死亡,22,A patient with rabies, 1959,诊断,临床特点 被动物咬伤 病理检查：海马部神经细胞内发现内基小体有助诊断,防治原则,控制或消灭传染源（17.8%是健康带毒犬咬伤所致）动物接种兽用疫苗,25,被动物咬伤局部处理：主要为清创 1、立即20%肥皂水或0.1%新洁尔灭和清水充分冲洗,至少20分钟 2、3%碘酒消毒 3、注意！伤口不包扎与缝合 4、及时注射狂犬病毒疫苗与特异性Ig,27,小结,28,Children are particularly at risk, with almost half of all rabies deaths occurring in children under 15 years. The main source of human exposure to rabies, especially in children, is from dogs. Rabies can be transmitted from dogs not vaccinated against the disease. Unfortunately, vaccination is neglected in many parts of the world.,29,学习要求,1、掌握狂