A 6-year-old boy who died of rabies during the weekend could have been saved with a vaccine, doctors say.
Ryker Roque died after being scratched by a bat his father had put in a bucket after finding him.
The vaccine that could have saved it is one of the most effective vaccines that exist, with 100 percent effectiveness against a virus that is otherwise almost 100 percent fatal, according to the Centers for Disease Control and Prevention. of Diseases.
But it is also one of the most feared and misunderstood vaccines.
Here is what you need to know about the modern rabies vaccine:
They used to be horrible
The first vaccine against rabies was developed more than 100 years ago and was crude. "It was a nerve tissue vaccine, which means that it infects an animal with rabies, takes its brain, mixes it and makes a vaccine with that," said Dr. Ryan Wallace, a rabies expert at the National Emergency Center and Emergency of the CDC. Zoonotic infectious diseases.
"There are many really bad reactions that people and animals have to nervous tissue vaccines." They included a temporary paralysis similar to Guillain Barre syndrome, caused when the body's immune system mistakenly attacks healthy nervous tissue.
And yes, once he took 13 doses of the vaccine administered in the stomach muscle, partly because the vaccine itself was large volume and produced a large amount of fluid.
Rabies vaccines are better now
Modern rabies vaccines are grown in cells in laboratory dishes and are cleaner and more effective. "They have very low rates of adverse events and are more potent, so we only need a series of four injections, unlike the 13 injections that would get in the stomach in the previous version of the vaccine," Wallace said.
The four-dose regimen is 100 percent effective in preventing rabies, Wallace said.
People who fear having been exposed to rabies first receive an injection of immunoglobulin, prefabricated antibodies designed to catch any circulating virus immediately. Then they get four doses for 14 days of the preventive vaccine, which increases the body's own immune response.
"It's the same volume and the same level of pain as the flu shot," said Wallace.
It is not a routine vaccine for people
Dogs and cats are regularly vaccinated against rabies and most jurisdictions have strict laws to vaccinate these pets. But it is not like that for people. The Advisory Committee on Immunization Practices details who should be routinely vaccinated against rabies and includes veterinarians, speleologists (people who explore caves) and laboratory workers.
"The vaccine is administered as needed," Wallace said.
People traveling to areas with a lot of anger, such as India or Peru, can request rabies vaccines as a precaution. And the vaccine is administered to anyone who may have been exposed to rabies: as people bitten by a known rabid animal; those bitten or scratched by an animal that could potentially be rabid; and those exposed to rabies by bites or saliva.
"Between 40,000 and 60,000 people a year receive the rabies vaccine, almost everyone who should," said Wallace. "It's widely available, it's one of the reasons why we have so few human deaths from rabies in the United States."
There is time to get one, but not too long
People usually have time to get vaccinated after believing that they have been exposed to rabies.
"With rabies, the incubation period is extremely variable, from three weeks to three months," said Wallace.
Once people begin to show symptoms, it is almost always too late to vaccinate. A treatment called Milwaukee protocol has saved 18 people out of 80 people who have tried it, says its inventor, Dr. Rodney Willoughby, of the Children's Hospital of Wisconsin.
Any animal bite should be cleaned immediately. "Washing the wound can reduce the risk of death by 40 percent," said Wallace. And then people need to go see a doctor immediately.
"If it has been previously vaccinated … any future exposure requires a series of two-dose reinforcement, and according to that protocol, we have not had failures in the vaccine," Wallace added.
There is still a lot of anger around
The rage continues to kill 55,000 or more people a year around the world, says the World Health Organization. There are only a handful of cases in the US UU Thanks to vaccination. Strict dog immunization laws have eliminated the canine rabies strain in the US UU Although there are other strains in bats, raccoons, cats and other species, and dogs can catch those strains.
"Cats are the rabid animal No. 1 among domestic species, more than dogs, more than cattle, more than horses," said Wallace.
Any mammal can get rabies, but bats are the main reservoir in the USA. UU That is dangerous, since bats have small teeth that can cause painless cuts and people, especially young children, do not even realize they have been bitten.