GB 17014-1997 Diagnostic criteria and treatment principles for rabies
Some standard content:
GB17014—1997
Rabies, also known as hydrophobia, is an acute infectious disease caused by the rabies virus invading the nervous system. It is a natural zoonotic disease. Human rabies is mostly caused by bites from infected dogs, cats or wild animals, with a mortality rate of nearly 100%. The symptoms of this disease are typical and unique, and can be diagnosed based on clinical conditions. This standard was proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Tianjin Infectious Disease Hospital. The drafters of this standard are Zhu Limin and Yu Shuwen. This standard is interpreted by the Chinese Academy of Preventive Medicine, the technical management unit entrusted by the Ministry of Health. 566
1 Scope
National Standard of the People's Republic of China
Diagnostic creteria and principles of management of rabies
Diagnostic creteria and principles of management of rabies
This standard specifies the diagnostic criteria and management principles of rabies. GB 17014--1997
This standard applies to the diagnosis, reporting and treatment of rabies by personnel of medical, health and epidemic prevention institutions at all levels and of all types. 2 Diagnostic principles
Clinical diagnosis can be made mainly based on the epidemiological history of the disease and typical and unique clinical manifestations. 3 Diagnostic criteria
3.1 Epidemiological history
History of being licked or bitten by dogs, cats or other host animals. 3.2 Clinical symptoms
3.2.1 Abnormal sensation, numbness, itching, tingling or tingling in the healed bite wound or surrounding area. Excitement, irritability, fear, abnormal sensitivity to external stimuli such as wind, water, light, sound, etc.
3.2.2 "Hydrophobia" symptoms, accompanied by sympathetic hyperexcitability (drooling, sweating, fast heart rate, increased blood pressure), followed by muscle paralysis or cranial nerve paralysis (aphonia, aphasia, arrhythmia)). 3.3 Laboratory examination
3.3.1 Immunofluorescence antibody method for antigen detection: Saliva, nasopharyngeal wash, corneal print, skin slices were collected within the first week of onset and stained with fluorescent antibodies. Rabies virus antigen was positive.
3.3.2 For patients who survived for more than one week, serum neutralization test or complement fixation test was performed to detect antibodies. For patients with increased titers, if they had been vaccinated, the neutralization antibody titer should be more than 1:5000.
3.3.3 Postmortem brain tissue specimens were positive for virus isolation or positive for fluorescent antibody staining of prints or Negligible bodies were detected in brain tissue. 3.4 Case classification
3.4.1 Clinical diagnosis cases: meet 3.1 plus 3.2.1 or 3.2.2. 3.4.2 Confirmed cases: meet any of 3.4.1 plus 3.3. 4 Treatment principles
4.1 Strictly isolate the patient in a quieter, darker single ward to avoid unnecessary stimulation. 4.2 Strictly disinfect the patient's secretions and excretions. 4.3 Strengthen the monitoring of complications of respiratory and circulatory systems. 4.4 Symptomatic treatment: Supplement water, electrolytes and calories, correct acid-base imbalance; use various sedatives in turn for those who are restless and spasmodic, such as diazepam, phenobarbital, chloral hydrate and hibernation drugs. Dehydration agents are given for cerebral edema. Prevent respiratory muscle spasm from causing ventricular asphyxia. If necessary, perform tracheotomy and intermittent positive pressure oxygen. When there is tachycardia, arrhythmia, and high blood pressure, beta-receptor blockers or cardiotonic drugs can be used. 5
Prevention (see Appendix A for details)
Manage the source of infection.
2 Wound treatment.
3 Vaccination.
A1 Management of infection sources
GB 17014-1997
Appendix A
(Standard Appendix)
Prevention of rabies
Strengthen the management of dogs, and kill wild dogs as much as possible. Domestic dogs should be registered and vaccinated. Rabid dogs should be killed, burned or treated immediately. A.2 Wound treatment
Immediately wash all wounds and wounds thoroughly with 20% soapy water or clean water, rinse repeatedly for at least 20 minutes, and then apply 75% ethanol or 2% iodine. If the wound is deep, wide, severe, or occurs on the head, face, hands, neck, etc., after the skin test is negative, high-efficiency immune serum can be injected into the wound. The wound will not be sutured for a few days. Antibiotics and tetanus antitoxin can also be used as appropriate. A3 Vaccination
At present, the human rabies vaccine used in my country is the adapted strain of rabies fixed virus (aG), which is inoculated into primary hamster kidney monolayer cells. After culture, the virus liquid is harvested, inactivated by formaldehyde solution, concentrated 3 to 5 times, and then made by adding aluminum hydroxide. A3.1 Vaccination targets
Anyone bitten or scratched by rabies or other crazy animals should be injected with this vaccine in time. A3.2 Usage
A3.2.1 For general bites, 1 amp of vaccine (2 mL of liquid vaccine, 1 mL or 2 mL of freeze-dried vaccine) should be injected on days 0 (1st day, the day of injection), 3 (4th day, and so on), 7, 14, and 30. The dosage for children is the same. For serious bites, in addition to the above method of vaccination, double the amount of vaccine should be injected on days 0 and 3, and anti-rabies serum should be used at the same time as the vaccine on day 0 (wound treatment has been described). Anyone who uses anti-rabies serum in combination must receive 2-3 booster shots after the full course of vaccination, i.e., booster shots on the 15th, 75th, 10th, 20th, and 90th days after the full course of vaccination. Www.bzxZ.net
A3.2.2 Injection in the deltoid muscle.
A4 Application of anti-rabies serum
A4.1 Anyone who is known to have been bitten by a rabid dog or other rabid animal must be injected with anti-rabies serum or specific immunoglobulin at the same time as the vaccine.
A4.2 Those whose bites are close to the central nervous system or whose injuries are serious must be administered at the same time as the vaccine. A4.3 Application dose of anti-rabies serum:
Human antiserum (specific immunoglobulin) 20IU/kg. Heterologous antiserum 40IU/kg.
A4.4 Allergy test is required for heterologous antiserum. The method is to use 1/10~1/100 dilution of antiserum to inject 0.1ml of serum intradermally. If the redness of the skin papule is less than 1cm after 30 minutes, it is negative and the full amount can be injected. If it is positive, the dose can be gradually increased to desensitize the injection with complete base. 569
Tip: This standard content only shows part of the intercepted content of the complete standard. If you need the complete standard, please go to the top to download the complete standard document for free.