狂犬病病毒狂犬病rabies.ppt

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1、狂犬病病毒狂犬病rabies Still waters run deep.流静水深流静水深,人静心深人静心深 Where there is life,there is hope。有生命必有希望。有生命必有希望nDespite being 100%preventable,one person dies from rabies every ten minutes.n It is estimated that 55,000 people die worldwide from rabies each year.-流行情况-22007年统计：n中国狂犬病发病数全球第2，死亡率近100%n疫情最严重的疫情

2、最严重的5个省份分别是广西、贵州、个省份分别是广西、贵州、四川、湖南和广东四川、湖南和广东-流行情况-3n病毒形态：似子弹状n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）4生物学性状5nElectron micrograph of rabies virus in brain cells at 64,000 x magnification.The bullets surrounding the smoothe gray circle are rabies.nThe circle itself is the negri body,which c

3、an be seen with a light microscope.6helical nucleocapsid(RNA plus N protein)G glycoprotein SPIKESlipid bilayer membrane M proteinRHABDOVIRUSES7n56。C 30min灭活n100。C 2min全部死亡n常温 脑组织存活710dn1%甲醛、新洁而灭 灭活8 易感动物狼狼猫猫狗狗蝙蝠蝙蝠狐狸狐狸狂犬病病毒狂犬病病毒易感动物易感动物9致病性n传染源：狂犬（主）带病毒的动物 n感染途径：带病毒的动物 咬伤 10A rabid dog,with saliva dr

4、ipping out of the mouth 1112nRabies is known to have been transmitted between humans by transplant surgery.13CasenIn October 2004 a female brown bear killed one human and injured several others near the city of Braov in Central Romania.nThe bear was killed by human hunters and diagnosed with rabies.

5、nMore than one hundred humans were vaccinated afterwards.14致病性15Rabies attacks the Central Nervous SystemnWatch 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.1617狂犬病常见症状n早期症状：发热、乏力、头痛、伤口四周及传入

6、神经通路相应皮肤麻木、发痒、疼痛或蚁爬感n中枢神经症状：烦躁不安、焦虑、郁抑n吞咽或饮水时咽部肌肉痉挛（又名恐水症）18恐水症 渴极畏饮，饮而不能下咽n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。n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。19n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。n其他如音响、光亮、触动等，也可引起同样发作。20n惊厥、发作性全身肌肉痛性抽搐，精神异常、嚎叫、咬人、n麻痹、昏迷、呼吸衰竭而死亡21A patient with rabies,1959 22诊断诊断23防治原

7、则防治原则24n被动物咬伤局部处理：主要为清创n1、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 n2、3%碘酒消毒n3、注意！伤口不包扎与缝合n4、及时注射狂犬病毒疫苗与特异性Ig2526小结27nChildren are particularly at risk,with almost half of all rabies deaths occurring in children under 15 years.nThe main source of human exposure to rabies,especially in children,is from dogs.n

8、 Rabies can be transmitted from dogs not vaccinated against the disease.nUnfortunately,vaccination is neglected in many parts of the world.28学习学习要求要求1、掌握狂犬病病毒内基小体，传染源，掌握狂犬病病毒内基小体，传染源，传染途径，发病机理。传染途径，发病机理。2、熟悉、熟悉防防治原则（伤口处理原则，治原则（伤口处理原则，狂犬病灭活疫苗，特异性免疫球蛋狂犬病灭活疫苗，特异性免疫球蛋白）。白）。3、了解形态结构，微生物学检查。、了解形态结构，微生物学检查。29思考题n一儿童被街上买回来的苍鼠咬伤手指，伤口出血，来到医院看病，请问正确的处理方法是什么？30