118 CHA

Spain is free of rage since 1978, although there are cases in animals in Ceuta and Melilla, and very exceptionally, in humans, All of them imported; Mass migrations or trips to endemic countries without taking due precautions today constitute the main risk today.

Cases such as that of the Valencian tourist who remain in the UCI in a very serious state are unusual in Spain, where only two others of human rage have been declared since 2000, all imported from Morocco: one, in Madrid in 2014 and another in Euskadi in 2019. Both died.

In 2004, another was documented in an Austrian tourist, also imported from Morocco, but was finally declared in Austria, according to the Carlos III Health Institute.

The appearance of these cases, and other sporadic in animals – fundamentally, in Ceuta and Melilla – have not stripped Spain of their status as a country free of rage, which it reached in 1978 and that only lost for 6 months in 2013 due to a case in a dog illegally introduced from Morocco.

Thus, the main risk of import, as detailed by Carlos III in the document ‘Situation of Earth Rabies in Spain in the 21st Century’, are tourism, cooperation or business trips to countries with endemic rage without taking appropriate measures.

If any, it would not represent any risk for the general population, although its nearby contacts must be monitored and evaluate the type of contact they could have to assess the administration of anti -rabies or immunoglobiulin vaccine, they clarify Efe from the Ministry of Health.

It is a high lethality zoonosis caused by several types of ‘lysssavirus’. It is present in 150 countries of all continents, except Antarctica. Half of the world’s population lives in an endemic zone, being Africa and Asia those who bring together 95 % of fatal cases.

In Europe, the main reservoirs are red fox, followed by small wild carnivores such as the Mapache dog in central and the Baltic Europe and the bat in Spain.

The incubation period is usually 2 to 3 months, although it can reach the year. The virus penetrates the peripheral nerves and is spread through the neurons, so it depends on the location of the wound, the amount of affected nerve tissue and the distance to the central nervous system.

The first symptoms include fever, headache and pruritus in the virus entrance area; When it moves to the central nervous system, they begin another symptomatology that goes from confusion, agitation or hypersensitivity to light and sound to the delirium and progressive paralysis that ends in death.

It occurs, fundamentally, by bite of a sick animal, or when its saliva is put in intimate contact with fresh and open wounds. The risk of infection is greater if there are several bites, if they occur in the face or if the area is not covered by clothing.

The first thing to do when you go to endemic areas is to avoid contact with wild animals or whose sanitary status is unknown.

After a bite, you have to deeply wash the wound for a few minutes with plenty of running water and soap, and urgently go to a health center.

Vaccination against rabies in humans is not systematic in Spain, so it is not included in the common calendar, although there are certain circumstances (laboratory workers, zoologists, veterinarians, etc.) in which Its administration is recommended before exposure to virus (pre -exposition prophylaxis) or later (possexposition prophylaxis).

Before making any decision and before any questions, public health services must be consulted.

And treatment?

The treatment is based on preventing the dissemination of the virus by the nervous system with the early administration of post exposure prophylaxis.

Once neurological symptoms are developed, it is mainly symptomatic and support, but the prognosis is terrifying: almost all cases end in a coma, respiratory paralysis and death. EFE

there/ram

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06/05/15-56/25 EFE 05-06-25 17:58:56