Incubation period

The incubation period is usually 1-2 months, but the time varies greatly, ranging from 4 days to 6 years in records. At this time, the virus reproduces in the muscles of the wound. The time depends on the distance between the muscles and the central nervous system, the amount of virus infection, the degree of wound ulceration, immunity and other factors. During the incubation period, infected people have no symptoms and are not contagious. Treatment is most effective at this stage and can be treated with vaccinations.

Initial stage (lasting 2 to 10 days)

Most patients experience non-specific symptoms, including general malaise, fever, fatigue, restlessness, nausea, loss of appetite, etc., and are sensitive to pain, Sensitivity to external stimuli such as sound, light, etc., causing a tightness in the throat. As the virus multiplies profusely near the wound and causes peripheral nerve irritation, you may feel numbness, itching, tingling, or crawling insect sensations near the wound. This stage is the transition period for the virus to transfer from the peripheral nerves to the central nervous system.

Middle stage (convulsive period, lasting about 1 to 3 days)

At this time, the virus multiplies in large numbers in the central nervous system, causing damage and making it impossible to treat. The original symptoms became intense and obvious, and severe spasms occurred. The patient becomes insane and develops symptoms such as hallucinations, delirium, and auditory hallucinations. At the same time, the patient's reaction to external stimuli such as light, sound, water, and wind becomes more intense, with the most severe reaction to water. Damage to the vagus nerve nucleus, glossopharyngeal nerve nucleus, and hypoglossal nerve nucleus causes protective reflexes in the respiratory tract, spasms of respiratory muscles, and swallowing muscles, resulting in symptoms such as hydrophobia, swallowing, and dyspnea, which may last for 5 minutes.
In particular, hydrophobia is a symptom that occurs in up to 80% of patients (the symptoms of hydrophobia in individual patients are not typical and may not appear early). This symptom is an important symptom to confirm whether they are suffering from rabies. One, because this symptom has not appeared in other diseases except rabies. The manifestations of this "water fear" are quite diverse. For example, "drinking water", "the sound of running water", and "seeing water" may cause severe spasm of the throat muscles. At this time, the patient often suffocates and dies due to severe laryngeal spasm.
Due to the invasion of the brain, various cognitive functions have begun to deteriorate. Coupled with pain and swelling in the throat and lack of oxygen, the face will appear distorted and irritable, and impulsive and out-of-control scenes may suddenly occur, such as Behaviors such as yelling and self-mutilation, as well as dehydration due to excessive sweating due to persistent high fever. Some patients with milder conditions still have some speech and autonomy during this period, but their consciousness is no longer clear. During this period, most patients may die of central nervous failure, respiratory failure, heart failure, high blood pressure, or major stroke at any time due to high fever and nerve damage.

Terminal stage (paralysis period, lasting 6 to 18 hours)

As the spasms and convulsions gradually stop, the disease enters the terminal stage. thisThe patients seemed to gradually become quieter, and a few patients showed temporary improvement and regained consciousness. They were able to cooperate with treatment, answer simple questions, or barely drink and eat. The disease seems to be getting better, but consciousness will soon become blurry again, and various paralysis symptoms gradually appear, especially limb paralysis, which also includes "facial paralysis", "abdominal wall reflex, cremasteric reflex, knee jerk reflex" and other physiological reflexes. Symptoms that disappear can also appear.
At this time, the patient quickly fell into coma, his breathing gradually weakened and became irregular, and a large number of "phlegm sounds" appeared. The pulse becomes progressively weaker, irregular, or even undetectable. The heartbeat slows, the heart rate becomes confused, and the blood pressure gradually drops. The skin loses color and becomes clammy, with patterns and the tips of the fingers becoming gray.

The patient's pupils eventually became dilated, brown liquid leaked from the mouth and nose, and he quickly died of respiratory, circulatory and systemic failure. The terminal process progresses very quickly, and the patient may die in less than a day.