Rabies Article

By David W. Blodgett, MD, MPH

SWUPHD Director & Health Officer

 

I sometimes have the opportunity to speak to local middle school-aged students about how various diseases spread.  Knowing this can make all the difference in keeping disease from spreading and avoiding infection in the first place. One of the points I always make is this: if you encounter a wild animal that seems easy to catch, but would normally not be, stay away! This generally means there is something wrong, so consider it a warning sign to keep your distance.

Rabies, tularemia, and plague are among diseases that can infect animals and then be transmitted to humans. This year there have been more reports than usual of rabid animals throughout Utah, including several cases here in our part of the state.  I thought it might be helpful to share some information about rabies and its risks.

Rabies is a deadly virus spread to people from the saliva of infected animals, usually through a bite. In developing countries, stray dogs are most likely to spread rabies to people. While any mammal could transmit the disease,  the animals most likely to do so in the United States include bats, coyotes, foxes, raccoons, and skunks. Cases in domestic dogs and cats are fewer in number due to vaccination programs, but can still occur. Most of the rabies identified in southwest Utah occurs in bats or animals that have been bitten by bats.

Human rabies cases in the United States are rare, with only one to three cases reported annually. Thirty-four cases of human rabies have been diagnosed in the United States since 2003, although ten of those cases were found to have been infected outside of the country.

Rabies infection usually results in flu-like symptoms along with confusion, anxiety, and agitation; followed by insomnia, abnormal behavior, and hallucinations. Unfortunately, once a person begins showing signs and symptoms of rabies, the disease is nearly always fatal. For this reason, anyone who is determined to have possibly been infected should receive rabies vaccine for protection. When given soon enough, the vaccine is very effective.

Seek immediate medical care if you’re bitten by any animal, or exposed to an animal suspected of having rabies. Based on your injuries and the situation in which the exposure occurred, you and your doctor can decide whether you should receive treatment to prevent rabies. It may be helpful to consult with the health department as well. In our area, only emergency rooms administer rabies vaccines and medication,

To be on the safe side, seek medical attention, even if you’re unsure you were bitten. If you awaken to find a bat in your room, assume you’ve been bitten, which may have occurred without waking you. If you find a bat near a person who can’t report a bite, such as a small child or a person with a disability, also assume that person has been bitten.

There’s no way to know whether a bite from a rabid animal has actually transmitted the virus to you. For this reason, treatment to prevent infection is recommended if the doctor thinks there’s even a chance you have been exposed.

Rabies vaccines are given as injections which include:

  • A fast-acting rabies immune globulin to prevent the virus from infecting you. Part of this injection is given near bite area, if known, and as soon as possible after being exposed.
  • A series of four rabies vaccines to help your body learn to identify and fight the virus. These shots are given in the arm over a 14 day period.

In many cases it’s possible to determine whether the animal that bit you has rabies before starting the vaccine series. If the suspect animal turns out to be rabies-free, you won’t need the shots, which can be very expensive. Procedures depend on the scenario:

  • After a bite from a cat, dog, or ferret, the animal can be observed for ten days for signs and symptoms of rabies. If the animal that bit you remains healthy during the observation period, then you won’t need rabies shots. Other pets and farm animals are considered on a case-by-case basis. Talk to your doctor or the health department to determine whether you should receive rabies shots.
  • A bite from a wild animal that can be found and captured, such as a bat that entered your home, can be killed and tested for rabies. Negative test results mean you won’t need the shots.
  • If the animal that bit you can’t be found, discuss the situation with your doctor and the health department. In certain cases, it may be safest to assume that the animal had rabies and proceed with the rabies shots. In other cases, it may be unlikely that the animal in question had rabies and that rabies shots aren’t necessary.

If an animal bites you, get medical attention for the wound as soon as you can. Make sure to tell the doctor about the circumstances of your injury. The doctor will ask:

  • What animal bit you?
  • Was it a wild animal or a pet?
  • If it was a pet, do you know to whom the animal belongs? Was it vaccinated?
  • Can you describe the animal’s behavior before it bit you? Was the animal provoked?
  • Were you able to capture or kill the animal after it bit you?

In the meantime, wash your wound gently and thoroughly with soap and generous amounts of water, which may help prevent infection from the virus.

If the animal that bit you can be contained or captured without further injury to yourself or others, do so. Tell your doctor that you have captured the animal that bit you. Your doctor may then contact the local health department to determine what to do next. Do not kill the animal with a blow or a shot to the head, as this may make it difficult to perform laboratory tests on the brain to determine whether the animal has rabies. If the animal is dead, put it on ice or in a refrigerator to preserve it for testing. Heat and freezing can make the test unreadable.

Animal owners can do their part by having their pets vaccinated against rabies according to the recommended schedule. This will protect the animals from contracting rabies, which in turn protects the people around them.

A final reminder: if a wild animal lets you get close to it, back off and don’t touch it!

 

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