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What is rabies?
From the
Centers for Disease Control and Prevention (CDC) website on rabies:
“Rabies is a preventable viral disease of mammals most often transmitted
through the bite of a rabid animal. The vast majority of rabies cases
reported to the Centers for Disease Control and Prevention (CDC) each year
occur in wild animals like raccoons, skunks, bats, and foxes. Domestic
animals account for less than 10% of the reported rabies cases, with cats,
cattle, and dogs most often reported rabid.
“Rabies virus infects the central nervous
system, causing encephalopathy [a brain disease] and ultimately death.
Early symptoms of rabies in humans are nonspecific, consisting of fever,
headache, and general malaise [a vague feeling of unwellness]. As the
disease progresses, neurological symptoms appear and may include insomnia,
anxiety, confusion, slight or partial paralysis, excitation,
hallucinations, agitation, hypersalivation [this is the so-called ‘foaming
at the mouth’], difficulty swallowing, and hydrophobia (fear of water).
Death usually occurs within days of the onset of symptoms.”
How
common is rabies?
Rabies is not very common in Louisiana. During 2008 there were 6 positive
cases (3 skunks and 3 bats); 6 were also reported for 2007 (1 skunk, 3 bats,
1 dog, and 1 horse). In some parts of the country, however,
rabies occurs much more frequently. For example, in the Northeast, there
is much more rabies because of an epizootic (an epidemic that occurs in
animals) among raccoons. In the United States human rabies is very rare,
but almost every year a few people contract the disease and die, usually
because they do not recognize the risk of rabies from the bite of a wild
animal and do not seek medical advice.
What animals are most
likely to be rabid?
In Louisiana, most rabies reports are from skunks and bats. In south
Texas, gray foxes, skunks, and coyotes are often found rabid. Along the
Atlantic Seaboard, there is a lot of raccoon rabies. For maps that show
the distribution of wild animals in the United States that carry rabies,
please see the
Centers for Disease Control and Prevention (CDC) website on rabies.
Is it
really necessary to vaccinate my pet against rabies?
Yes! In 1955 there were over 4,000 cases of rabies in domestic animals in
the United States; in 2007 there were only 482. The decrease is due to the
laws requiring rabies vaccination of dogs and cats. But rabies is still
very much present in this country; in 2007 over 6,000 cases were reported
in wild animals, mostly raccoons, skunks, bats, and foxes. Because cats
and dogs can come into contact with wild animals that may have rabies, it
is still necessary to vaccinate them and to keep their vaccines up to
date. Besides, it's the law.
Should I be
vaccinated against rabies?
Most people do not need to be vaccinated. But if your activities
frequently bring you into contact with the rabies virus or potentially
rabid animals such as bats, raccoons, skunks, etc., you should take the
pre-exposure rabies vaccination. If you are a spelunker or an
animal-control or wildlife worker in an area where there is a lot of
rabies in wildlife, the Advisory Committee on Immunization Practices (ACIP)
recommends you take the primary vaccine series and either be tested for
immunity or take a booster dose every two years. People who work in
animal-control or with wildlife in areas where there is not much wildlife
rabies (such as Louisiana) should take the primary series but do not need
to take any further boosters unless they are actually exposed to rabies.
People who are planning international travel to areas where there is a lot
of dog rabies, such as in parts of Africa and Asia, and where immediate
medical care may not be readily available, may also be candidates for
vaccination. (See
"Rabies Information for Travelers" on the CDC website.) The
complete recommendations for preventing rabies in humans can be found in
the publication "Human Rabies Prevention—United States, 2008;
Recommendations of the Advisory Committee on Immunization Practices (ACIP)"
which is
available from the CDC.
Click here to download a pdf file.
How can you tell if an
animal has rabies?
There is no way to accurately diagnose rabies in a living animal. The only
way to be sure is to examine brain tissue and perform a special test such
as the direct fluorescent antibody test (dFA). But there are some signs
may be suggestive of rabies, such as profuse salivation, indiscriminate
biting (at people, other animals, and inanimate objects), persistent
difficulty in swallowing, a change in vocalization, or paralysis that
begins in the hind limbs and progresses toward the body.
How is
rabies treated?
There is no treatment for rabies; once symptoms begin, the disease is
always fatal. It can be prevented, but not cured.
What should I do if I am bitten by a pet dog, cat, or ferret?
First, cleanse the wound thoroughly with plenty of soap and water,
irrigate it with a povidone-iodine solution if you have one available, and
contact your doctor. If the animal has been vaccinated, rabies is very
unlikely but other infections, including tetanus, are a possibility with
any bite wound (See What You Should Know
About Animal Bites).
According to the
Compendium
of Animal Rabies Prevention and Control, 2008, National Association of
State Public Health Veterinarians, Inc.:
“A healthy dog, cat, or ferret that bites
a person should be confined and observed daily for 10 days;
administration of rabies vaccine is not recommended during the
observation period. Such animals should be evaluated by a veterinarian
at the first sign of illness during confinement. Any illness in the
animal should be reported immediately to the local health department. If
signs suggestive of rabies develop, the animal should be euthanized, its
head removed, and the head shipped under refrigeration (not frozen) for
examination of the brain by a qualified laboratory designated by the
local or state health department.”
What if I am
bitten by a stray dog or cat or a wild animal?
Immediately and thoroughly cleanse the wound with plenty of soap and water
and irrigate it with a povidone-iodine solution if you have one available.
If the animal was indeed rabid, thorough washing and disinfecting can
remove a lot of virus. Then seek medical attention without delay.
If the animal can be captured, it should be
euthanized and submitted for rabies testing. If it tests positive for
rabies, you should begin the post-exposure rabies treatment at once. If
the animal is not available for testing, your doctor should evaluate your
case and recommend whether you should take the treatment based on the type
of animal involved and how likely it is to be rabid. According to
"Human Rabies Prevention — United States,
2008: Recommendations of the
Advisory Committee on Immunization Practices (ACIP)," if a skunk,
raccoon, fox, or other carnivore, or a bat bites a person, the animal
should be presumed rabid unless it is proven negative by laboratory tests.
Thus, if you are bitten by one of these animals and the animal cannot be
tested, you should begin the antirabies treatment immediately. If the
biting animal is a rodent or rabbit, your doctor will probably consult
public health officials for their recommendations. According to the CDC
and ACIP, small rodents such as squirrels, hamsters, guinea pigs, gerbils,
chipmunks, rats, and mice, and animals such as rabbits and hares are
almost never found to be infected with rabies and have not been known to
transmit rabies to humans. But, again, whether to administer antirabies
treatment following a bite from one of these animals is a decision to be
reached by medical authorities.
I’ve heard that you have to have 21 shots in the stomach if you’re bitten
by a rabid animal. Is this true?
Not any more. For over 20 years now the recommended post-exposure regimen
in the United States has been administration of human rabies immune
globulin (HRIG) as soon as possible after the bite, half to be injected
into the tissues surrounding the bite itself and half into the hip. Then 5
doses of vaccine are given in the deltoid muscle (the outer portion of the
upper arm) on days 0, 3, 7, 14, and 28. In other words, if a person is
bitten on May 1st, the HRIG and first vaccine dose are given then, as Day
0. The second vaccine dose will be on May 4, the third on May 8, the
fourth on May 15, and the fifth on May 22. The HRIG may cause some
discomfort, but this usually goes away within a day. The vaccine doses are
not particularly painful; as with most vaccines, some redness or arm
soreness may occur but does not usually cause any real problems. For
complete information on the post-exposure treatment, please see
"Human Rabies Prevention — United States,
2008: Recommendations of the
Advisory Committee on Immunization Practices (ACIP)."
I’ve read that bats are no more likely to carry rabies than cats or dogs
are. Is this true?
In the United States, cats and dogs do not carry rabies. That is,
the disease does not perpetuate itself among cat or dog populations. When
a domestic animal becomes infected with rabies in this country, it is from
the bite of a wild animal, usually a skunk, fox, or raccoon. In Louisiana,
skunks are responsible for most cases of rabies in domestic animals.
Bats, however, do actually carry rabies. It
circulates in their populations, just as it does with skunks, raccoons,
and foxes. Bats are mainly active at night and sleep during the day in
trees and other secluded places. If you see a bat in the daytime, such as
on the ground in your yard or in your house, use caution. This is abnormal
behavior and many bats found in such situations do have rabies. Unless you
are a trained wildlife zoologist with the proper protective equipment and
have been vaccinated previously against rabies, it is safest not to ever
handle a bat.
I found a bat in my
house. What should I do?
Bats have very small teeth and sometimes people don’t know whether they
have been bitten. If you awaken and find a bat in your room, see a bat in
the room of an unattended child, or see a bat near a mentally impaired or
intoxicated person, pick up the bat using heavy gloves or push it into a
box using a piece of cardboard or some other object. Do not handle the bat
with bare hands, even if it is dead. Call your physician to arrange to
have the bat tested. If the bat is positive for rabies, post-exposure
treatment may be needed for any people that could have been bitten without
being aware of it. The CDC has some excellent information for dealing with
bats. Please see their
Bats and Rabies site if you have more questions.
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