I'm sure that most everyone has heard about the recent increase in rabid animals in central Kentucky. This summer rabies has been confirmed in two bats found in downtown Lexington and three skunks in Nicholasville. As of July 11, there have been 12 confirmed cases of rabies in domestic and wild animals in central Kentucky. What does this mean to you and your loved ones, furry and human?
Rabies virus causes acute encephalitis (inflammation of the brain) in mammals, including humans. The name rabies is derived from a Sanskrit word meaning "to do violence." The outcome is almost always fatal. The first description of the disease in humans dates from 2300 B.C. The link between human disease and animals, especially dogs, was recognized early on. During the 19th century canine or street rabies was a scourge throughout Europe. Public fear was fueled by the mode of infection, being bitten by a "mad" dog, and the fact that there was no effective treatment. Many dog bite victims killed themselves or were killed by neighbors when bitten by a dog suspected of carrying rabies. Louis Pasteur gained international renown when he developed an effective post-exposure treatment in 1885.
Infection with rabies virus usually occurs when saliva from an infected animal passes to an uninfected animal. This can include contamination of mucous membranes (eyes, nose or mouth), aerosol transmission or, most commonly, a bite. Humans have also contracted infection following corneal transplantation from an infected donor. The incubation period (the time from exposure to development of symptoms) varies from several days to several years, depending on the animal. During this time there are no obvious symptoms. After the virus reaches the brain it multiplies rapidly, passes to the salivary glands and symptoms develop. The animal usually dies within 10 days of developing symptoms.
Today rabies virus accounts for over 55,000 human deaths annually worldwide, more than polio, diphtheria and yellow fever combined. Globally, a bite from a rabid dog remains the most abundant source of human infection. In the United States, 80 percent of human cases prior to 1965 were due to an animal bite, usually a rabid dog. Over the last decade, 80 percent of human cases have developed after no known animal exposure, the apparent source being bats. In the United States, animal rabies reservoirs include foxes, raccoons, skunks and bats. It is through these reservoirs that domestic animals and humans are infected.
Once exposed, a person must undergo post-exposure prophylaxis, PEP, before symptoms develop. This consists of an injection of rabies immunoglobulin and five doses of vaccine. I have been exposed to rabies three times and have had PEP twice. I can tell you from personal experience that PEP is painful, expensive (about $1,200) and time consuming.
The first symptoms are non-specific and include malaise, fever or headache, which may last for days. Soon symptoms of brain dysfunction develop and can include anxiety, confusion, agitation, delirium, abnormal behavior, hallucinations and insomnia. Once symptoms appear, the disease is nearly 100 percent fatal. As part of the curriculum for veterinary students at Auburn University, we were shown videos of human rabies patients in varying stages of the disease. Suffice it to say that it was some of the most disturbing footage I have ever seen. To date, there have only been six documented cases of survival from human rabies. The disease is considered incurable.
Now for the good news: human and domestic animal rabies-related deaths are nearly 100 percent preventable. Comprehensive vaccination of dogs has been demonstrated to result in local extinction of dog associated strains of the virus. When rabies is eliminated in the main animal reservoir, human exposures from that source no longer occur. The main point here is that you should never, never handle a wild fox, raccoon, skunk or bat. As my instructors in vet school said, "Think rabies first." If you come across one of these animals, call the LFUCG Division of Animal Control and they will send an officer out to handle the situation.
World Rabies Day (www.worldrabiesday.org) has been developed as a way to promote rabies awareness around the world. This year World Rabies Day is Sept. 28. Check out the Web site to learn more or to get involved. You may also be interested in a new report from the Centers for Disease Control, "Human Rabies Prevention-United States, 2008." You can find it on their Web site (www.cdc.gov), or email me and I will send you a link.
Rabies is a horrible, incurable disease that can affect any mammal. Fortunately, it is easily prevented through vaccination of domestic animals and pubic education. Make sure that your dogs and cats are vaccinated. If you cannot afford rabies vaccination, you can attend the annual rabies clinic sponsored by the Fayette County Health Department. Do not handle wild animals; if you are bitten by a wild animal, call the health department or division of animal control as soon as possible. If you are bitten by a dog or cat whose rabies vaccination history is unknown, call the health department or division of animal control as soon as possible. If possible, try to contain the animal until officers arrive. The animal can be euthanized and tested for rabies, potentially saving you a lot of time, pain and money. In this case, an ounce of prevention could be worth your life.