LET'S TALK RABIES

By Danielle G. Timothy RN, BSN

SWUPHD Epidemiologist

It was in France, July 1885 when 9-year-old Joseph Meister was bit by a rabid dog and brought to a physician for care. The doctor realized he would not be able to save little Joseph and sent the patient and his family to a local scientist, the famous Louis Pasteur, who had previously discovered how to make vaccines for cholera and anthrax. A rabies vaccine had been tested on dogs with great success, but had not yet been used on humans. In consultation with three other doctors in the area, Louis Pasteur and his team decided that if they did nothing, the boy would die, and therefore it would be best to attempt to save his life by trying the vaccine. The 9-year old was then injected with dried-out rabies virus from the spinal fluid of a rabid rabbit. Pasteur’s theory was that if someone was exposed to a weakened version of a disease, the body would build up a defense mechanism to fight off the real thing. The child was given 13 more rabies injections over the next ten days. Three months later, Louis Pasteur announced that the child’s life was no longer in danger. By 1886, he had successfully treated 350 rabies patients. Due to Pasteur’s discovery and advances in medicine over the past century, average rabies deaths in the United States have decreased from over 100 to two, annually. According to Utah Division of Wildlife Resources (DWR), Utah has had 59 instances of a person being exposed to a confirmed rabid animal since 2016, with one fatality in 2018. In that same time period, 98% of wild animals testing positive for rabies by the Utah Public Health Lab were bats, followed by an occasional fox or skunk.

There are two forms of rabies. One form is referred to as “dumb rabies”, where animals behave wounded, dazed, or tamed. The other form is “furious rabies”, where animals behave aggressively, exhibit unusually excited behavior, and salivate more than usual. Behaviors, however, are not used exclusively to diagnose rabies. Definitive diagnosis requires testing of brain matter. Rabies can be transmitted to humans through the saliva (usually a bite) of an infected animal. It is nearly 100% fatal once symptoms begin to show, which is why contacting your State or Local Health Department for treatment recommendations as soon as possible after a suspected exposure is so important. If you have contact with a wild animal - especially if you were bitten or scratched - call your local Animal Control or Department of Wildlife Resources for capture of the animal, along with the Health Department for investigation (see page 4 for contact information). If it’s not able to be captured for testing, it may be presumed that you have had contact with a rabid animal, depending on the situation and the animal you were exposed to. Rabies post-exposure prophylaxis (disease prevention) for humans includes four rabies vaccinations on days 0, 3, 7, and 14, as well as human rabies immune globulin (HRIG) injected into and around the wound as much as possible. Here in Southwest Utah, post-exposure prophylaxis is only given in the emergency room. If a pet comes into contact with a wild animal, you should contact Animal Control or DWR for capture. If the animal tests positive, the next steps depend on your pet’s rabies vaccination status. Again, it will be presumed your pet has been exposed to rabies if there is no animal to test, depending on the animal. Dogs, cats, and ferrets that have been scratched or bitten by a rabid animal and are not vaccinated with rabies will be required to be euthanized immediately. If the pet is up to date on rabies vaccinations, they will be required to receive a booster rabies vaccine and a strict 45day home quarantine in partnership with Animal Control. Preventive measures include: • Keep your pet’s rabies vaccinations up to date (required for dogs, cats, and ferrets) • Do not handle wild, stray, or sick animals • Do not handle dead animals • Cover your garbage cans • Do not keep wild animals as pets • Do not handle bats (scratches or bites are so small, they may go unnoticed) For more information relating to rabies, please visit cdc.gov/rabies.