Safeguards Against Rabies
By the staff of The Concord Magazine. Rabies has already been found here this spring, so this is a good time to review safety and prevention.
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It's a pretty scary subject: Rabies. Let's first start off with the good news.
Rabies has been with us for a long time. Yet, since 1980, there have been no human deaths in the United States due to racoon-transmitted rabies. There have been only 2-3 other rabies deaths per year, and those have been attributed to bat-transmitted rabies. Preventive treatment for people who have been exposed is very good, and pet vaccination is very helpful for preventing non-human animal to human transmission. And in Concord from September 1992 through October 1997, there have been 6 cases of rabid racoons in Concord. Likewise, four skunk instances, and three woodchucks. Birds do not carry or transmit rabies. And rodents are at low risk for transmission.
The not so good news: Rabies is not going away. In fact, it's incidence is cyclical and is on the rise this year. Any mammal can be considered suspect as a carrier. There is no treatment for rabies once it has been contracted, and it is invariably fatal. In Concord since the start of 1998, there have been 4 rabid animals found so far. So, this is an excellent time to brush up on what you need to know about preventing and reducing the chances of rabies exposure.
And now for the confusing news
While all sources agreed that treatment in cases of exposure or possible exposure was vital, what constitutes possible exposure is not agreed upon. While everyone agrees that a bite from a rabid animal and other exposure to saliva or brain tissue to be the well-accepted best way to get rabies, there are also two known cases of aerosol transmission. This may makes collecting information for making treatment decisions confusing, as it did for the culling of expert opinions for this article."Because of the terminal outcome of rabies infection and these cases of aerosol transmission, we treat rabies exposure not just out of knowledge, but also out of fear," says Paul Krochmal, MD, an emergency physician at Yale-New Haven Hospital. "It's unclear how long rabies can be transmitted from a dead animal and if the dog could have caused transmission to the humans," he said when he heard the incident report at right, "but I, too, would have gotten vaccinated in a heartbeat if I had had this type of exposure. I would have also recommended that all the caretakers in the family of the exposed people be vaccinated, too."
And there are myths about what a rabid animal looks like which also confuse the general public. Violence and frothing-at-the-mouth is not entirely the whole picture of a rabid animal. They may also be docile, dazed, and therefore invitingly approachable.
Pet-to-human transmission
Concord's Public Health Administrator, Mike Moore, says pets that have been exposed to rabies and who have up-to-date vaccinations should be given an immediate booster and may be quarantined as long as 90 days, depending upon their level of exposure. Allison Robins, DMV, a Concord resident and director of the Cape Cod Oral Rabies Vaccine Program, says that the first ten days of strict confinement is considered crucial, with some indication that transmission to a human might not have occurred if the pet passes through these ten days without illness. Animals that eat the carcase of an infected animal need a booster and will need some level of quarantine, says Moore.Treatment for exposed or potentially exposed humans involves multiple groups of injections over 28 days. While the course of treatment is not nearly as painful as it was in years past, it is not delightful to undergo and costs approximately $1500. Treatment is recommended to begin as soon as possible following exposure. The vaccination lasts for three years. If a vaccinated person has a subsequent exposure during this time, Krochmal recommends they receive a booster.
Moore wants to encourage people not to overreact to the presence of rabies. "Rabies is a part of nature like everything else. It is something to be wise and cautious about but it's important to go out and enjoy and appreciate nature, too," he reminds us.
Common sense tips: If an animal is acting ill or strangely, call the Concord Police (Emergencies: 9-1-1, other business 978 369-7400). Stay inside or away from the animal until help comes. A healthy wild animal should flee when people approach.
Don't pet live wild animals, even if they are docile and seemingly friendly.
Just because a nocturnal animal is out during the day doesn't mean it is rabid.
A sick animal (one whose fur doesn't look right or is acting oddly) may need help, and should be dealt with cautiously, though rabies is not necessarily the problem.
Don't attract wild animals to your home by leaving pet food or food-laden trash outside.
Don't touch dead animals. Call the Concord DPW (978 371-6280) during the day for animal removal or the Police during off hours.
If you need to move a dead animal, pick it up with a shovel. If you really must touch it for some reason, wear disposable gloves.
Keep your pet's vaccinations up to date.
Contact your pet's veterinarian if there has been contact with a wild animal or a strange animal which is acting oddly.
If you are bitten by an animal, keep in mind it is best if it is available for testing to see if it is rabid (killing the animal is required to perform the test).
If you have a possible exposure but don't really know, contact your physician or the emergency room evaluate your case.
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Also consulted for this article: Thanks to Paul Macone, Concord Police.
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A Concord Rabies Story
The people in this story each tried to do the right thing. But because as this story unfolded none of them really knew ahead of time what was needed, some made mistakes which put others at risk.
The scene is a residential street near the South Bridge: an early spring day in March. An obviously sick racoon stumbling around during the day is observed by a man living there. After careful thought, he notices young children nearby and realizes the racoon is a danger to the neighborhood. The man kills the racoon, and because he doesn't know what else to do with it, he deposits the body in a stream on the street, hoping it will be swept away by the current.
Switch the scene to later that day: children and a dog playing outside...a little brook crossing under the street with plenty of things to examine. And that included the dead racoon the dog found at the water's edge. It was natural that the dog might gnaw on it a bit...the kids poke at it with sticks. Later, the two adults who own the dog collect the racoon (carefully trying not to touch it) and take it for testing to see if it was rabid.
Sure enough: the racoon had had rabies.
"We had a hard time figuring out if we had had a rabies exposure," said Keith Sunderland (not his real name), one of the adults who brought the racoon's corpse in for testing, and whose son was among the children playing with the dog and racoon. "We talked to a lot of experts on rabies and got several different opinions. But the research we have done shows it is slightly possible we were exposed through the dog."
To be on the safe side, Keith and his son as well as the other adult who handled the racoon opted for treatment. Their dog is being quarantined for 45 days.
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Related Links
Infectious Disease Control from the College of Veterinary Medicine, NC State
Mass Medical Society: Rabies Prevention
Mass Department of Public Health Bureau of Communicable Disease Control: Prevention of Rabies in Humans
About raccoon rabies
Commonwelath of MA Public Fact Sheet on Rabies
The Centers for Disease Control has many articles on prevention which mention rabies: index of these articles
