Recently, I saw a report that a bat tested positive for rabies in Green Lake County. What do you need to know about rabies?
Rabies is a viral illness contracted through exposure to the virus through contact with an infected animal. Fortunately, rabies is rare in humans, but when it occurs it is generally a fatal illness. Several years ago, a young Fond du Lac woman contracted rabies and became the first known survivor of rabies in the world.
Rabies has been around for a long time. Even though human cases in the United States are very rare (only 1 to 3 cases annually) it remains a potential problem especially in rural areas where people can come in contact with wild animals. I think my first knowledge of rabies was through the story “Old Yeller” (good movie, but old).
The rabies incidence in other countries is much higher with reports of tens of thousands of deaths worldwide each year. Most cases in the U.S. come from bites by bats. However, skunks, raccoons, foxes and other mammals are at risk for transmitting the disease. In other countries where dogs are not routinely vaccinated, they are the major source of disease.
Rabies is transmitted through contact with saliva or nerve tissue of an infected animal, usually through a bite. Rabid animals have been described as “foaming at the mouth” due to the infected saliva glands. It is rare, but handling a dead animal with rabies could transmit disease.
The incubation period (time from bite to illness) varies, but is generally one to three months. So there is a period of time when post-exposure preventive shots can be given before symptoms occur. Once symptoms occur, shots are no longer effective. Symptoms include initial flu-like illness with fever, headache, loss of appetite, sore throat, nausea and vomiting. This then progresses to dramatic neurologic symptoms that can cause paralysis or brain dysfunction and eventually death.
The best treatment is prevention. High-risk individuals like veterinarians or wildlife workers can be given a rabies vaccine before an exposure occurs. People traveling to countries that have unvaccinated dogs can be vaccinated prior to travel. But most of the preventive treatment is done after exposure (like a bite). If someone has been exposed, post-exposure vaccinations and immune globulin are given.
The vaccination shots are given over several days, but the immune globulin is done one time, as soon as possible, and is injected into the skin around the bite. If at all possible, the animal that caused the exposure should be quarantined and monitored for two weeks or killed and sent to the state lab for testing.
Defining a significant bat exposure can be confusing. Obviously, a known bite is significant. Touching a bat or contacting a bat in flight or even sleeping in a room where a live bat is found could be a significant exposure. Since the disease is so serious, providers tend to error on the side of over treatment to prevent disease.
What can you do to prevent rabies? Have your pets vaccinated. Do not approach live wild animals or handle dead animals. Do not leave pet food or food scraps where it can attract wild animals. If you are bitten, immediately wash the site with soap and water. Urgently report a suspicious bite and, if possible, capture or kill the animal that bit you so you can bring it in for analysis. It is best to avoid damaging the head of the animal since it is the brain that is sent to the lab for analysis.
Dr. Michael Shattuck is a family practice physician at ThedaCare Physicians-Wautoma.
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