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| Rabies |
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Throughout history rabies has been the most recognizable and dreaded "zoonotic disease" (transmissible from animals to humans) because of its invariably fatal outcome and its close association between man and his historical companion, the dog. Rabies is still an extremely serious problem in many parts of the world and kills an estimated fifty to seventy thousand people a year with the majority of cases caused by dog bites. In the U.S. human cases have declined steadily since the 1940’s when the first rabies vaccines became available and widespread canine vaccination programs were implemented. However, rabies is still a serious problem of wild animals in large areas of the U.S. including S.E. Florida. Rabies is a virus that attacks the central nervous system and damages the brain resulting in a polioencephalitis. It can infect any warm-blooded animal including people, dogs, cats, cows and horses. In the U.S. the wild animals most commonly infected and that serve as reservoirs of the disease are raccoons, skunks, foxes, bats and coyotes. The virus is spread in saliva and enters the body through a bite wound or scratch or by contacting mucus membranes such and the eyes or mouth. Once inside the body the virus replicates and spreads up nerves into the CNS. The virus then travels to the salivary glands and is shed in saliva, ready to spread to its next victim. Once the virus infects the CNS variable clinical signs are exhibited by the animal. Early on, the animal may show behavioral changes such as seeking solitude, or becoming apprehensive, nervous, anxious or overly shy or aggressive. Some animals will progress to the "furious" stage and become vicious, biting and snapping at objects, wandering aimlessly and attacking people or animals. Rabid wild animals often lose their fear of people and attack people or their pets. Wild animals have even been known to enter homes and attack the occupants. The disease then progresses to the "dumb" or paralytic form. Paralysis of the jaw muscles and larynx make eating and swallowing impossible resulting in a change in a dog’s bark and the typical excessive salivation and frothing at the mouth. There is no blood test to diagnose rabies; rather testing must be done on the brains of animals suspected of having rabies, necessitating the animal’s euthanasia. There is no treatment for rabies and once an infected person or animal is exhibiting signs the disease is nearly 100% fatal, with only a few cases of recovery documented down through history. This is the reason that rabies vaccination of dogs and cats is required by law in the U.S. All dogs and cats should be vaccinated around 3-4 months of age and boostered in 1 year and then every 1 or 3 years depending on the vaccine used. Indoor only cats and dogs should also be vaccinated appropriately since they may get loose or be exposed should a rabid wild animal enter the house. Owners are encouraged to keep their pet current on its rabies vaccine not only to prevent disease but to also help prevent costly legal and financial problems as well. For if their unvaccinated pet were to be bitten by a known or suspected rabid animal it may be confiscated and euthanized or quarantined at their expense for up to 6 months. And if their unvaccinated dog or cat bites a person the animal may also be confiscated and euthanized or quarantined for an extended period at the owner’s expense. Vaccinated dogs and cats that are bitten by an unknown or wild animal should be reboostered with a rabies vaccine within several days of the bite to help ensure active immunity should the attacking animal actually be rabid. Humans bitten by a wild animal or unknown dog or cat should seek the advice of their physician and contact their local health department. Current recommendations for humans bitten by a wild animal (or unknown dog or cat) are to start PEP (postexposure prophylaxis) immediately unless the animal is captured and tests negative for rabies. Special caution should be noted regarding bats. Bat teeth are very tiny and sharp and bats can inflict a bite wound that may go unnoticed. So if a person were to awake to find a bat in their room or if a bat is found in a room of a child or a mentally disabled or intoxicated person a bite may have occurred but be undetectable, therefore a physician and the health department should be contacted and PEP considered unless the bat is able to be captured and proves negative for rabies. People living in rabies endemic areas such as ours are strongly cautioned against becoming complacent against this deadly disease. Rabies is not just the subject of books like Old Yeller and Cujo and even though the U.S. doesn’t suffer the high mortality rates seen elsewhere, rabies has killed an average of 3 people a year in the 1990’s. For more information on Rabies visit www.cdc.gov/ncidod/dvrd/rabies/ www.who.int/health_topics/rabies/en/ |
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