By Capt. Kelsy AbellSeptember 27, 2018
Rabies is a viral disease that attacks the body's nervous system. It is a preventable disease that is still prevalent throughout the world in the human population.
Unfortunately, several cases of rabies exposure in humans have occurred recently across the United States. The majority of these exposures were easily preventable and likely occurred secondary to lack of public knowledge on this important disease. To combat that, here are five basic things to know about rabies:
1. Transmission of rabies occurs by coming into contact with the saliva of an infected mammal. The most common route of transmission to animals and humans is via a bite. Human-to-human transmission is rare but has been reported via corneal and organ transplants. Early symptoms of rabies are similar to the flu and include weakness, muscle aches, fever and headaches. As the disease progresses, abnormal behavior, anxiety, confusion and delirium develops. Once clinical signs of rabies appear the disease is almost always fatal.
2. In the United States, the majority of rabies cases occur in wildlife with the most common carriers being bats, raccoons, skunks, foxes and coyotes. While in theory all mammals can contract and transmit rabies, small mammals such as squirrels, chipmunks, guinea pigs, hamsters, mice, rats, gerbils and rabbits are unlikely to be infected with rabies. Domesticated animals such as dogs, cats, cattle and horses carry a high risk of contracting rabies and transmitting it to humans if they are unvaccinated or not current on their rabies vaccine.
3. All animal bites should be evaluated by a medical provider. The medical provider will evaluate the risk of rabies exposure and the need for post-exposure prophylaxis. These decisions are based off the type of animal that caused the bite, the nature of the bite, and if the animal that caused the bite is available for observation or testing. Bites that are considered high risk for rabies exposure are unprovoked bites from a wild or unvaccinated animal. If the animal that caused the bite is available for observation or testing, then post-exposure prophylaxis is usually delayed until the observation period is over or test results are available. Observation or quarantine is reserved for vaccinated domesticated animals that were exhibiting normal behavior prior to and at the time of the bite. At this time there is no test for rabies that can be performed on live animals. Rabies testing is therefore reserved for wildlife, unvaccinated animals and animals that were exhibiting symptoms of rabies at the time of the bite. Studies have shown that gently cleansing the wound with water or a dilute water povidone-iodine solution immediately after the bite markedly decreases the risk of likelihood of contracting rabies.
4. Animals with a current, unexpired rabies vaccination status that are bitten by rabid animals are unlikely to contract rabies. The highest contributing factor to the low prevalence of human rabies in the United States is vaccination of this population that is most at risk of passing it to humans. Vaccination against rabies is the only vaccine required by law for dogs in all 50 states. While vaccination against rabies in cats is highly encouraged, only 28 states require cats to be vaccinated. Rabies vaccines can only be administered by licensed veterinarians. Rabies vaccines administered by owners through other means are not recognized by the government for any animal.
5. In the Army, bite reports are monitored by medical providers and veterinarians. Bite reports are a tracking system for the Army medical team to evaluate the risk of exposure to rabies and ensure proper medical treatment is provided. If a domesticated cat or dog is the cause of the bite, the owner will be contacted by Veterinary Services to schedule quarantine examinations. These examinations occur at the beginning and end of a 10-day quarantine for the animal. Quarantines are performed at home under the supervision of the owner. Quarantines are mandatory regardless of the rabies vaccination status of the animal. Animals that are still exhibiting normal behavior and have no symptoms of rabies 10 days from the date of the bite were not infectious at the time of the bite, even if the animal is infected with rabies. This quarantine process saves the human who received the bite from having to undergo the painful process of post-exposure rabies prophylaxis treatment.
(Editor's note: Abell is a veterinarian on Fort Leonard Wood. She is the branch chief of Fort Leonard Wood Veterinary Services.)