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Rabies and the ACO Rabies Rabies Transmission Rabies Transmission www.wendyblount.com Rabies and the ACO Wendy Blount, DVM Rabies Rabies Transmission • Infectious agent : virus that attacks • Hosts: nervous system – All warm-blooded animals are susceptible – Causes brains cells to malfunction • Reptiles and birds don ’t get rabies – Worldwide - tens of thousands of human – Young animals are more susceptible than deaths yearly adults – 0-5 deaths per year in the US – Least susceptible to disease (rare): – Death by lightening strike is more likely • Marsupials – opossums (curriculum says no) – Fear of disease such as rabies was a major contributing factor to the – Domestic animals most likely to be diagnosed development of animal control which with rabies in the US: began in the late 1800 ’s in the US • Cat > Dog > Cow > Horse/mule > sheep/goat Rabies Transmission Rabies Transmission • Hosts: • Hosts: – Cats are more likely to have rabies than – Those to which the virus has an adapted subtype dogs in the US transmit the virus best – These are called “high risk ” animals and are • Most of these spill over from raccoon rabies on “reservoir species ” the East Coast • Dog (wild or domestic – fox,fox coyote,coyote wolf,wolf etc.) • Fewer cats than dogs are vaccinated for rabies • Raccoon, Skunk,Skunk Mongoose • There are fewer leash laws for cats than for • Cow (South America only) dogs • Bat (vampire, insectivorous, not vegetarian) – Cats, bobcats and cougars can also be vectors • Vector – animal that actively or passively transmits a disease 1 Rabies Transmission Rabies Surveillance • Hosts: • Hosts: Terrestrial Rabies – Reservoir Species • the virus is passed amongst these animals, keeping it alive in the population for long periods of time – Population Density • Number of animals per square foot of ground • Higher population density increases rate of transmission – Herd Immunity • Immune animals protect susceptible individuals within their herd Rabies Surveillance Rabies Surveillance • Hosts: Sylvatic (Bat) Rabies • Hosts: Rabies in Wild Animals Rabies Surveiilance Rabies • Hosts: Rabies in Domestic Animals • Incubation: – 2 weeks to years • 1-5 weeks is most common*** – Why is rabies quarantine only 10 days? – The closer the bite to the brain, the shorter the incubation – Rabies virus travels 1 cm per day • Diagnosis: – brain biopsy (usually after death) – Negri Bodies (virus particles) are found – There also is a saliva test which is inaccurate 2 Rabies Rabies • Symptoms : neurologic • Transmission: – Early signs are non-specific – Spread by bites or contact of infected • Fever, headache, weakness, achy muscles saliva with mucous membranes (eyes, – Incoordination, confusion, strange behavior mouth, etc) • Attacking and biting moving and stationary – Saliva becomes non-infectious when it objects dries – Salivation (can’t swallow, like choking) – Also transmitted by contact with nervous – Fear of water (hydrophobia) tissue – Paralysis – People have been infected by aerosol in – Seizures bat caves – Death within 2 weeks of showing signs Rabies Rabies • Transmission: • Transmission: – Disinfectants that kill rabies virus: – Asymptomatic carriers are possible in species adapted to rabies • Formalin • Can carry and transmit disease but never show • Phenols (Lysol) signs • Halogens (bleach) • There are documented cases of human carriers • Quats – Rabies remains infectious in a carcass for • UV light (sunlight) and heat less than 24 hours at 20C (frozen) • Survives days when the carcass is refrigerated Rabies Rabies • Transmission: • Treatment & Prognosis – Rabies is not transmitted by causal contact – Dogs and Cats between people • Recovery is possible, but may have prolonged shedding for many months – Transmission by organ transplant • There is a protocol for treatment (PEP – post- • 4/40 people who have died of rabies in the US exposure prophylaxis) in dogs since 1990 contracted rabies through organ – Not recommended for unvaccinated dogs transplant when there is known exposure to a rabid – the single donor died of undiagnosed rabies animal from a bat bite – transplants killed 4 others – Risk for vaccinated dogs may be worth • 8 people have died of rabies after corneal taking, if caretakers do so with informed transplant consent – Some donors were asymptomatic at the • No proven protocol for PEP in any other animal time of death except people 3 Rabies Rabies • Treatment & Prognosis • Excluded from adoption due to – People rabies risk , unless quarantined for 14 • Nearly 100% treatable if exposure is known and post-exposure treatment begins before signs of days: disease – Animals with bite wounds of unknown • Nearly 100% fatal once symptoms occur origin • Only 6 people have ever survived (with brain – Feral animals damage) when treated after clinical signs began – Animals who have bitten or scratched – http://en.wikipedia.org/wiki/Jeanna_Giese within the past 10-14 days • Once symptoms begin, death within 2 weeks – Often within days – Wolf hybrids (no approved vaccine) – Usually within 1 week Management of Exposed Animals Management of Exposed Animals National Assoc. State Public Health Vets National Assoc. State Public Health Vets Animal Status Disposition SUSPECTED rabies exposure • If a dog is bitten by a rabies vector species and the Unvaccinated dogs, cats Immediately euthanize or biting animal is available for testing, then it is killed in a and ferrets with a known strict isolation for 6 way to preserve the brain and tested ASAP. • If the biting animal is not available, then the animal is exposure to a rabid months and vaccination 1 quarantined for up to six months. Some states allow animal month before release home quarantine. • If a dog is not vaccinated, some jurisdictions Vaccinated dogs, cats Re-vaccinate and keep recommend vaccinating for rabies immediately and and ferrets with a known under owner’s control for repeatedly, while others do not allow vaccination during rabies exposure 45 days the quarantine period. • Vaccination is usually allowed once the quarantine Healthy dog, cat or ferret Confine and observe for period is over. who bites a person 10-14 days • In the case where humans are potentially exposed, there may be different rules. Management of Exposed Animals National Assoc. State Public Health Vets Rabies Quarantine Procedures • If animal bitten is not eligible for rabies • Dogs, cats and ferrets vaccination • Never rotate animals – Not a dog, cat, ferret, horse or cow in most from cage to cage states • Maintain cages & – Some states prohibit vaccination of wolf hybrids kennels in good repair – Animal is managed according to state law or at the discretion of the LRCA • Keep all cage doors locked with appropriate signs • Designate one person to work in that area 4 Rabies Quarantine Procedures Rabies Quarantine Procedures • No doors leading directly • The quarantine period is 10 days from the bite to outside • Rabies quarantine evaluates for likelihood • Solid walls separating animals of rabies transmission by the bite • Never keep in public area – insurance against the remote possibility that an animal might appear healthy but actually be sick of • Watch for signs of illness rabies & behavior changes – Or determination whether a sick animal who bit is • Disinfect all surfaces that possibly sick from atypical rabies come into contact with suspect (including hands) – No person has ever contracted rabies from an animal that survived a 10 day quarantine • WEAR GLOVES AND MASK!! • Rabies quarantine does not guarantee that the animal is free of rabies – Incubation commonly 1-5 weeks and can be years Rabies Testing Procedures Rabies Testing Procedures • Euthanize humanely, in a way that does not • Ship in state approved container with proper damage the head or brain labeling • Carcass should be refrigerated, not frozen – We ship by bus – arrives the same day – If frozen by mistake, submit anyway – Contact the lab to let them know your sample is on the way • Remove head from the body with hand saw – Follow up to make sure it arrived – Power saws can cause aerosolization – Wear PPE (personal protection equipment) • Complete history should accompany the specimen – Include contact information of those exposed Need for Post-Exposure Prophylaxis Need for Post-Exposure Prophylaxis • Indications for PEP • Indications for PEP – Animal bite by an animal at high risk for rabies, – Bite by an animal with neurologic disease that when the animal can not be tested is not being immediately tested • Skunk • Animal may be in quarantine • Fox/Coyote • Requires close observation by a veterinarian for • Raccoon 1-2 weeks after the bite • Bat • 2-4 day window for treatment is closing – Any contact with a bat that is not available for • Always involve the health department on these testing cases – Bite by an animal that has tested positive for rabies – Contact with saliva or nervous tissue of a person or animal infected with rabies 5 Need for Post-Exposure Prophylaxis Need for Post-Exposure Prophylaxis Dogs, Cats and Ferrets Animals at Low Risk for Disease or Transmission • No PEP is indicated for a person who is bitten • For exposure to horses, cattle and other livestock, contact by an apparently healthy dog, cat or ferret, health department to discuss need for PEP when that animal is quarantined for 10 days – Risk in these animals and even high risk animals varies – Regardless of vaccination status of animal by location • The person bitten should contact the health – Regardless of vaccination status of animal department to discuss PEP if: • PEP is almost never needed for animals susceptible to
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