Rabies - Myth & Reality- ahead/ILIAD

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Rabies - Myth & Reality
ALERT Update, April 2002: As a result of involvement in a situation in Arkansas the FAS project has learned that the 1991 recommendations of the ACIP for post-exposure prophylaxis are being applied by doctors as rules, rather than as guidelines. The American Public Health Association has clearly stated "The ...recommendations are only a guide. In applying them, take into account the animal species involved, the circumstances of the bite or other exposure, immunization status of the animal and presence of rabies in the region. Local or state health officials should be consulted if questions arise about the need for rabies prophylaxis.
ALERT Update, August 2000: A disturbing notion has surfaced in recent months. It is that the recommended vaccination schedule for domestic pets (every 1-3 years) is based on collusion between veterinarians to increase private practitioner income. This is an unfortunate and dangerous notion. Schedules for vaccination and re-vaccination are based on epidemiological data, and are recommended for the protection of both pets and the human population.

Myth: Rabies is transmitted only by a bite of an animal.
Reality: Rabies can be transmitted through a wound, scratch or abrasion when it comes in contact with the saliva of a rabid animal, and through a scratch inflicted by an animal if fresh saliva is on the nail of the animal that inflicts the scratch. Further, rabies can be airborne in bat caves.

Myth: Rabies is not always fatal to humans.
Reality: Rabies is ALWAYS fatal if prophylactic injections are not started within 24-48 hours of being infected.

Myth: If I live in a highly populated area, my only threat of being infected by rabies is by contact with a wild or unvaccinated dog.
Reality: While most urban transmission is indeed through unvaccinated dogs, there have been numerous and recent examples of rabid wild animals found in urban settings. A recent event occurred January 9, 2001 at a New Bedford, Massachusetts housing complex where a police officer was attacked by a rabid otter. Rabies is also transmitted by cats.

Myth: Even if I live in the country, my biggest concern is still with rabid dogs.
Reality: Many species of wild animals are a threat. This includes bats, raccoons, foxes, wild pigs, rodents, skunks and beaver. Livestock, as well, can contract rabies and infect humans, although this is extremely rare.

Myth: Rabies occurs only occasionally in the U.S.
Reality: There is an ongoing epidemic of rabies in wild animals in the U.S. Efforts to control the spread by dropping meat laced with vaccine into wooded areas are on-going, but they have not been totally successful. Further, most experts believe it is impossible to completely eradicate the disease in non-island countries.

Myth: The only thing I can do about the problem is make sure my pets are vaccinated on schedule.
Reality: This is essential, but only a good first start. There are other ways you can assist in controlling the disease:

a. Do not release any unwanted family pets into the wild. Find them a home or turn them over to a local SPCA facility or animal shelter.

b. Educate yourself and all members of your family about rabies. In particular, warn young children never to get close to animals that appear sick or any wild animal that approaches them or does not quickly move away in their presence. Healthy wild animals avoid humans and scamper away. However, this does not mean that when you are unsuccessful in finding the suspect animal after the contact was brought to your attention the animal is not rabid. It could have slowly wandered off.

c. Be sure you know what telephone number in your area to call when you spot an animal that you suspect is sick.

Myth: First aid is of no help to a person who has been bitten or scratched by an animal suspected to be rabid. Get the person to a doctor or emergency room immediately.
Reality: Immediate and thorough cleaning of the wound is ESSENTIAL. Flush with a strong stream of water. Wash well with soap or detergent. Next, apply a disinfectant (isopropyl alcohol, tincture of iodine or quaternary ammonium compounds) to the wound and surrounding tissue, taking care to get it under skin flaps. Then, take the person to a doctor or emergency room.

Myth: The prophylactic shots for humans who have been exposed to rabies are extremely painful.
Reality: This was once true, when the shots were administered through large-circumference needles through the abdominal wall. The shots are now administered around the site of the wound and intramuscularly.

Myth: Post-exposure treatment consists only of an injection of rabies immune globulin.
Reality: The immune globulin is ALWAYS followed by a five-dose course of vaccine, except when the person has been vaccinated prior to exposure. Then, the person is given a two-dose course.

Myth: There is no need for wildlife shelter employees and volunteers to be vaccinated against rabies.
Reality: Any person who comes into contact with animals that have been identified as carriers of rabies should be protected by pre-exposure Human Diploid Cell Vaccine.

Sources: AHEAD project archives and Zoonoses: Recognition, Control and Prevention, Hugh-Jones, Hubbert and Hagstad, University of Iowa Press, 1995