Rabies



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  • Questions and
    Answers about Rabies

    What is rabies?

    Rabies is a viral
    infection that affects the nervous system of mammals. It invariably causes
    swelling of the brain and death after a relatively short illness. 

    How is rabies
    transmitted?

    The rabies virus is
    found in the nervous tissue of infected mammals. As the virus works its way
    to the brain, it begins to be secreted in the saliva of the animal. People
    and mammals get rabies when infectious saliva is introduced into the body,
    usually through a bite from an infected animal. Rabies transmissions from
    other types of exposures are extremely rare. These types of exposures include
    saliva or nervous tissue entering an open wound or saliva or nervous tissue
    coming into contact with a mucous membrane such as the eyes, nose or mouth.

    What are the symptoms of
    rabies in people?

    After an average of 30 to
    50 days (as short as 14 days or longer than a year) from exposure to a rabid
    animal, a person develops an illness that may include fever, sore throat,
    stiff muscles, headache, tiredness, restlessness, nausea, and itching or
    tingling at the site of the bite. As the disease progresses, a person may
    become agitated, with periods of calm. Fear of water caused by severe throat
    spasms when trying to drink may occur. Paralysis then starts in the legs and
    moves towards the head. Most people die from cardiac arrest or respiratory
    failure within a short period after onset of illness.

    What are symptoms of
    rabies in animals?

    The animal may have a
    change in personality or behavior. For example, wild animals may lose their
    fear of humans or pets may become aggressive or withdraw. Often the animal
    does not eat, may fear water, and have an unsteady gait. Paralysis may start
    in the rear quarters and progress to the front of the body.

    What should I do if I am
    bitten by an animal or exposed to the saliva of a possibly rabid animal?

    NDDoH Rabies Exposure Assessment Algorithm (PDF)

    First, thoroughly
    wash the wound with soap and running water. Gather as much information about
    the animal as possible. Contact your physician as soon as possible and notify
    your local public health unit or the state health department as well as local
    law enforcement. 

    How long is the rabies
    virus infectious after it is outside of the rabid animal?

    The rabies virus is a very
    fragile virus. As soon as the saliva dries, the virus is no longer
    infectious. The virus is easily killed by soaps, detergents, bleach, alcohol
    and ultraviolet light.

    What will happen to the
    animal after a person has been bitten or otherwise exposed?

    • NDDoH Rabies Exposure Assessment Algorithm (PDF)
    • If the animal is a healthy domestic dog, cat or ferret it should be
      confined and held for observation for 10 days. A licensed veterinarian
      must examine the animal at the beginning and end of the 10-day observation
      period.  If the animal develops symptoms suggestive of rabies, it should
      be humanely destroyed and the brain sent for testing. If the animal is
      healthy at the end of the 10-day period, then no rabies exposure occurred and
      the person bitten will not need rabies vaccination.

    • If the animal is not a domestic dog, cat or ferret, it should be captured, humanely destroyed and the brain sent for rabies testing. If the animal is a domesticated farm
      animal (cow, horse, etc.), consult with your physician and veterinarian. 

    • “Other biting animals that might have exposed a person to
      rabies should be reported immediately to the local health department.
      Management of animals other than dogs, cats, and ferrets depends on the
      species, the circumstances of the bite, the epidemiology of rabies in the
      area, the biting animal’s history, current health status, and the animal’s
      potential for exposure to rabies. Previous vaccination of these animals
      might not preclude the necessity for euthanasia and testing.
      What to do with an animal that has bitten a person. (2011). Retrieved from http://www.cdc.gov/rabies/specific_groups/veterinarians/person_bitten.html

    What is meant by
    confinement?

    Confinement in North
    Dakota, as it pertains to rabies, means separation of an animal from humans (other than the owner, caretaker, a member of the owner’s family or the
    caretaker’s employees) and from other animals, by means of a building, cage,
    fence, pen or other secure enclosure that restricts the animal’s movement
    within definite boundaries and prevents the animal from exiting the
    enclosure.  

    Why can a healthy
    domestic dog, cat, or ferret be held for ten days?

    Studies have shown that
    dogs, cats, and ferrets only shed the rabies virus in their saliva for a short
    period of time (usually 4 to 5 days) before they develop symptoms.  If the
    animal has not developed symptoms by the tenth day after the exposure then the
    animal would not have been shedding the virus at the time of the exposure.

    Why can’t the ten-day
    observation period be used for other animals?

    Only domestic dogs,
    cats, and ferrets have been studied enough to determine with certainty the
    period of viral shedding.  Although this period of viral shedding may be
    similar for other species of animals, without more studies, there is too much
    uncertainty and too great of risk for error. 

    What if the animal is not
    available for observation or testing?

    NDDoH Rabies Exposure Assessment Algorithm (PDF)

    If you have been bitten or
    otherwise exposed to the saliva of an animal that is not available for
    observation or testing, contact your physician, local public health unit or
    state public health department and local law enforcement. If it was a
    domestic dog, cat, or ferret, try to locate the animal or the owner of the
    animal. If the animal cannot be located, speak with your physician, as you may
    need to start preventive treatment for rabies which will include the rabies
    vaccine.

    Does an animal have to be
    destroyed to be tested for rabies?

    Yes, the only proven test
    is to examine the brain for the rabies virus. Blood tests have proven not to
    be reliable. Because rabies is so serious, the test needs to be as accurate
    and reliable as possible.

    What if the owner of an
    animal who has bitten someone refuses to have it evaluated for rabies?

    In situations where the
    owner refuses to have an animal evaluated for rabies, you should contact local
    law enforcement officials.

    How can I protect myself
    from rabies?

    • Vaccinate your domestic dog,
      cat, or ferret (and be sure to keep the animal’s vaccinations up-to-date).

      For more information on each state’s vaccination laws, please see the

      American Veterinary Medical Association website .

    • Avoid contact with wild or stray animals, and domestic/wild hybrid
      animals.

    • Do not touch dead
      animals.  

    • Keep wild animals out of
      homes, workplaces and other dwellings. 

    • Report stray, sick,
      and injured animals to local animal control authorities or law enforcement
      officials.

    What is a domestic/wild
    hybrid?

    A domestic/wild
    hybrid is the offspring of a domestic animal crossed with a wild animal. The
    most common example is a domestic dog/wolf hybrid. Although wolves may be
    raised in captivity, they are still considered wild animals.

    Are there any vaccines
    for wild or hybrid animals?

    At this time no
    vaccines have been approved for wild or hybrid animals. Although some zoos
    vaccinate their animals for rabies, this is only done to try to protect the
    animals from rabies. A wild or hybrid animal that bites a person should be
    humanely destroyed and the brain submitted for rabies testing. If the animal
    is a valuable specimen (at a zoo, for example) then rabies shots can be given
    to the exposed person instead of destroying the animal.

    What happens if my dog,
    cat, or ferret is bitten or fights with a wild animal or another animal that may
    have rabies?

    • If the animal that bit your pet can be captured, have the animal’s brain
      tested for rabies. If the test is negative for rabies and your pet has not
      been vaccinated, you should vaccinate your pet immediately.

    • If the biting animal tested
      positive for rabies and the pet is current on its rabies vaccination, the pet
      should be given a booster vaccine immediately. Observe
      your pet for 45 days for any symptoms of rabies after the booster shot. 

    • If the biting animal tested positive for rabies and your pet has never been vaccinated, the recommendation is to put the pet down. If you are
      unwilling to euthanize the pet, it must be confined for 6 months and vaccinated
      against rabies (the rabies vaccine must be administered at least
      1 month prior to release).  

    • If the biting animal tested
      positive for rabies and the pet is NOT current on its rabies vaccination (i.e., it was vaccinated against rabies in the past, but is now overdue for a booster vaccination), it should be evaluated based on severity of exposure, time elapsed since last vaccination, number of previous vaccinations, current health status, and local rabies epidemiologic factors to determine need for euthanasia or immediate revaccination and observation with isolation. 

     If the animal
    cannot be captured, assume it is rabid and proceed as described above.

    Our dog killed a skunk and when I handled the dog after the
    attack it was all wet. Could I have been exposed to rabies by handling the dog?

    Although there may have
    been skunk saliva on the dog, the risk of an actual exposure is very low. The
    saliva has to enter an open wound or get onto mucous membranes. If this did
    not happen, there was no rabies exposure. If you think you were exposed,
    call your health care provider. You will want to test the skunk to see
    if it was rabid in this situation. The test results will be needed by you and your veterinarian
    to determine what to do with your dog, and it can be used by you and your
    health care provider to make a determination about your possible exposure.

    What if I have livestock
    exposed to rabies?

    All species of livestock are susceptible to rabies. As with domestic pets,
    livestock that have been vaccinated for rabies (with a vaccine approved by
    USDA for that species) should be revaccinated immediately and observed
    for 45 days. If the animal has not been vaccinated, it should be
    euthanized. The animal can be used for human consumption if
    it is slaughtered within 7 days of exposure, provided liberal amounts of the
    tissue around the exposed area (bite) are discarded. Consult with your
    veterinarian.

    What if I am bitten by a
    mouse or gopher?

    Small rodents, including
    mice, rats, gophers, chipmunks, squirrels, rabbits and hares, rarely have
    rabies and are not known to have transmitted rabies to humans. You should
    always consult with your physician regarding bites from these animals.
    Depending on the circumstances, the animal may need to be humanely destroyed and
    the brain tested for rabies. Bites or saliva exposure from other larger
    rodents such as muskrats or groundhogs may result in a rabies exposure.

    What animal serves as the
    reservoir for rabies in North Dakota?

    The skunk serves as
    the primary reservoir for rabies in North Dakota. Any bite from a skunk should be
    considered an exposure to rabies until a laboratory test indicates otherwise. 

    Do bats in North Dakota
    get rabies?

    Any mammal, including bats
    can get rabies. Bites from bats may not be easily noticed. Bats have small
    teeth and bites may cause very little discomfort. You should contact your
    physician or a public health department if you come into contact with a bat or
    find a bat in your home.

    Can a person get rabies
    shots before they are exposed?

    Pre-exposure rabies vaccines
    are recommended only for people at increased risk of coming into contact with
    rabies. Such people include rabies laboratory workers, veterinarians, animal
    control officers, and cave explorers. Some people may get pre-exposure shots
    when they travel to developing countries. Consult your health care provider or
    public health department for more information.

    I work in a high risk
    occupation where I have a greater risk of being exposed to rabies.  What is
    recommended for me?

    The Advisory Committee on
    Immunization Practices (ACIP) and the Centers for Disease Control and
    Prevention (CDC) recommend that you receive pre-exposure vaccination. This
    consists of three doses of vaccine administered on days 0, 7 and 21 or 28. You should be tested for protective antibody every 2 years and booster
    vaccination is recommended for unacceptable antibody levels. If you are
    working in a rabies research laboratory or are a rabies biologic production
    worker then you should have your antibody level checked every 6 months.

    If I need rabies shots,
    what should I expect?

    • If you never had rabies
      shots before, then you can expect to receive four doses of vaccine over a 14
      day period and a dose of rabies immunoglobulin (RIG) on the same day as the
      first dose of vaccine. Rabies immunoglobulin provides immediate protection
      against rabies until your body has responded to the vaccine and makes its own
      antibodies to rabies.  

    • If you have been
      vaccinated previously with one of the currently licensed vaccines, you
      will still need two booster doses of rabies vaccine. The first dose should be given as
      soon as possible and the second dose three days later. Rabies
      immunoglobulin should NOT be given.

    What are the side effects
    of the vaccine?

    As with most vaccines the
    most common side effect is soreness and redness at the site of the injection. 
    More severe reactions are rare and often related to allergies to the
    ingredients in the vaccine.  Contact your health care provider if you are
    having any health effects which you think might be related to the vaccine.

    Are the rabies shots
    given in the stomach?

    No, the rabies vaccine has not been given in the stomach since the 1980s.
    For adults, it should only be given in the deltoid muscle of the
    upper arm (administration to the gluteal area is NOT recommended, as studies
    have shown this can result in a less effective
    immune response). For children, the anterolateral aspect of the thigh is also an acceptable site (depending on the child’s age and body mass). Rabies immunoglobulin is recommended to be given at the site
    of the bite, if possible.

    When is it too late to
    start rabies vaccinations after an exposure?

    Ideally, the vaccination series should begin as soon as possible after an exposure has occurred and a health care provider has determined
    rabies vaccination is warranted. Usually you can wait for test results
    from a healthy domestic animal to see if rabies shots are needed. Bites and
    exposures from wild animals should be treated as if the animal were rabid
    until rabies has been ruled out. There have been instances when a person did
    not start rabies shots for months after an exposure because the exposure was
    never suspected.

    Once a person develops rabies symptoms it is too late to vaccinate against
    rabies!

    How much does rabies
    vaccine cost?

    Rabies vaccine and
    immunoglobulin is very expensive. A typical vaccination series with the
    rabies immunoglobulin can cost anywhere from $2,000 to $7,000+ per person. 

    As a local law
    enforcement official, what can I do protect the public from rabies?

    If your jurisdiction has
    rabies vaccination ordinances and leash laws, enforcing these ordinances will
    help reduce the risk of rabies in your communities. Enforcing the proper
    confinement of animals that have bitten a person helps ensure that the animal
    will not escape during the observation period, so a veterinarian can declare
    the animal in question healthy. It also minimizes the risk for other
    people or animals to be exposed to the confined animal and helps prevent
    people from getting unneeded rabies shots.

    Where can I send an
    animal brain for rabies testing?

    • The brain can be sent to the North Dakota Department of Health Division of
      Laboratory Services or to the North Dakota State University Veterinary
      Diagnostic Laboratory for testing. Please contact one of the labs for
      more information.

      • NDDoH Division of Laboratory Services :  701.328.6272

      • NDSU Veterinary Diagnostic Laboratory :  701.231.7527

    How should I collect and
    ship the specimen?

    Humanely destroy the animal, avoiding damage to the skull and brain. This
    should be done by a professional such as a veterinarian. Only a veterinarian
    or other trained professional should remove the head and extract the brain
    leaving the brain stem intact. Contact the
    NDDoH
    Division of Laboratory Services (701.328.6272) or the
    NDSU Veterinary Diagnostic
    Laboratory (701.231.7527) for further
    instructions.

    The animal that I was
    exposed to has been dead for a while, can it still be tested?

    Consult with your
    veterinarian to determine if the animal can still be tested. If it has been
    cold, the animal may still be testable. However, brain tissue decomposes rapidly,
    especially in warm temperatures, and it may be too decomposed to test.

    If you have any
    other questions about rabies submit them
    here or call 800.472.2180.

     

     

    

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