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Animal Bites and Rabies

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Rabies in a Bull, Illinois, 2011 Decreasing Animal Rabies Testing in Illinois Animal Rabies Testing Animal Bite Consultations Rabies, ... – PowerPoint PPT presentation

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Title: Animal Bites and Rabies


1
The Rabies Virus
Family Rhabdoviridae Genus Lyssavirus
  • One of the oldest zoonotic diseases known
  • Affects mammals
  • Targets nervous tissue
  • ataxia/incoordination
  • behavior change
  • paralysis
  • seizures/coma
  • Shed in salivary glands of an infected animal
  • Strains of rabies

2
Public Health Importance of Rabies
  • Rabies is the infectious disease with the highest
    known case fatality rate
  • The annual cost of preventing rabies in the USA
    is estimated to be over 300 million and rising

3
Human rabies cases worldwide
33,075
Worldwide number of human rabies deaths/year est.
50,000 Most cases in India (gt 30,000)
India Bangladesh Cambodia China Indonesia Iran Ma
laysia Nepal Philippines Sri Lanka Syrian Arab
Republic Thailand Vietnam
Number of reported deaths in 1998
204
87
Ethiopia Egypt Sudan Nambia Algeria Ghana
Brazil Mexico Paraguay Peru
7
Russia
Africa
Asia
Americas
Europe
WHO. Rabnet, world Survey of Rabies No 34. WHO
Web site. http//www.who.int/emc-documents/rabies
/whocdscraph996c.html.
4
Which of the following tissue/fluids can transmit
rabies?
  • Blood
  • Saliva
  • Nervous tissue
  • Cerebrospinal fluid
  • Hair
  • Feces
  • Urine
  • Skunk spray

5
Rabies Transmission
  • Major Mode of Transmission Saliva into open
    wound or mucous membrane, usually by a bite
  • Not found to a significant extent in other body
    tissues or fluids except for brain and spinal
    cord
  • The virus does not invade intact skin
  • You dont get rabies from
  • Touching a rabid animal
  • Touching something a rabid animal touched
  • Being near a rabid animal

6
Rabies Virus is Environmentally Fragile
  • Killed by heat, UV light, drying
  • If its dry, its dead
  • Soap and water - any disinfectant is effective in
    killing the virus
  • Immediate washing of a wound with soap and water
    is a very important first aid measure.

7
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8
Situation Confinement period
Low risk healthy dog, cat or ferret bites a person in a provoked manner 10 day. NO testing needed if animal survives 10 day period
Vaccinated dog, cat or ferret is exposed to a suspect rabid or known rabid animal 30 days (revaccinate immediately)
Unvaccinated dog, cat or ferret is exposed to a suspect rabid or known rabid animal 6 months (revaccinate immediately and at 5 months)
9
How to prove an animal does NOT have rabies after
they have bitten someone..
Quarantine (dog, cat, or ferret) Lab testing
10
Provoked vs Unprovoked
11
Reporting of Animal Bites
  • Animal bites are reportable to animal control
  • Coordination between animal control and public
    health to share information

12
Rabies and Animal Bites
13
Percent of Animal Bites Due to Various Animals
14
Bite Management
  • Persons who are bitten should be referred to the
    local public health and health care provider for
    evaluation

15
Which animals can get rabies?
  • Reptiles
  • Dogs
  • Skunks
  • Birds
  • Rodents
  • Frogs
  • Bats

16
  • Why do we (public health and animal control) do
    animal control and animal exposure followup?

17
What animals do not get rabies?
Birds, reptiles (snakes, turtles) and amphibians
(frogs, toads) do not get rabies.
Rodents (squirrels, hamsters, mice, rats, etc.),
rabbits and hares are very rarely infected and
have never been known to cause rabies in humans
in the United States.
18
Source Centers for Disease Control and
Prevention, November 2010
19
Canine Rabies
  • Emerging Infectious Diseases Rabies Elimination
    in Dogs in the United States

20
Dog Importation
21
Source Centers for Disease Control and
Prevention, November 2010
22
Source Centers for Disease Control and
Prevention, November 2010
23
Animal Reservoirs in Illinois
  • Skunk
  • Insectivorous bats
  • Solitary tree dwellers
  • Silver-haired bat and Eastern Pipistrelle
  • House bats
  • Big brown bat- most common species in IIlinois
  • Little brown bat
  • Remember all mammals can be infected with Rabies

24
Bat Species in Rabies Tested Bats in Illinois,
2009
  • Big brown bat 1995
  • Silver-haired bat 218
  • Eastern red bat 123
  • Little brown bat 59
  • Hoary bat 25
  • Northern long eared bat 25

25
Rabies Positivity Rate by Species in Illinois,
1991-2010
26
Animal Rabies in Illinois, 1992-2010
27
Bat Testing in Illinois, 2000-2010
28
Bat Testing by Month in Illinois, 2010
29
The Importance of Skunk Surveillance
30
Illinois Skunk Road Kill Index, 1976-2009
31
Skunk Rabies Testing in Illinois, 1991-2010
32
Romeo, Oh Romeo. Rabies in a Bull, Illinois, 2011
33
Decreasing Animal Rabies Testing in Illinois
  • Testing animals where testing of the animal will
    influence whether rabies PEP is recommended
  • Testing animals that have signs of rabies
  • Surveillance testing of skunks

34
Animal Rabies Testing
  • No antemortem test!
  • Refrigerate, dont freeze brain
  • Overnight mail or hand deliver
  • Package appropriately
  • Special arrangements if not during regular
    working hours
  • No live animals to PH labs

35
Animal Bite Consultations
  • Species of the biting animal
  • Type of exposure-bite/non-bite
  • Availability for testing or observation
  • If domestic dog or cat
  • Circumstances of the bite
  • Amount of terrestrial animal rabies virus
    circulating
  • Geographic location

36
Rabies, Potential Human Exposure in Illinois,
2005-2010
37
Rabbits or Small Rodent Bites
  • Rarely, if ever, require rabies PEP

38
Wild animal (bat, skunk, coyote, raccoon, fox)
bite
  • Rabies PEP recommended unless can test the animal
    negative

39
Human Rabies in the U.S. and Puerto Rico,
1993-2010
40
Human Rabies Cases U.S. 2000-2010
  • Organ donor recipients (2004) 4
  • U.S. Bat-associated 18
  • Raccoon-associated 1
  • VA 2003
  • Foreign associated 9
  • __________________________________
  • Total cases by source 32

41
Bat bite on finger
42
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43
Illustrations courtesy of Penn State University
and the University of Missouri.
44
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45
Goals of Rabies Prevention Program
  • To prevent animal and human cases of rabies
  • To minimize human exposures and costly
    post-exposure treatment

46
Rabies Control Measures
  • Rabies vaccination of animals
  • Education of the public
  • Bite management
  • Report animal bites and strangely acting animals
  • Control strays and roaming of pets
  • Pre-exposure vaccination
  • Oral rabies vaccination of wildlife?

47
Oral Rabies Vaccination of Wildlife?
  • Expensive (labor and )
  • Available for coyotes and raccoons
  • Pilot project for skunks

48
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49
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50
Problems when terrestrial animal rabies is
occurring
  • Increased exposure to animals and humans
  • Rabies labs have increased testing
  • Increased rabies PEP needed for persons bitten by
    escaped dogs and cats
  • Increased calls for animal control

51
Pre-exposure vaccination
  • Recommended for wildlife workers, animal control
    officers, veterinarians and their staff,
    travelers to certain countries, lab workers
  • Initial series of 3, followed by titer testing
    every 2 years
  • Titer needs to be gt15 or need booster
  • Still need rabies PEP if exposed!

52
Illinois Public Health Rabies Resources
  • www.idph.state.il.us
  • Animal rabies numbers
  • Information sheets
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