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Rabies

 Summary—During 2007, 49 states and Puerto Rico reported 7,258 cases of rabies in animals and 1 case in a human to the CDC, representing a 4.6% increase from the 6,940 cases in animals and 3 cases in humans reported in 2006. Approximately 93% of the cases were in wildlife, and 7% were in domestic animals. Relative contributions by the major animal groups were as follows: 2,659 raccoons (36.6%), 1,973 bats (27.2%), 1,478 skunks (20.4%), 489 foxes (6.7%), 274 cats (3.8%), 93 dogs (1.3%), and 57 cattle (0.8%). The United States remains free of dog-to-dog transmission of canine rabies virus variants. The total number of cases of rabies reported nationally in foxes increased 14.5%, compared with 2006. Increases in the number of reported rabid foxes were attributable to greater numbers of foxes reported with the Arctic fox rabies virus variant in Alaska, the Texas gray fox rabies virus variant in Texas, and the raccoon rabies virus variant in Virginia. The 1,973 cases of rabies reported in bats represented a 16.6% increase over numbers reported in 2006. One human rabies case was reported from Minnesota during 2007. Although typing of the rabies virus variant in this case was not possible, an investigation of this case indicated a bat as the most likely source of exposure.

 The spatial boundaries of enzootic rabies in reservoir species are temporally dynamic . Affected areas may expand and contract through virus transmission and population interactions.  The rabies virus can be tested to see if it is skunk, fox, bat or other type rabies virus.  A bat virus can be found in a dog because the dog is bit by it or the dog eats the bat.

 Rabies control programs, including extensive vaccination campaigns implemented during the 1940s and 1950s, resulted in a substantial decline of rabies in domestic animals in the United States and eliminated the circulation of the major canine variants of the rabies virus in dogs by the late 1960s. During the late 1980s, a canine rabies virus variant reemerged in south Texas. This virus had been maintained historically in coyotes and transmitted to unvaccinated dogs. Oral rabies vaccination programs were initiated to interrupt transmission of this rabies virus variant. Vaccine in food was distributed by land and dropped from the air in areas of rabies.  No cases of animals infected with this rabies virus variant have been reported since 2004. After more than 10 years of oral vaccination, this variant has now been eliminated from the United States.  Rabies cases associated with a second rabies virus variant found mainly in gray foxes in west and central Texas have similarly been reduced. Regulations in place in Texas and other states prohibiting the translocation of certain wild animal species for hunting and restocking purposes may have reduced the likelihood of accidental introduction of rabies virus variants into unaffected areas. 

 

 Raccoons

Raccoons have been recognized as a major reservoir for rabies in the southeastern United States since the 1950s. An outbreak that began during the late 1970s in the mid-Atlantic states was attributed to the translocation by humans of infected raccoons from the Southeast.  Although identifiable as separate foci prior to 1994, the mid-Atlantic and southeastern fronts merged in North Carolina in 1995. Raccoon rabies is now enzootic in all of the eastern coastal states as well as in Alabama, Ohio, Pennsylvania, Tennessee, Vermont, and West Virginia.  Distribution of an oral V-RG recombinant vaccine targeting raccoons in the eastern United States and gray foxes and coyotes in Texas has shown promise as an important adjunct to traditional rabies control methods.

 

 Bats

Rabies in bats accounted for 27.2% of all cases of rabies in animals reported in 2007. The 1,973 cases reported in 2007 represented an increase of 16.6% over those reported in 2006. Bats tested show that in  2007 6.6% had rabies. Rabies in bats is widely distributed throughout the United States, with cases reported from all 48 contiguous states. Six states reported > 100 cases of rabies in bats: Texas (482; 24.4%), Michigan, California, Arizona, Illinois, and New York. Seven states (Idaho, Illinois, Mississippi, Nevada, Oregon, Utah, and Washington) reported rabies in bats but not in terrestrial mammals.

 

 Skunks

The 1,478 reported cases of rabies in skunks in 2007. Percentage of skunks that tested positive were 26% positive in 2007. Ten states there where endemic rabies in skunks including Kansas, Wyoming, Arkansas, Michigan, Montana, Oklahoma, and Texas.

 

 Foxes

Foxes accounted for 6.7% of all cases of rabies in animals reported in 2007. The percentage of test-positive foxes submitted for testing during 2007 were 28.7%. Most cases of rabies in foxes (76%) were reported by states affected predominantly by the raccoon rabies virus variant. Sixteen states reported increases in the number of rabid foxes, compared with 2006:

 Rabies in Domestic Animals

Domestic species accounted for 6.6% of all rabid animals reported in the United States in 2007. With good vaccination programs in domestic animals, there has been a shift of rabies from domestic to wild animals.

 

 The number of domestic animals reported rabid in 2007 (482) represented an 11.9% decrease from the total reported in 2006. Reported cases of rabies in cats, cattle, and horses decreased 13.8%, 30.5%, and 20.8%, respectively. Reported cases of rabies in dogs increased 17.7%, compared to 2006. Virginia reported the largest number of rabid domestic animals (50 cases), followed by Texas (41), Pennsylvania (38), North Carolina (36), and Georgia (31).

Cats

Most (221) of the 274 cases of rabies in cats were reported from states in which the raccoon rabies virus variant is present cases were reported principally by Central Plains states, where most cases were presumably the result of spillover from rabid skunks. Ten states reported > 10 cases of rabies in cats: Virginia, Florida, Pennsylvania, North Carolina, Maryland, New Jersey, New York, Georgia, Texas,  and Kansas.

Dogs

Texas (12 cases), Georgia (10), and North Dakota (7) reported the largest numbers of cases of rabies in dogs by individual states. No other states reported > 5 cases of rabies in dogs in 2007. No cases were reported involving the dog/coyote rabies virus variant. Twenty-four states, the District of Columbia, and New York City did not report any rabid dogs. 84 cases, 58%, were typed for which virus variant. One dog in Ward County, Tex, was determined to be infected with a rabies virus from the Mexican free-tailed bats, and 1 dog in Suwanee County, Fla, was infected with the rabies virus variant associated with red bats. The rabies virus variants isolated from all other positive dogs typed in 2007 were identified as the terrestrial rabies virus variant associated with the geographic area where the dog was collected .

 The article above was summarized from a CDC article from http://www.cdc.gov/rabies/pdf/surveillance_us_2007.pdf


 

A couple of points:

 1.      More than 55,000 people, mostly in Africa and Asia, die from rabies every year - a rate of one person every ten minutes.

2.      Although rabies in humans is rare in the United States (only one case in 2007), as many as 18,000 Americans get rabies shots each year because they have been in contact with animals that may be rabid.

3.      For many types of bite wounds, immediate gentle irrigation with soap and water or a dilute water povidone-iodine solution (Betadine)  has been shown to markedly decrease the risk of bacterial infection and rabies.

4.      You cannot feel the bite of bats so if there is a bat found in the house, everyone should get vaccinated.  If the bat can be safely caught, then have the bat tested for rabies.

5.   Bites from cats or dogs from families (not strays) you can observe the animal for 10 days before getting shots.

6.      The vaccine is not 21 shots in the stomach any more.  It is 4 shots in the arm and as painful as flu shots.  The emergency room and county health clinics are the places that carry vaccine.  The average doctor does not have it in his office. 

CDC pamphlet on the rabies vaccine

 For bite care and vaccine information:  http://www.cdc.gov/rabies/medical_care/index.html

 Video of child dieing of rabies.  Caution, this is not pleasant: http://www.youtube.com/watch?v=iO_E1SO8_io&NR=1