Harms way...

What do you think of when you think of a rabid animal, an animal with the rabies virus?  Do you picture a viciously aggressive animal foaming at the mouth?  If you do, then you would be only able to recognize a small fraction of rabid animals.  Although Hollywood portrays rabies positive animal’s as having floods of foam coming from the mouth, this is not a common sign.

What do you see with a rabid animal and which animals are of concern to contract and/or spread rabies?  In Michigan, the most commonly rabies diagnosed animals are bats.  However, rabies can infect most mammals and those most commonly susceptible includes skunks, raccoons, fox and coyote (in Michigan).  Rabid animals can be abnormally aggressive or abnormally afraid, they seem to be drunk and have a staggered walk, they may simply keep circling, there may be a sensitivity to light (photophobia), the animal will try to drink water and will not be able to (may gag up water or seem thirsty and refuse water, hydrophobia) and lastly may foam at the mouth. 

Rabies is a neurological virus, it affects the brain.  Once rabies infects an animal (or person) it makes its way to the brain and attacks the area of the brain that controls fear and anger.  Rabies is transmitted via salvia so by affecting the area of the brain that controls biting essentially, it makes the animal more likely to bite thereby transmitting the illness.  The foaming at the mouth is caused from the swelling and spasm in the neck, around the jaw and related area’s caused by the virus.  The victim attempts to drink and cannot and may give a sensation of drowning or choking.  Unable to drink, the victim salivates excessively.

In Michigan, if an unvaccinated pet bites another animal, it is supposed to be either quarantined for 10 days or, if this is not possible or the animal is acting ill, euthanized and sent for rabies testing.  If the animal has bitten a person, the quarantine could be up to six months.  Again, if quarantine is not possible, euthanasia and rabies testing.  Rabies can take up to six months (or longer in rare cases) to surface in an infected animal (or human).

Keep in mind rabies attacks the brain, so the brain must be intact to test for rabies.  Otherwise only a necropsy (an animal autopsy) can be performed and may indicate nothing as rabies does not typically affect any other area of the body for virus identification.  Rabies testing, again in Michigan, is performed at Michigan State University and is sent in by the Health Department.  Certain packing measures are taken to keep the animal from decomposing quickly and deteriorating the brain otherwise making it difficult or impossible to test for rabies.  Animal that are tested for rabies should NEVER be frozen as this also causes damage to the brain affecting test results.

One June 12^th a woman was bitten by a raccoon in Suttons Bay Township (Northern Michigan).  9 and 10 .com reported the woman was gardening at her home, which is near a wooded area, and a raccoon ran up to her and attacked her.  She attempted to kick it back however was unsuccessful and the raccoon was able to bite her on her right ankle.  Her husband shot and killed the raccoon.  According to the reporter, the local Animal Control Officer (ACO) took the raccoon to a local veterinarian for rabies identification.

Many moons ago (more than 20 years ago) there was reason for concern if you saw a raccoon out during the day.  Raccoons are (use to be more so) nocturnal animals, out during the night.  However they’ve adapted to daytime hours.  If, for instance, you put your trash on the curb during the day or there is another food source available during the daylight hours, you will see them out during the day.  Raccoons are opportunistic scavengers and will not turn down a food source regardless of the time of day.  Therefor the time of day when a raccoon is out is no longer a reliable indicator of disease.  In regards to this woman’s case, raccoons are not typically territorial or so protective of their young that they would ran after someone.  This reported news story of the woman in Suttons Bay Township sounds suspiciously like rabies.  The concern is her husband shooting the animal, hopefully it wasn’t in the head and/or the brain was damaged to the point that it could not be tested for rabies.  Although a veterinarian’s job is to diagnose disease in animals, this is not a case for a veterinarian.  A report needs to be made with the Health Department and then, through the Health Department, the animal is sent for rabies testing to the State of Michigan.  The Health Department also tracks these incidents to determine the rate of incidents of rabies and the species affected.  A helpful tool for those at hospitals and veterinary hospitals when trying to determine if rabies is actively in their area.

So, why am I writing about this?  This is a case where is it imperative for physicians and veterinarians to work hand-in-hand.  The emergency room physician should be recommending for the woman to receive rabies inoculations to help her body identify and kill the virus if she was in fact bitten by a rabid raccoon.  The raccoon was taken to a veterinarian, where he/she would identify a need to send it out for rabies testing and in turn following protocol.  Especially during the warming months, people are out-and-about more often gardening, hiking, camping, walking their dog, etcetera bringing them, potentially, in harm’s way.  Any pets in the vicinity of this raccoon incident should be up-to-date on the rabies vaccines and distemper series vaccines.

Although it is rare in the United States for rabies positive domestic animals, or even rarer yet, rabies positive humans, vaccinations should be taken very seriously.  YouTube has multiple videos showing rabies positive people and it’s frightening.  Once neurological signs show, it is 100% fatal and to watch a loved one go through this, especially since it is 100% preventable through vaccination, would be horrifying.  Dogs and cats should be vaccinated even if your cat is 100% indoors or if your dog only goes outside to use the bathroom and is immediately brought back in.  If a bat was to get into your home, your pets as well as yourself could be potentially exposed.  Read my previous post “The Community Task Force” for an explanation of groups of individuals that should always have their pets up-to-date on the rabies vaccine.

Human medicine professionals should also be recommending individuals that work in industries where animals are handled (example. Kennels, training/grooming facilities, veterinary hospitals, lab’s, etcetera), to have their vaccines as well.  The rabies vaccination for people is painless and has few possible side effects (nothing is without risk).  The Center for Disease Control and Prevention has a wonderful site on the rabies vaccine and can be found at  http://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html.

This woman bitten by a raccoon in Northern Michigan is another reminder of the need for cohesive actions between ALL medical professionals, veterinary and human medicine.  We all need to be on the same page and that’s community education and protection.  Neither profession has greater responsibility, both are equally responsible and required to act in the best interest of their patient, client and society.