What You Should Know
Human rabies, if left untreated, has a 99% mortality rate.
For anyone who has had an encounter with an unfamiliar animal where they have been bitten or scratched, they should contact their provider immediately.
People who have been bitten or scratched by a rabid animal are given a series of shots before the infection takes hold.
If patients exhibit symptoms pertaining to the central nervous system, clinicians may want to consider rabies as part of a differential diagnosis.
September 28 marks World Rabies Day, which is an international awareness campaign coordinated by the Global Alliance for Rabies Control, a non-profit organization with their headquarters in the United States. The day is also recognized by the World Health Organization (WHO).
“September 28, is so important to bring the media, educators, researchers, and clinicians together, and just really remind everybody that in the United States, we're very fortunate but we still have a lot of work to do, especially in the realm of wildlife and animal health,” said Rodney E. Rohde, PhD, SV/SM/MB(ASCP)CM, FACSc, University Distinguished and Regents’ Professor and Chair for the Clinical Laboratory Science (CLS) Program in the College of Health Professions (CHP) at Texas State University.
This year’s theme for the awareness day, is, “All for 1, One Health for all,” and highlights that one health is not for a selected few but for everyone according to the WHO. It will mark the 17th World Rabies Day.
Rohde points out that approximately 3 Americans die annually from human rabies, compared to 59,000 deaths globally.
Although rabies has declined significantly in recent years in the US, it still is a very serious, and can be, fatal disease. “In the United States, we've become less aware. It's not nearly as deadly to as many people as you might have seen back in the mid 20th century,” Rohde said. “And that's really thanks to a lot of things, including domestic and wildlife vaccination, and education around getting dogs and cats vaccinated.”
Rabies can be contracted by a bite, or less commonly through a scratch, from a rabid animal. If not treated after the virus has entered the brain, human rabies is 99% fatal. It is vital for someone who has been in contact with an unknown animal to contact a medical provider right away to get tested.
People who have had an encounter with a rabid animal can be given a series of shots to prevent the infection from taking hold. “Postexposure prophylaxis (PEP) consists of a dose of human rabies immune globulin (HRIG) and rabies vaccine given on the day of the rabies exposure, and then a dose of vaccine given again on days 3, 7, and 14,” The CDC writes on its website.
If someone is not given PEP, and the infection does get into the central nervous system, there is no treatment for people.
Rohde spent a decade as a public health microbiologist and molecular epidemiologist with the Texas Department of State Health Services Bureau of Laboratories and Zoonosis Control Division prior to his academic career. During his time there, he was involved in a novel animal rabies elimination program.
“We've eliminated canine rabies in Texas,” Rohde said. “The vaccine was in the form of little sachets that had a liquid vaccine in them with attractants. They delivered them by aircraft and wildlife would eat that. It will open and squirt the tonsil area and vaccinate the animal, so you can really eliminate rabies. Who would have thought that you could eliminate rabies in all the coyotes and foxes in Texas, and that's basically what we've done.”
That program is a potential template for other rabies eradication programs. He notes there are still concerns about raccoons as vectors for pet and human rabies all along the eastern seaboard of the US, and he would like to see an effort made towards eradication, especially in areas of the world where it is a bigger problem. In some countries there is more human interaction with bats who are one of the primary vectors of the viral disease.
Contagion spoke with Rohde recently and he offered more information on eliminating rabies and when clinicians should be considering rabies in differential diagnosis.