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.
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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.
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"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.
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Avoid contact with wild or stray animals, and domestic/wild hybrid
animals.
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Do not touch dead
animals.
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Keep wild animals out of
homes, workplaces and other dwellings.
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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?
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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.
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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.
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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).
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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?
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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.
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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?
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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