Rabies: Fear, Prevention

by Food and Drug Administration (FDA)

(Page 3 of 3)

"We are encouraged with the use of the vaccine and the results we have seen in the Northeast to date. It took from 1983 to 1995 to get a conditional license because we don't have all the bugs worked out yet, but by the next decade we should be generating enough data to come to grips with that," he notes. "The United States has the most complex rabies problem in the world because of the size of the country, the affected area, the diversities of reservoirs [host animals], and the viruses adapted to them. Socioeconomic philosophies here have also not [traditionally] supported the concept of oral vaccination."

The four human deaths that occurred in 1995 in the United States were due to bites from bats or from animals bitten by rabid bats. In that sense, the four human fatalities were not related to the current raccoon epizootic. (Rabid bats have been associated with at least 21 human deaths since 1951 in the United States.) Although most animal cases involve raccoons, there has never been a reported human rabies death directly or indirectly connected to a raccoon.

CDC has provided the 1995 compendium of animal rabies control recommendations to veterinarians, public health officials, and others concerned with rabies control. The recommendations included immunization procedures with detailed vaccine information; information on human rabies prevention and rabies in domestic animals and wildlife; preexposure animal vaccination and management; and postexposure management directives.

CDC's Rupprecht emphasizes that despite the advent of oral vaccines for wildlife and advances in human rabies vaccines, the key to rabies control remains education.

"We need to keep nature in perspective; the world is not all bright and beautiful. That's the reason why we perceive wildlife as wild," he says. "The same old things that worked 50 years ago still work: Vaccinate your pets, and have a healthy attitude toward wildlife. To paraphrase a common rabies control idiom: Love your own, leave others alone."

He adds, "But the dynamics of rabies have changed, and will continue to change. The dynamics have changed both in shifts of rabies from domestic to wild animals, within domestic animals from dogs to cats, and shifts in the number of important wildlife species annually and geographically that are affected by rabies. This will continue to press us to come up with novel ways to control the disease in wildlife."

FDA's Fitzgerald agrees with the concept of change in terms of human rabies vaccine.

"I've seen an awful lot change over the years. Rabies vaccines were much cruder, such as those made from duck embryos. We are now into a whole new level of purification and potency," Fitzgerald says. "We have good vaccines for humans with few side effects. You only have to look at other countries where people by the thousands die of rabies to know how lucky we are here."

Justified Fear

Rabies — its name comes from a Latin word meaning "to rage" — has struck fear in people for centuries. An Italian physician, Girolamo Fracastoro, discovered that rabies was a disease fatal to humans as well as animals in the 16th century, calling it "an incurable wound." Louis Pasteur created the first rabies vaccine in 1885 using live rabies virus. Pasteur's early vaccine could cause serious, even fatal, reactions, but it was a start on the road to today's effective rabies vaccines.

The fear caused by rabies begins with its very transmission. A viral infection affecting the brain and spinal cord, rabies is transmitted through the saliva of an infected animal, usually by a bite. It can also be transmitted when infected saliva comes in contact with a cut or skin break. Infected bat droppings are suspected of transmitting the disease, and at least two people are believed to have been exposed to rabies by breathing the air in caves where rabid bats live. Other rare deaths have occurred in people who have received corneal eye transplants from donors with undiagnosed rabies.

Bite transmissions can be difficult to detect, as illustrated by the death of a 4-year-old girl last year who was exposed to rabies from a bat that flew in her room while she was sleeping. The bat was killed and buried, and no signs of a bite were found on the girl. When she died a month later of rabies, health authorities recovered the bat carcass, tested it, and found the bat and the child both had the same variant of rabies.

Rabies Prevention

Prevention is the best way to keep you and your pets safe from rabies:

• Keep pet shots up-to-date and observe leash laws. Don't leave your dog chained alone in the yard: If attacked by a rabid animal, it can't escape.
• Don't make your house or yard attractive to wildlife; feed your pet indoors, and keep garbage cans closed tightly.
• Seal basement, porch, and attic openings, and cap chimneys with screens.
• No matter how cute, avoid contact with wild or unfamiliar animals. Don't touch a wild animal even if it's dead.
• Report strays or animals acting strangely or sick to local authorities.

If you are bitten, immediately wash the wound with soap and water. Clean the bite by allowing the wound to bleed, and get medical help at once. If possible, use a large box to trap and confine the animal, but only if it can be done safely.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.