Rabies, Animal, Human - Russia (02) : Moscow Region

RABIES, ANIMAL, HUMAN - RUSSIA (02): (MOSCOW REGION)
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Thu 2 Jul 2009
Source: IA Moscow news [trans, abbreviated, Mod.NP, edited]


According to RosSelhozNadzor (The Federal Agency for Veterinary and
Phytosanitary Supervision), the numbers of stray dogs and cats, the vectors
of rabies, have continued to increase throughout the Moscow region.

The number of rabies cases among animals during 2008 was 2.5 times their
number during 2007. 80 per cent of the cases involved wildlife, of which
the population growth is uncontrolled. The other 20 per cent involved pets.

During the 1st 5 months of 2009, 11 000 persons applied for post-exposure
treatment. This is an 11 per cent more than in the same period of 2008.

communicated by:
ProMED-RUS


[According to VmDaily , 13
cases of human rabies have been recorded within the Moscow region since
1987; 9 of them died during the last 5 years. - Mod.NP

Clearly, the reservoirs of the virus in the Moscow region are wild animals;
according to previous postings, these are predominantly raccoon dogs
(_Nyctereutes procyonoides_) and foxes. Stray or unvaccinated pet dogs
(and, to a lesser extent, cats) exposed to wildlife deliver the fatal virus
into the human population.

The reported increase in the number of rabies cases in animals (probably
referring to both wildlife and domestic pets) deserves some explanation; it
could also reflect intensified monitoring. The increased number of exposed
(and subsequently treated) people may, however, reflect a growth in the
stray animal population or deficient vaccination coverage of pets.

Oral vaccination of wildlife is the recommended mode for spatial rabies
control. Several of the vaccines which have been long demonstrated as
highly effective and safe in controlling the disease in foxes -- in western
Europe and elsewhere -- have been tested in raccoon dogs as well, with
similarly satisfactory results. - Mod.AS]

Rabies, Human, Canine - Viet Nam (Lai Chau)

RABIES, HUMAN, CANINE - VIET NAM (LAI CHAU)
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Wed 1 Jul 2009
Source: VNS, Viet Nam News agency [edited]


Northern Lai Chau Province announced a rabies epidemic after 4 people died
of the disease and at least 500 people had been bitten by rabid dogs in the
last 2 months. "The 500 cases only account for the number of patients who
got a rabies [vaccination] at the province's Preventive Healthcare Centre
after being bitten," said Do Van Giang, deputy director of Lai Chau
Province's Health Department, adding that the actual number of infected
people could be much higher.

Due to the high demand for dog meat, many local people transported dogs
from Phu Tho and Vinh Phuc provinces. These dogs then infected the local
dogs, leading to the rabies outbreak, said Nguyen Cong Huan, director of
the province's Health Department.

"More people will die of rabies because they do not get the vaccine," he
said. The cost for the vaccine is high -- nearly VND one million (USD 56)
for a course of 5 injections -- and 40 per cent of people in the province
have an average monthly income of VND 200 000 (USD 11), according to Giang.

"My pregnant daughter was killed by a rabid dog because she couldn't get
the vaccine in time," said a 64 year old in Lai Chau Town, who recovered
from rabies after several days of treatment in the province's hospital
[presumably as a result of prophylactic immunization before any symptoms of
infection developed. - Mod.CP]. "Authorities should support patients like
us and get us free treatment. If not, we will not be able to afford the
vaccine," said Thanh.

The province recently decreed that the poor would get free rabies vaccines
and others would get 50 per cent of the vaccine cost subsidised, said Huan.
Some local ethnic minorities lack information about the disease and choose
to treat it with herbal remedies instead of getting the vaccine. "Many
people rush around looking for herbal medicine after being bitten by dogs.
However, this is useless and causes more harm because there is no
scientific basis for this treatment," said Bui Tien Thanh, a doctor at the
province's General Hospital.

Local health officers have handed out leaflets about rabies and treatment
to educate people about the disease and have asked anyone who has been
bitten by dogs to go to the Preventive Healthcare Centre for treatment,
according to Nguyen Van Ngoc, deputy director of the Preventive Healthcare
Centre. "In addition, relevant authorities have increased the management of
dog transports from other provinces and are more closely monitoring the
province's current canines," said Huan.

So far, the province's Veterinary Department has vaccinated 4 dogs and cats
in the province. "It has been decades since the last rabies epidemic, and
the province is trying to stop the spread of the disease as quickly as
possible," said Giang.

communicated by:
HealthMap Alerts via
ProMED-mail

[A map of the provinces of Viet Nam can be accessed at:
. The province of Lai Chau
lies in the far western part of the northern region.

Rabies in Viet Nam continues to be a problem partly on account of lack of
regulation of the trade of dog breeding and provision of dog meat for human
consumption (see references below). Comprehensive vaccination of canines
would both protect human health and have long term economic benefits. - Mod.CP]

Rabies, Fox, Human Exposure - USA : (North Carolina)

RABIES, FOX, HUMAN EXPOSURE - USA: (NORTH CAROLINA)
***************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Sun 28 Jun 2009
Source: InjuryBoard.com, North-east Carolina [edited]


Rabid animal attacks have been reported recently in Durham and Orange
counties, which underlines the fact that rabies also exists in north
eastern North Carolina's wild animal population. Recently, a 4 year old
Durham girl was bitten by a fox that climbed a fenced-in yard at a day care
center, according to a report by the News and Observer in Raleigh. Another
fox attacked 2 women in Chapel Hill hours later, the paper reported.

Rabies can become a public health issue when a person is bitten or a pet is
attacked by a wild animal. Rabies is very dangerous; left untreated, it is
deadly. Despite its danger, rabies exposure in pets and humans is a
relatively rare occurrence in northeastern North Carolina. Cats are the
most commonly affected domestic animals, according to North Carolina
Department of Health and Human Services. The largest majority of reported
rabies cases each year occur in wild animals like raccoons, skunks, bats
and foxes.

It is imperative to make sure your pets have updated rabies shots.
Potentially exposed pets that have not had a rabies vaccination or a
booster shot within 3 years will be quarantined for 10 days to see if
rabies is present in the animal. Pets thought to be infected must be
quarantined for 6 months. However, most families are unable to afford the
cost of quarantining pets and are forced to have the animal put to sleep.

Rabies is most often transmitted by the bite of a rabid animal, according
to the Centers for Disease Prevention and Control at the US Department of
Health and Human Services website. When a human is exposed to rabies, an
effective method to decrease the chance of infection is to thoroughly wash
the wound with soap and water according to CDC. People exposed to the
disease also may need to have a series of 6 shots over a 28-day period [now
reduced to 4, see: Rabies, human - USA: vaccination protocol change:
20090625.2312. - Mod.CP]

[byline: Randy Appleton]

communicated by:
ProMED-mail rapporteur Susan Baekeland

[The date of these attacks is not given, but they do not appear to have
been recorded previously in ProMED-mail. The fate of the rabid animals and
the treatment of their victims are not revealed.

The adjacent counties of Durham and Orange lie in the north of the state
and can be located using the map of the counties of North Carolina at:
. - Mod.CP]

Rabies, Canine - Angola (03) : (Luanda)

RABIES, CANINE - ANGOLA (03): (LUANDA)
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Tue 23 Jun 2009
Source: OIE, Animal Health Information & Angolan Veterinary Services [edited]

[Re: ProMED-mail Rabies, canine - Angola (02): (LU), RFI 20090611.2164]
-----------------------------------------------------------------------
Quote [edited English]: "Monkeys have been vaccinated because they
were considered as pets. They live in houses in contact with humans
and dogs. After considering the risk of being a source of infection of
certain human cases in Luanda, the decision was to vaccinate this
species as well."

Communicated by:
Karim Ben Jebara

[We requested clarification on monkey vaccination against rabies by
Angola and got this information, which in my opinion makes sense. -
KBJ.]

[I thank Karim for going to the trouble to clarify this question.
Because "trapping" was mentioned, this moderator mistakenly thought
the monkeys involved were wild. - Mod.JW]

Rabies, Antelope - Namibia : Request for Information

RABIES, ANTELOPE - NAMIBIA: REQUEST FOR INFORMATION
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Fri 19 Jun 2009
From: Herbert Schneider

Rabies in Namibia
-----------------
A massive outbreak of rabies, affecting kudu antelopes, started early
last year [2008] in Namibia. During a helicopter count in the Khomas
highlands during the winter months of 2008 some 500 dead kudu bulls
were counted. Similar outbreaks were observed in the past, with the
largest one during the years 1977-1985 , when an estimated loss of
30-50 000 antelope (20 per cent of the population) was reported,
apparently involving oral spread of rabies infection between
individuals.

It is estimated that over 20 000 antelopes have died during the
current epizootic.

Dr Herbert P Schneider
Namibia


[Dr Schneider's authoritative clinical/epidemiological observation is
gratefully acknowledged. Laboratory confirmation and information on
possible control measures will be anticipated with interest. A
picture of a kudu is available at
.

The major, unique epizootic of 1977-1985, which decimated about 20
percent of the kudu antelope (_Tragelaphus strepsiceros_) population
of Namibia, as well as the later, smaller outbreaks of 2002 and 2006,
provided an example of horizontal spread between individuals by means
of non-bite transmission. The social behavior of kudu was believed to
be the contributing factor, through the exposure of mouth lesions
from the browsing of thorn bushes to the infected saliva.

References
----------
1. Schneider HP: Rabies in South Western Africa/Namibia. In Rabies in
the Tropics. Edited by: Kuwert, Merieux, Koprowski, Bogel. Berlin:
Springer; 1985:520-535.
2. Swanepoel R, Barnard BJH, Meredith CD, Bishop GC, Bruckner GK,
Foggin CM, Hubschle OJB: Rabies in southern Africa. Onderstepoort J
Vet Res 1993, 60: 325-346. Abstract available at
.
3. Mansfield K, McElhinney L, Huebschle O, Mettler F, Sabeta C, Nel
LH, Fooks AR: A molecular epidemiological study of rabies epizootics
in kudu (_Tragelaphus strepsiceros_) in Namibia. BMC Vet Res 2006,
Jan 13; 2:2. Available at
. - Mod.AS]

[The HealthMap/ProMED-mail interactive map of Namibia can be accessed at
. - Sr.Tech.Ed.MJ]

Rabies, Canine - Angola (02) : (Luanda), Request for Information

RABIES, CANINE - ANGOLA (02): (LUANDA), REQUEST FOR INFORMATION
***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: 11 Jun 2009
From: Jack Woodall

Re: Rabies, canine - Angola: (LU) OIE
----------------------------------------
This OIE report states: "Vaccinations in response to the outbreak(s)
in Luanda: 4457 cats vaccinated in all the municipalities of Luanda
province; 108 531 dogs vaccinated in all the municipalities of Luanda
province; ***901 wild monkeys vaccinated***" (my emphasis).

CDC says: "Cases of monkey-transmitted human rabies are rare;
however, one extremely long incubation period (37.5 months) was
reported (Wilson JM, Hettiarachchi J, Wijesuriya LM. Presenting
features and diagnosis of rabies. Lancet 1975;2:1139-40). CDC also
reports a human fatality in 1987 in Australia after a bite from a
monkey in a market in India, but none since (CDC (1988) Imported
Human Rabies -- Australia, 1987 Vol.37(22);351-3
).

The island of Bali, Indonesia has recently been experiencing a rabies
outbreak in dogs, reported by ProMED. Soegiarto, head of the
Denpasar-based Veterinary Main Office in Bali, recently urged local
authorities to monitor areas where tourists go to view wild monkeys,
while admitting that: "In countries affected by rabies outbreaks,
such as India and Pakistan, cases of rabies among monkeys have
***never*** been reported" (my emphasis)
.

As visitors and residents of India and Thailand know, there are many
monkey temples in those countries, wherein feral macaques mix with
stray dogs, which are a major source of human rabies in those
countries, but no rabies has been reported in the monkeys.

I am not aware of such places in Angola. So can anyone explain the
rationale behind spending a considerable amount of money to trap and
vaccinate nearly 1000 wild monkeys there?

Jack Woodall
Associate Editor, ProMED-mail

Rabies, Skunks - USA : (Texas)

RABIES, SKUNKS - USA: (TEXAS)
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: 10 Jun 2009
Source: Fort Bend Now [edited]



Rabid Skunks Near Needville And Beasley
---------------------------------------
The discovery of rabid skunks near Needville and Beasley has prompted
Fort Bend County Animal Control officials to urge that owners make
sure their pets' rabies vaccinations are up to date. Animal control
officers found one skunk that tested positive for rabies in an
unincorporated area near Beasley, and the other inside Needville city
limits, according to a statement issued Wednesday [10 June 2009] by
the Fort Bend County Health and Human Services. No other details
about the discoveries was immediately available.

"Although the incidence of rabies is low among domestic animals in
the United States, with the occurrence of wildlife rabies comes the
increased risk for infection of humans," said County Animal Control
Director Vernon Abschneider.

Abschneider's department is urging pet owners to keep their animals'
rabies vaccinations current.

"It is also important to keep your animals restrained and not allow
them to roam freely, as this will further protect them from
confrontation with wildlife," Abschneider said.

He added that skunks are nocturnal, and if they're active in the
daytime, it's an indication they're rabid. Therefore, any daytime
sightings of skunks should be reported to local animal control officers.

Rabies is a viral disease affecting the central nervous system and
transmitted by the bite of an infected animal. It is almost always
fatal once symptoms in humans or signs in animals appear. Humans and
animals can be exposed to rabies from the saliva or brain and spinal
cord tissue of a rabid animal that bites or scratches them. Wild
animals, such as raccoons, bats, skunks, foxes and coyotes are more
likely to carry rabies. Exposure can also occur if infected saliva or
tissue gets into a fresh wound (one that has bled within 24 hours) or
the eyes, nose or mouth.

Several things can be done if one is exposed to rabies. After being
bitten, it is important to quickly wash the animal bite or scratch
with a lot of soap and water. Then, contact your doctor immediately
to receive rabies immune globulin and a series rabies vaccine to
prevent infection. The rabies immune globulin and the 1st vaccine
should be given as soon as possible after exposure. However, if the
animal can be caught and observed or tested for rabies, it is safe to
wait up to 10 days before starting the series.

The early symptoms of rabies include irritability, headache, fever,
itching or pain at the site of exposure.

Communicated by:
ProMED-Mail Rapporteur Susan Baekeland

[To test for rabies in an animal, the suspect animal must be dead.
Therefore it is advisable for pet owners to protect their pets,
including horses and cattle with rabies vaccination. - Mod.TG

A map of Texas is available at:

- CopyEd.EJP]

Rabies - China (03) : (Shaanxi)

RABIES - CHINA (03): (SHAANXI)
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Tue 9 Jun 2009
Source: Xinhua News Agency [edited]



In Hanzhong city of northwest China's Shaanxi Province, 2 more people
have died of rabies bringing the rabies death toll in the city since
March [2009] to 11. The 2 fatalities were both women, one aged 58 and
the other 56, said a local government official.

The 1st death was reported on 21 Mar [2009], and number of people
injured by dog bites in the city has since reached 6256. So far,
approximately 335 900 pet dogs have been vaccinated in the city, said
the local government official. The city, with more than 370 000
registered dogs, reported 35 deaths of rabies from 1985 to 1992.

Human deaths indicated the rabies virus was very active, posing a
great public health threat, Shi Ruihua, local agricultural bureau
chief, said earlier this month [June 2009]. The city carried out a
rabies prevention campaign from 23 May-1 Jun [2009], implementing
door-to-door compulsory vaccinations of dogs and urging dog owners to
put their pets on a leash or keep them off the streets.

Communicated by:
HealthMap Alerts via ProMED-mail


[These 2 deaths apparently are the 2 individuals hospitalized and
under treatment in the previous rabies report from Shaanxi Province
(see ProMED-mail archive no. 20090607.2105).

Hanzhong is located in the southwest of Shaanxi Province. An
interactive map showing the location of Shaanxi province in
east-central China can be accessed at
.
The HealthMap/ProMED-mail interactive map of China is available at
. - Mod.TY]

Rabies - Mexico : (Jalisco)

RABIES - MEXICO: (JALISCO)
**************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Thu 21 May 2009
Source: Milenio online [in Spanish, trans. & summ. Mod.TY, edited]


A 63-year-old man residing in a small community in the
Hostotipaquillo municipality became the 2nd fatal sylvatic [wildlife]
rabies victim so far this year [2009] in the state. After inquiries
with family members, the Jalisco Secretariat of Health (SSJ) presumed
that he was bitten by a bat that transmitted the virus.

Yesterday [20 may 2009], the director general of Public Health of the
SSJ [Jalisco Health Secretariat], Elizabeth Ulloa Robles, said the
man indicated to his family that something bit him on the elbow, but
that it was not important. On 10 May [2009], 3 days before going to
the Magdalena Regional Hospital, he began to show general weakness,
paralysis of the hands, and alterations in gait, among other
symptoms; an internist considered that he had neurological
deterioration and sent him to the Juan I Menchaca Civil Hospital of
Guadalajara. Ulloa Robles added that the patient came to [the
Magdalena Regional Hospital] on 17 May [2009], "when he presented
with a 40 deg C [104 deg F] temperature, alterations in the state of
consciousness, ataxia, stiff neck ... when this was evaluated, as
detected by the temperature, it raised [indication of] an infectious
neurological [disease] process.

He underwent tests, including tomography, but he died the same day
[17 May 2009] at 22:50 hours. After discarding diseases such as
tuberculosis and influenza A H1N1, a sample of brain [tissue] was
sent to the state Public Health Laboratory, and it was determined
that he suffered from rabies [virus infection].

Ulloa Robles indicated that epidemiological barriers were established
in La Venta de Mochitiltic, where the man resided, as well as in 8
other localities in Hostotipaquillo [municipality], villages where
other possibly affected individuals are being sought.

This is the 2nd case of sylvatic rabies death in 2009 [in Jalisco].
On 2 Jan [2009], a 4-year-old girl died after being bitten by a bat,
in San Sebastian del Oeste. There have been no [human] rabies cases
transmitted from a dog or a cat in Jalisco since 1995. Given this
case of wildlife rabies, the SSJ requested that SAGARPA [Ministry of
Agriculture, Livestock, Rural Development, Fisheries, and Foods]
analyze the bat population that inhabits caves in the area for
circulation of rabies virus, and if found, to proceed with their destruction.

[Byline: Maricarmen Rello]

Communicated by:
Dr Eduardo Santana C.
Universidad de Guadalajara
Mexico


[It is not clear from this report which species of bat might have
been involved in these 2 cases. However, the bites of vampire bats
(_Desmodus rotundus_), a common transmitter of rabies virus to
livestock and occasionally to humans in the neotropics, are
characteristic and well known to rural people in Mexico. Vampire bat
bites can be discarded in these cases. However, there is evidence of
occurrence of rabies in several species of insectivorous bats in
Mexico (see the following references).

Rabies, Fox, Raccoon, Bat - USA : (Pennsylvania, Kentucky, Maryland, Alert)

RABIES, FOX, RACCOON, BAT - USA: (PENNSYLVANIA, KENTUCKY, MARYLAND), ALERT
***********************************************
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ProMED-mail is a program of the
International Society for Infectious Diseases


[1]
Date: 20 May 2009
Source: WBOC.com [edited]


The Worcester County Health Department is alerting residents that
since 1 May 2009, there have been 6 laboratory confirmed rabid
raccoons in Worcester County.

In the last week, 4 of the confirmed raccoons have been found in
highly populated areas, according to the department.

Those areas include north Ocean City, Ocean Pines, White Marlin Mall
in West Ocean City and South Point. The Health Department says that
although rabies is present to some degree in Worcester County at all
times, these latest cases illustrate that the disease is not only
associated with rural settings but can, in fact, be found in suburban
and town settings.

Raccoons are the most frequently identified carrier of rabies in
Maryland as well as in Worcester County, but the deadly viral disease
has also been found in foxes, cats, bats, skunks and groundhogs.

The Health Department recommends several things you can do to protect
your family and pets from exposure:

-Make sure your dogs and cats are currently vaccinated against rabies
and keep those vaccinations current.

-Do not let your pets roam free. They are more likely to have contact
with a rabid wild animal

-Avoid feeding your animals outside. This draws stray and wild
animals to your doorstep.

-Teach your children not to approach wild animals and animals they don't know.

-Avoid sick animals and those acting in an unusual manner. Report
this behavior to the local law enforcement.

-If your pet has contact with a wild animal, avoid touching your pet
with bare hands and do not touch the wild animal. Report the incident
to local law enforcement and to the Health Department. If you have
questions regarding rabies, you are asked to contact the Health
Department at (410) 641-9559 or consult with your veterinarian.

Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[2]
Date: 21 May 2009
Source: Kentucky.com [edited]


Health officials say they've found a rabid bat in Lexington, making
it the 9th animal in the city to test positive for the disease this
year [2009].

The Lexington-Fayette County Health Department announced the findings
Thursday [21 May 2009] and said it has posted signs in the
neighborhood reporting the incident and stressing the importance of
getting pets vaccinated.

Eight other animals in the city have tested positive for the viral
disease this year [2009], including 6 skunks, a fox and a horse.

The number of cases more than doubles the 4 confirmed cases of rabies
in Lexington in all of 2008.

Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[3]
Date: 21 May 2009
Source: Pittsburg Live.com [edited]


The adult victim and her son fired several shots at a rabid fox and
finally knocked it unconscious with a mop handle after the animal
attacked the New Sewickley woman's 4-year-old grandson.

The adult victim got out of her truck Saturday [15 May 2009] and was
walking to her daughter's house to get her grandson, when she saw
something dart out from beneath her truck.

"I looked over, and the fox had my grandson pinned up against the
truck, attacking him," The adult victim said. "My grandson wasn't
making any sound. I think he was in shock. I grabbed the fox by the
jaw to make it release, and threw my grandson in the bed of the
truck. But the fox bit the inside of my right arm and then was right
back on my grandson. It wouldn't stop attacking him."

After the adult victim's son fired at the fox, they were able to stop
it with the mop handle, the adult victim said. A township police
officer shot the fox to death. Tests on Tuesday [19 May 2009]
confirmed the animal had rabies.

The adult victim and her grandson began a 28-day course of rabies
vaccination shots [post exposure prophylaxis, PEP] the day they were bitten.

Officials are monitoring the area, which is in Beaver County, for any
other human contact.

Rabies is a viral disease that affects the central nervous system and
usually is transmitted through saliva from an infected animal,
according to the state Department of Health.

Since 2000, between 350 and 500 animals annually have tested positive
for rabies in Pennsylvania.

In 2006, the most recent year for which statistics are available,
raccoons comprised 56 percent of cases, followed by skunks at 12
percent, cats at 11 percent, bats at 8 percent and foxes at 6
percent, according to the Health Department.

State health officials couldn't say how many people are infected with
rabies each year in Pennsylvania. [Couldn't say, or wouldn't say?
They should have records regarding each rabies case, as it is a
reportable disease. - Mod.TG]

The incubation period for rabies typically runs 3 to 8 weeks but can
be as short as one week or as long as 9 years. Symptoms are
irritability, fatigue, headache, fever and pain or itching at the
exposure site.

Untreated, rabies can result in paralysis, spasms of the throat
muscles, seizures, delirium and death.

People who are bitten by an animal they suspect to be rabid should
wash the wound with soap and warm water immediately and get to a
hospital, Health Department officials said.

Treatment involves a series of shots given in the arm, or thigh for
small children.

Health officials caution that people should call an animal control
officer to capture the animal, and it should be observed for 10 days.
Humane officials might euthanize the animal and test the remains at a
laboratory.

[Byline: Jill King Greenwood]

Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[In any of these cases, having your pet vaccinated against this
disease is an increased measure of protection for yourself and your family.

It is always wise to not pick up bats and to avoid animals that are
acting strangely, such as the fox. However, in the case reported
above, contact with the fox may have been unavoidable. - Mod.TG]

Rabies, Wildlife - USA (03) : (Arizona) - fast evolving Rabies virus found

RABIES, WILDLIFE - UNITED STATES OF AMERICA (03): (ARIZONA)
***********************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Mon 4 May 2009
Source: National Geographic News [edited]


Fast-evolving rabies virus found -- and spreading
-------------------------------------------------
Evolving faster than any other new rabies virus on record, a
northern-Arizona rabies strain has mutated to become contagious among
skunks and now foxes, experts believe. The strain looks to be spreading
fast, commanding attention from disease researchers across the United
States. It's not so unusual for rabid animals to attack people on hiking
trails and in driveways, or even in a bar as happened 27 Mar 2009, when an
addled bobcat chased pool players around the billiards table at the
Chaparral in Cottonwood. Nor is it odd that rabid skunks and foxes are
testing positive for a contagious rabies strain commonly associated with
big brown bats.

What is unusual is that the strain appears to have mutated so that foxes
and skunks are now able to pass the virus on to their kin not just through
biting and scratching but through simple socializing, as humans might
spread a flu. Usually the secondary species in this case, a skunk or fox
bitten by a bat -- is a dead-end host. The infected animal may become
disoriented and even die but is usually unable to spread the virus, except
through violent attacks.

Skunks have already been proven to be passively transmitting the strain to
each other, as documented in a 2006 study in the journal Emerging
Infectious Diseases [see comment below - Mod.CP]. Genetic studies suggest
foxes are also spreading the new strain to each other, though the results
have not yet been peer reviewed.

When a skunk in Flagstaff, Arizona, died of rabies in 2001, wildlife
specialists thought it was a "freak accident" due to a one-off,
run-of-the-mill bat bite said Barbara Worgess, director of the Coconino
County Health Department. Laboratory tests later showed that the virus had
adapted to the skunk physiology and become contagious within the species.
"It shouldn't have been able to pass from skunk to skunk," Worgess said.

Rabies has continued to crop up in skunks for 8 years now, despite periodic
vaccination campaigns. And so far this year [2009], county officials have
documented 14 [now 33] rabid foxes in the Flagstaff area. Now laboratory
studies at the US Centers for Disease Control and Prevention (CDC) in
Atlanta appear to confirm that the fox and skunk rabies viruses are mutated
forms of the bat strain. "We can see degrees of relatedness and patterns in
their genetic codes," said Charles Rupprecht, chief of the rabies program
for the CDC. This sort of rapid evolution is exactly what worries public
health officials when it comes to all manner of viruses. Virologists
haven't seen such fast adaptation to a new species in rabies before. That's
why Flagstaff is such an interesting story worldwide," said David Bergman,
the US Department of Agriculture's (USDA) state director for Arizona.
"We're watching evolution in action on the ground."

Could rabies become contagious in humans? The Arizona rabies situation is
risky, because the infected species live so close to people. Flagstaff's
sprawl in recent decades has created a perfect opportunity for rabies to
mutate into species-hopping forms, the CDC's Rupprecht said. New-home
construction, often in wooded areas, has actually increased habitat and
food sources for bats, skunks, and foxes. Skunks live under houses, for
example, and as diggers, make themselves at home on golf courses. Bats,
meanwhile, are adept at living in attics and under loose shingles. As more
rabies-susceptible animals congregate in the region, more infections can
take place. And each infection is an opportunity for the virus to mutate
into a more virulent form literally upping the odds of a new strain
developing. "That's a pattern that we see all over the United States,"
Rupprecht said. Similar suburban development in the eastern US in the late
1970s, he noted, led to the spread of raccoon rabies from the Canadian
border to the Deep South.

The risk of such a virulent strain jumping to people "should be a major
concern," said Hinh Ly, a molecular virologist at the Emory University
School of Medicine in Atlanta, who is not involved in studies of the
Arizona outbreak. But no one is expecting the rabies strain to become a
contagious, swine flu-like epidemic among humans. Flu viruses, for one
thing, tend to infect people fast, so "vaccination after exposure would be
too late to prevent infection," said Elisabeth Lawaczeck, the Arizona
Department of Health Services' public health veterinarian. Rabies takes its
time before going from incubation to infection, so post-exposure rabies
vaccinations tend to be effective at stopping the virus. If untreated,
though, rabies, which attacks the central nervous system, is often fatal in
humans.

Rabies cases among animals are expected to increase as the spring and
summer mating seasons bring potential pairs and rivals together. Already,
Flagstaff has declared a 90 day pet quarantine all dogs on leashes and all
cats indoors which began in April [2009]. A wildlife vaccination plan could
stem the virus's spread. Local and state officials enacted vaccination
programs in northern Arizona in 2001 and 2005 but discontinued each effort
after 2 years without rabies, reports the World Health Organization's
standard for declaring an area rabies-free. Now state vaccination funds
have been reallocated, the USDA's Bergman said, and emergency funds are
increasingly rare due to the recession. Adding to the worries, Lawaczeck,
the Arizona veterinary official, said she and other public heath officials
were "very unsettled" when the 1st rabid fox reports came in from Flagstaff
this year and not just because of the evolutionary implications for rabies.
"This means a much wider spread of rabies," she said, "because [foxes]
travel so much farther."

[byline: Anne Minard]

communicated by:
ProMED-mail rapporteur Mary Marshall

[The following extracts from the publication referred to above -- Mira J
Leslie, Sharon Messenger, Rodney E Rohde, Jean Smith, Ronald Cheshier,
Cathleen Hanlon, et al. Bat-associated rabies virus, skunks. Emerg Infect
Dis 2006; 12(8): 1275 (Aug)
-- gives an
account of the background to the current situation in Arizona.

"In North America, more than 90 per cent of cases of rabies in animals
occur in wildlife; several mammalian taxa harbor characteristic rabies
virus variants. In Arizona, skunks (_Mephitis mephitis_) and gray foxes
(_Urocyon cinereoargenteus_) maintain independent rabies enzootic cycles,
and in indigenous bats, rabies has been diagnosed in 14 of 28 species.

"Although skunks live throughout Arizona, until 2001, rabid skunks had been
found only in the southeastern quadrant of the state. In the United States,
bat variant rabies viruses are a source of infection for humans and other
mammals. Typically, interspecies infection produces a single fatal
spillover event; secondary transmission has rarely been observed. Antigenic
typing of rabid carnivores in Arizona from 1996 through 2000 identified bat
variant rabies viruses in one domestic dog and 2 gray foxes. This report
describes the largest documented rabies epizootic among terrestrial mammals
infected with bat variant rabies virus, with perpetuated animal-to-animal
transmission. Coincident with the zoonotic disease significance, this
report provides contemporary insight into pathogen evolution."

"Investigation of this novel outbreak showed evolution in action with the
emergence of a rabies virus variant that successfully adapted from
Chiroptera to Carnivora. Previously documented clusters involving 3-4 to
terrestrial mammals infected with a single insectivorous bat rabies virus
variant did not corroborate sustained transmission. Although more than one
skunk may have been exposed to a single rabid bat, it is highly unlikely
that each skunk was exposed to the same bat or that multiple bat-skunk
exposures occurred. We could not ascertain the complete scope of this
outbreak or whether it was the index event. Phylogenetic analyses support
the evolution of 2 independent lineages, suggesting establishment for
months or years. Additionally, virus isolation from salivary glands of 5
affected skunks and the reappearance of rabid skunks with the same variant
rabies virus in 2004 support the probability of independent transmission."

Rabies in skunks and foxes is now widespread in Arizona (see
) as a
result of sustained transmission of distinct variants of bat rabies virus
genetically adapted to different mammalian hosts. The National Geographic
News article uses the term contagious in an inappropriate manner. The virus
has become modified for tranmission in a new host, but infection still
occurs via exposure to rabies virus-containing saliva. The virus is no more
or no less contagious; it has become genetically adapated for sustained
transmission in an alternate host. Sustained transmission in humans has so
far never been observed. - Mod.CP]

Rabies, CAnine, Human - Angola (07) : (Uige) - 83 Children die in Luanda, Angola from Rabies

RABIES, CANINE, HUMAN - ANGOLA (07): (UIGE)
*******************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Thu 4 Jun 2009
Source: ANGOP [in Portuguese, trans. & summ. Mod.TY, edited]


Of 830 people bitten by dogs in the city of Uige from January to 4 Jun
of this year [2009], 6 died, the supervisor of the municipal Expanded
Program of Vaccination, Pedro Guilherme Fernando, reported today,
Thursday [4 Jun 2009]. He asked the population to go urgently to the
nearest health unit as soon as one is bitten.

Communicated by:
ProMED-PORT


[Apparently, a significant rabies outbreak, with human fatalities,
continues in Angola. In the 1st 3 months of this year (2009), 93
children died of rabies in the capital, Luanda (see ProMED archive no.
20090314.1051). Now cases are occurring in the nearby province of
Uige. Failure to obtain timely post-exposure treatment may be due, in
part, to scarcity of the vaccine and anti-rabies immunoglobulin and
their relatively high cost. The most effective measure to prevent
human cases such as these is to maintain the canine population rabies
virus immune through a continuous vaccination program.

A map showing the location of Uige city in Uige province in northwest
Angola can be accessed at

The HealthMap/ProMED-mail interactive map of Angola can be accessed at
.
- Mod.TY]

Rabies - China (02) : (Shaanxi) - human deaths reported

RABIES - CHINA (02): (SHAANXI)
******************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Mon 1 Jun 2009
Source: China View [edited]


Rabies has killed 8 people and left 2 people suspected of being
infected in hospital in Shaanxi Province since March 2009, the local
government said Monday [1 Jun 2009]. The outbreak of rabies has
spread to 11 counties in Hanzhong City since March, where 5523 people
were injured by dogs, said Qin Mingxian, director with the city's
agricultural bureau. The 1st death occurred on 21 Mar [2009], and the
2 people suspected of being infected were being treated in a
county-level hospital, he said at a press conference.

The city, with more than 370 000 registered dogs, reported 35
[human?] deaths of the disease from 1985 to 1992. The outbreak was
spreading at unprecedented speed, said Qin.

The city carried out a rabies prevention campaign from 23 May - 1 Jun
[2009], implementing door-to-door compulsory vaccinations of dogs and
urging dog owners to put their pets on a leash or keep them off the
streets. So far, more than 240 000 pet dogs had been vaccinated.

Human deaths indicated the rabies virus was very active, posing a
great public health threat, said Shi Ruihua, chief of the bureau's
stock breeding department. The city authorities would work out
measures to improve administration of pet dogs, he said.

[Byline: Deng Shasha, editor]

--
Communicated by:
ProMED-mail Rapporteur Dan Silver

[Rabies continues to pop up sporadically in various parts of eastern
China. This is the latest outbreak, and illustrates the need to
maintain the canine population immune through consistent vaccination
programs. One hopes that the aggressive dog vaccination effort
carried out over the past 2 weeks is successful in eliminating the
rabies risk in the city, and is extended to rural areas as well.

Hanzhong is located in the southwest of Shaanxi Province. An
interactive map showing the location of Shaanxi province in
east-central China can be accessed at

- Mod.TY]

RABIES, CATS, HUMAN EXPOSURE - USA (VIRGINIA)

RABIES, CATS, HUMAN EXPOSURE - USA (VIRGINIA)
***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Sat 9 May 2009
Source: The Free Lance-Star [edited]


Three people face treatment for rabies after being bitten by 2 cats
in Spotsylvania County that tested positive for the deadly disease
last month [April 2009].

One incident occurred off Hood Drive in the Four-Mile Fork area on 30
Apr 2009. The other incident happened on Duerson Road on 23 Apr 2009.
The county Health Department is handling both cases. County animal
control officers already have gone door to door to hand out
information on the disease.

Lisa Hill, environmental health supervisor, said that on 30 Apr 2009,
2 men were exposed to rabies when they attended to a cat they thought
was dead. She said one of the men was 85 years old, but she did not
know the age of the other person. On 23 Apr 2009, she said a
26-year-old woman was trying to help a cat hit by a car when she was
bitten on Duerson Road in the western part of the county.

Rabies is caused by a virus that attacks the nervous system. Rabies
is fatal to mammals and humans who are not treated "They are all
currently being treated," Hill said of the 3 people. "Both of these
cats come from an area where there have been cat colonies.
Spotsylvania Animal Control is trying to handle it through
education." Hill warned people not to touch or feed stray cats in
either of these areas. She said she is unaware of any other reported
cases. Rabies can be prevented in cats, dogs, ferrets and some
livestock with rabies vaccinations, she said.

[Byline: Dan Telvock]

Communicated by:
ProMED-mail

[Spotsylvania county can be located to the southwest of
Fredericksburg in the map of the state of Virginia at:
.
Hopefully, Spotsylvania Animal Control will be able to locate the
feral cat colony believed to be associated with these rabies cases
and eliminate the risk of further exposure of the human and animal
population of the county to rabies virus infection. - Mod.CP]

RABIES, BOVINE, HUMAN EXPOSURE - USA (03): (NORTH CAROLINA)

RABIES, BOVINE, HUMAN EXPOSURE - USA (03): (NORTH CAROLINA)
***********************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: 17 Apr 2009
Source: Salisbury Post [edited]


Calf dies after exposure to rabies
----------------------------------
A calf on a farm in Gold Hill has died as a result of exposure to
rabies. The diagnosis was made after the calf's owner sent the body
of the animal to a lab in Raleigh for a necropsy. It died last week
[week of 6-10 Apr 2009].

The owner said he has been involved in the raising of cattle for
about 50 years, and this is the 1st time one of his animals has
contracted rabies. He said someone saw a skunk in one of his pastures
last month, and said he thinks the female calf may have contracted
rabies from that animal. "They say they're real bad about carrying
diseases," he said of skunks.

He raises about 15 head of cattle on his farm on Spring Lake Lane. He
admitted that anything he knows about rabies and cattle, he's learned
only since his calf died. "I'm not very familiar with it, and I wish
I wasn't this familiar," he said. "I'd never crossed this bridge
before." He said the diseased calf was only about 2 or 3 months old.
He said most of his cattle are registered and said the calf would
have been registered had it lived.

The calf's owner said that when one of his heads of cattle undergoes
a necropsy, the result typically reveals the animal died of pneumonia
or some similar ailment. It is almost impossible, he said, to know
what killed a head of cattle without a necropsy.

Fran Pepper of Rowan County Animal Control agreed. She said even when
an animal has rabies, there are no sure signs of the disease. "Rabies
doesn't exhibit the same symptoms," Pepper said. "Some will walk the
fence line and bellow and some won't. There's really no tell-tale
signs of the disease." She said that while this is the 1st case of
rabies being diagnosed in cattle in Rowan County this year, it's not
that unusual. Pepper said there have been several instances of rabies
being diagnosed in cattle elsewhere in the state this year.

This was the 5th case of rabies reported in Rowan County this year.
The calf's owner and his wife are undergoing post-exposure rabies
shots due to their handling of the calf just prior to its death.

[Byline: Steve Huffman]

Communicated by:
ProMED-mail Rapporteur Susan Baekeland

RABIES, RAT, HUMAN EXPOSURE - UKRAINE

RABIES, RAT, HUMAN EXPOSURE - UKRAINE
*************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Wed 15 April 2009
Source: Komsomolskaya Pravda [translated by Mod.NR, edited]


Rabies outbreak in Energodar city
---------------------------------
Basements of apartments in Energodar city are being disinfested from
rats and mice. By the end of the month veterinarians should have
vaccinated all domestic animals against rabies. The reason for these
measures is the result of capture of a rat by taxi drivers. One of
the taxi drivers was attacked by a rat that appeared on on the street
outside an apartment block. The rat was killed and brought for
investigation. Subsequently it was confirmed that the rat had rabies.
The taxi driver [who was attacked] will be getting anti-rabies shots,
while 2 neighborhoods will be under quarantine.

According to Valentina Stulova, the head of the veterinary
department, these measures are being undertaken to prevent the spread
of rabies. However it is not considered an emergency situation. These
measures are standard practice and there is no threat for the
population. However it is quite rare to have rabid rats in this
region since usually rabies is associated with feral and abandoned
dogs. One case of rabies in a bat has been recorded in this region.
Nonetheless strict surveillance will be maintained for 2 months.

Communicated by:
ProMED-RUS


[Rabid rats attacking people is rare in this region. Fortunately
prompt action has prevented further human exposure. According to OIE
there were 8 cases of rabies in Russia in 2007. - Mod.NR]

[Rabies is rarely reported in rats, and rodents are these animals are
unlikely to the primary source of this outbreak. In a city
environment rabies-infected dogs and cats are more likely to be the
primary source of the infection. The city of Energodar is in the
Ukraine and can be located in the interactive map at:
. - Mod.CP]

[At first it is difficult to perceive how a rat would acquire a
rabies infection. If attacked by another rabid mammal the rat would
come off 2nd, i.e dead , even if it did not acquire an overwhelming
infection resulting in a rapid death. Being bitten by another rat
does not solve the question either. This leaves us with the
possibility it found a moribund rabid bat and ate it, just as cats do
and with the same result. It would be interesting to know if the
Ukraine authorities have attempted to type the rat virus and thus
identify a possible source in this unusual case. - Mod. MHJ]

RABIES - RUSSIA: (SARATOV, NISHEGORDSKY, UDMURTIA)

RABIES - RUSSIA: (SARATOV, NISHEGORDSKY, UDMURTIA)
*************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


******
[1]
Date: 10 Apr 2009
Source: news.sarbc.ru [translated and abbreviated by Mod.NP, edited]


Rabies, animals - Russia (Samara region)
----------------------------------------
In 2008, 305 cases of animal rabies were reported. In addition there
was 1 human case reported in Balashov, and in 2 further human cases
the people were severely attacked by rabid animals -- a girl in
Vyazovka and a guard in the Volsky districts.

On April 9 [presumably in 2009 - Mod.MHJ] the expert council of the
regional government reviewed 2 laws on keeping domestic dogs and cats
and about administrative responsibility for its contravention.

Communicated by:
ProMED-RUS

******
(2)
Date: 10 Apr 2009
Source: IA: "AIF-nn.ru", 2009 [translated and abbreviated by Mod.NP, edited]


Rabies, animals - Russia (Nizhegorodskiy region)
-------------------------------------------------
During the 1st 3 months of this year, 2009, 28 cases of rabies
[presumably animal rabies - Mod.MHJ] have been reported but for the
whole of 2008 there were only 27 animal rabies cases.

Dmitriy Nikulin, Deputy head of bureau of State Veterinary
Supervision, said that the increased incidence is connected with a
rise in the number the carrier infections. For example, the fox
population has grown from 5000 to 8000 animals. In relation to
climatic and ecological factors the most unfavorable areas for rabies
are in the central and southern districts.

During 2001-2009 years rabies has been reported in 338 animals: 227
foxes; 51 dogs; 34 cats; 3 horses; and 3 goats. Because of the
worsening situation funding for rabies vaccinations has been
increased.

[Byline: Olga Petrova]

Communicated by:
ProMED-RUS

******
(3)
Date: 10 Apr 2009
Source: IA: "Media-centre Alfa-PR" [translated and abbreviated by
Mod.NP, edited]


Rabies, animals - Russia (Udmurtia)
-----------------------------------
Acccording to Rospotrebnadzor data as of 9 Apr 2009, 13 cases of
rabies have been recorded this year in Udmurtia, which is more than
for all of last year. About 77 percent of all these cases have been
in foxes. The affected districts are Alnashsky, Uvinsky, Grakhovsky,
Mozhginsky, Vavozhsky, Balezinsky and Karakulinsky.

Communicated by:
Natalia Pshenichnaya, ProMED Russian Moderator

[According to OIE WAHID in 2007 Russia reported 8 human rabies cases;
there were no reports submitted for 2005, 2006 or 2008, which is not
to say that rabies cases did not occur. The disease is widespread in
Russian domestic animals and wildlife with 3679 recorded cases in
2005; 876 in the 1st half of 2006 -- no reports for the latter half;
44572 (2007); 2989 (2008).
- Mod.MHJ]

Rabies, Bovine - USA (Vermont)

Rabies, Bovine - USA (VERMONT)
******************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: 9 Apr 2009
Source: Boston.com


5 cows contract rabies
----------------------
Vermont agriculture officials are urging farmers to vaccinate theiir
cows for rabies after 5 have tested positive for the disease. The
cows were likely infected by a rabid raccoon.

WCAX-TV says it's unclear why rabies cases in cows are increasing.
But one veterinarian suspects farmers may have dropped the vaccine as
a cost-cutting measure.

The rabid cows pose a minimal risk to humans. No one has ever
contracted rabies from drinking milk but the Centers for Disease
Control says people who drink raw milk from a rabid cow are at risk
for the disease. Farm workers also are at risk.

Communicated by:
HealthMap Alerts via ProMED-mail


[It has been a battle to get producers to vaccinate cattle. If the
Vermont veterinarian believes that the vaccinations have been dropped
because of economic reasons, then Vermont has been more successful
than most of us at getting the producer to vaccinate for rabies.

I have long been an advocate of rabies vaccine in all mammalian
creatures that we deal with since it is a very cheap insurance for
us. If that bovine is a show animal or milk animal or a pet and we
are petting, brushing, or in any way having close contact with than
animal, then it should be vaccinated against rabies.

This article does not tell us over what period of time these animals
have been diagnosed with rabies. It also does not allow us to know if
they were all in the same part of the state or if they were owned by
the same owner. It may be part of an epidemiological investigation
regarding who may not be vaccinating, or if there is a perhaps a
change in the strain of rabies present in a particular area.

Rabies in cattle is not uncommon. Cattle are curious creatures if a
raccoon or skunk is not acting quite right, then they will
investigate, frequently being bitten on the nose or occasionally on the leg.

There are a number of diseases capable of passing to the milk. Those
who are insistent about consuming raw milk put themselves at risk of
a number of diseases. While CDC does not report any human contacting
rabies through milk, it may only be that the case was not reported
but it has occurred. If you have consumed raw milk from one of the
locations having a rabid cow, then you should discuss rabies
vaccination with your physician. - Mod.TG

[Back in February 2009, 2 cows died in Vermont and owners were urged
to get their gattle vaccinated -- see 1st ProMED ref. below. - Mod.JW]

[The HealthMap location of Vermont is available at:
- CopyEd.EJP]

Rabies, Wildlife, Equine, Human Exposure - USA (02) : (North Carolina, Georgia)

RABIES, WILDLIFE, EQUINE, HUMAN EXPOSURE - USA (02): (NORTH CAROLINA, GEORGIA)
******************************************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Fri 10 Apr 2009
From: David Dassey


This is regarding the moderator's comment on
Rabies, wildlife, equine, human exposure - USA: (NC, GA) 20090409.1364
on the statement, "[The patient] received 5 [vaccine] shots for rabies and
said he must have 5 more [This must be a mistake; only 5 shots are
needed, spread over 28 days, not just a week -- see below - Mod.CP/JW]."

The patient was probably referring to the number of needle insertions
to administer rabies immune globulin (RIG) in addition to vaccine
dose number 1. This is a common finding when interviewing bite
victims who present to a different healthcare provider for completion
of the PEP series. Many patients are unable to tell what was
administered, only how many sticks they received (a good reason for
giving the patient the package inserts and a written treatment
record). The other clue is the site of the multiple injections -- if
the needles infiltrated the bite wound(s), the substance delivered
was certainly RIG.

David Dassey


[The writer from LA County Public Health is almost certainly correct.
The patient only spoke of shots, not specifically of vaccine shots. I
made the mistake of inserting the word [vaccine] and extrapolated
incorrectly from that. - Mod.JW]

Rabies, Wildlife, Equine, Human Exposure - USA : (North Carolinga, Georgia)

RABIES, WILDLIFE, EQUINE, HUMAN EXPOSURE - USA: (NORTH CAROLINA, GEORGIA)
*************************************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


[1] North Carolina: wildlife
[2] Georgia: equine

******
[1] North Carolina: wildlife
Date: Tue 7 Apr 2009
Source: The Cherokee Scout [edited]


A rabid fox ran inside a house and bit a man at least twice on 30 Mar
2009. The victim, who lives near Fields of the Wood, was asleep about
7:15 a.m. when he heard scratching at his front door. Thinking it was
his cat, he opened the door. A fox immediately ran in and bit his big
toe. "It was a big fox and madder than hell," the victim said on 1
Apr 2009. "I thought it was my cat. I opened the door, and it
attacked me." He kicked the fox across the room and it went on a
rampage, running all over the house before it came back and grabbed
his other foot. He then kicked the fox again, then grabbed a mop
handle and killed the fox. "It was running wide open," he said. "I
kicked it and it never slowed down. It bit plumb through my big toe."

The victim called [neighbor] Michael Stiles, who looked at his foot
and told him to get to the emergency room. Stiles cut the fox's head
off and made sure it was sent off for testing. The next night, 31 Mar
2009, the victim received news that the fox was rabid. He received 5
[vaccine] shots for rabies and said he must have 5 more [This must be
a mistake; only 5 shots are needed, spread over 28 days, not just a
week -- see below - Mod.CP/JW].

The fox was the 6th confirmed case of rabies in Cherokee County this
year [2009], all occurring since 16 Mar 2008, when a large dog fought
and killed a raccoon in Peachtree. This was the 1st confirmed rabid
fox this year. The others have been raccoons, said Philip Anderson,
who is in charge of the Cherokee County Health Department's rabies
prevention program. There were 20 confirmed cases in the county in
2008. This was the 2nd confirmed case in Hiwassee Dam, the 1st being
a raccoon south of Hiwassee Dam School.

Jim Weller, who lives on Shoal Creek Road, said a fox was sitting at
the end of his driveway during the day. The fox tried to get up but
couldn't. "I could tell it was sick, so I shot it," Weller said. He
called the health department, but since they couldn't send anyone
immediately, he buried the fox. The next day, health department
personnel came and dug the fox up, Weller said.

Rabies cases have been spread all over the county with the exception
of the Andrews and Marble areas, Anderson said. He has collected 36
animals for the U.S. Department of Agriculture for a rabies
surveillance program in an attempt to convince the USDA that an oral
rabies vaccine drop [to immunize wildlife] is needed. Anderson said
USDA has collected 30 of the animals, which are animals that haven't
been proven to have bitten other animals or people and include animals
found dead on the roads. "We haven't heard back from [USDA] on any of
the animals," Anderson said. "We have been doing this [since August
2008]. I didn't expect this [long of a] delay."

The oral vaccination drop consists of plastic packets containing the
Raboral V-RG rabies vaccine which are dropped into selected areas by
airplane. The packets are sprinkled with fishmeal coating or encased
in fishmeal so they are eaten by wildlife. Animals that swallow an
adequate dose of the vaccine develop immunity to rabies. As the
proportion of vaccinated animals in the population increases, they
act as a buffer to stop spread of the disease to other wildlife,
domestic animals and people.

Anderson said rabies cases in Cherokee County seem to be escalating.
At this time last year [2008], there were only 2 confirmed cases of
[wildlife] rabies in the county. He got an e-mail from an USDA
representative who said the incidence of rabies in Polk and Monroe
counties in Tennessee have decreased. A bait drop was done in those
counties in September or October 2008.

Anderson asked people to be careful around strange-acting animals,
especially raccoons and foxes, which are not normally seen during the
day. Anderson said he has received calls from people long after they
killed a strange-acting animal and disposed of it. Anderson urged
people to call the health department in such cases. It will cost them
nothing. There will be a rabies clinic on Sat 16 May 2009 at various
locations across the county. A pet who hasn't been vaccinated for
rabies must be quarantined for 6 months before it is freed. Three
different families in Cherokee County have German shepherd dogs
quarantined because they came in contact with rabid animals. All 3
seem to be doing OK, and one is almost ready to come off quarantine,
Anderson said.

[Byline: Dwight Otwill]

Communicated by:
HealthMap Alerts via
ProMED-mail

[This report reveals a certain lack of urgency on the part of the
responsible authorities to respond to an increased risk of
transmission of rabies virus from wildlife to the human population.
The Raboral V-RG oral vaccine, which is a derivative of the
Copenhagen strain of vaccinia virus engineered to express the
immunogenic G protein of rabies virus, has been used successfully to
control wildlife rabies by air-dropped bait elsewhere in the United
States and to eradicate rabies entirely from much of Western Europe
by targeted habitat seeding.

Contrary to the statement in the preceding text, according to the CDC
website, post-exposure vaccination consists of a regimen of 5 1-mL
doses of HDCV or PCEC vaccines administered intramuscularly to
previously unvaccinated persons. The 1st dose of the 5-dose course
should be administered as soon as possible after exposure. Additional
doses should be administered on days 3, 7, 14, and 28 after the 1st
vaccination. For adults, the vaccination should always be
administered intramuscularly in the deltoid area (arm). For children,
the anterolateral aspect of the thigh is also acceptable. The gluteal
area should never be used for rabies vaccine injections, because
observations suggest administration in this area results in lower
neutralizing antibody titers.

Hiwassee Dam, North Carolina can be located in the
HealthMap/ProMED-mail interactive map of the United States at:
.
- Mod.CP]

******
[2] Georgia: equine
Date: 7 Apr 2009
Source: Independent mail.com [edited]


3 members of a Franklin County family are undergoing treatment
for rabies prevention after it was discovered their horse had the
disease.

The family owns a farm on [route] SR 327 in Franklin Springs and
involves 2 adults and a 7-year-old child.

The news of the county's 1st horse rabies case came Friday [3 Apr
2009] afternoon to the Franklin County Health Department.

"Late Friday [3 Apr 2009], I got a call from the University of
Georgia letting me know they had a horse that had been sent down
there that had tested positive for rabies," said Louis Korff,
Environmental Health manager for the Franklin County Health
Department. "This horse had lived over in the Victoria Bryant Park
area and had never been vaccinated. When I asked the family if the
horse had been vaccinated for rabies, they were surprised you could
vaccinate a horse."

While rabies is relatively rare in horses, Korff said horses as well
as dogs, cats, and other warm-blooded mammals are at risk for rabies
if not vaccinated.

"All horse owners should have their animals vaccinated against rabies
and keep them up because here's a classic example. Some skunk or
raccoon went out there and bit that horse and gave it rabies," he
said. "The horse got sick, and the humans tending to the horse got
themselves exposed. Now I have 2 adults and a 7-year-old child
getting post-exposure shots and going through a lot of emotional
trauma, which could have been avoided by a [horse] vaccination."

The family told Korff the elderly horse was a beloved family pet and
had recently stopped eating and drinking water.

According to the University of Kentucky College of Agriculture's
Cooperative Extension Service, signs of rabies in horses can be hard
to diagnose. The main sign to watch for is any behavioral change in
the horse.

Historically, initial signs have been categorized as "furious" and
"paralytic" or "dumb."

"Horses are more likely to get the "dumb" version of it. This horse
stopped eating and stopped drinking water. That's what led to the
people trying to help the horse. They were feeding it and trying to
get it to drink water and were exposed to the disease while the horse
was shedding the virus," Korff said.

The family is now undergoing a series of 5 expensive injections to
prevent them from contracting rabies, which is always fatal in humans.
"You 1st get a human immuno-globulin shot then a series of 4 [actually
5] post-exposure shots," Korff said. Those shots for humans run about
USD 1500 for the series for each
person, according to Korff.

[Byline: MJ Kneiser]

Communicated by:
ProMED-mail Rapporteur Susan Baekeland

[Rabies is more common in horses than the writer of the article realizes.

It is important to understand rabies has different forms, as
mentioned in the article, but the name of the form is not nearly as
important as recognizing a change in your animal's behavior, posture,
and attitude. A normally quiet animal that is suddenly aggressive or
an aggressive animal that is quiet and withdrawn are both major
changes to be noted and respected as possible rabies.

I have always advocated vaccinating horses and even cattle,
especially if they are pets or show animals, because we are around
them so much. A rabies preventative is the cheapest insurance for the
family. It would have prevented the post-exposure shots they are now
taking and would have prevented the loss of the horse. - Mod.TG]

[All suspected rabid animals have to be killed and their brains sent
to a rabies lab for confirmation. - Mod.JW]

Rabies, Canine, Human - Indonesia (08) : Comment on Vaccination

RABIES, CANINE, HUMAN - INDONESIA (08): COMMENT ON VACCINATION
***********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Sat 4 Apr 2009
From: Allan Grill

The regimen for an individual receiving rabies pre-exposure
prophylaxis consists of 3 intramuscular doses of rabies vaccine on
days 0, 7 and 21. This is usually recommended for certain groups who
may be at higher risk of exposure to the rabies virus (e.g.
veterinarians, individuals traveling to rabies endemic areas). Should
these individuals have a subsequent exposure to the rabies virus
(e.g. bite from a suspected rabid animal), they would require a
post-exposure prophylaxis regimen consisting of 2 intramuscular doses
of rabies vaccine on days 0 and 3 post-exposure. Rabies immune
globulin (RabIg) would not be required in this case.

For individuals who have not received rabies pre-exposure
prophylaxis, their 1st suspected rabies exposure would require 5
intramuscular doses of rabies vaccine on days 0, 3, 7, 14, and 28
days post-exposure. They would also require a dose of RabIg on day 0
post-exposure as well (given at a different anatomical site from the
1st dose of vaccine). Should these individuals ever have subsequent
suspected rabies exposures requiring post-exposure prophylaxis, the
regimen would be the same as the one mentioned above for individuals
who had received pre-exposure prophylaxis: 2 intramuscular doses of
rabies vaccine on days 0 and 3 post-exposure.

I believe it was mentioned in the previous posting [Rabies, canine,
human - Indonesia (07): comment on vaccination 20090404.1300] that
individuals who have had pre-exposure prophylaxis in the past require
3 doses of rabies vaccine post-exposure. As mentioned above, they
would only need 2 doses.

Communicated by:
Allan Grill, M.D., C.C.F.P., M.P.H.
Medical Consultant
Toronto Public Health
Toronto, Ontario, Canada


[ProMED-mail thanks Dr. Allan Grill for this additional
clarification. - Mod.CP]

Rabies, Canine, Human - (07) : comment on vaccination

RABIES, CANINE, HUMAN - INDONESIA (07): COMMENT ON VACCINATION
********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Sat 4 Apr 2009
From: Stephen Toovey

A comment on rabies vaccination
-------------------------------
With regard to the ProMED-mal post: "Rabies, canine, human -
Indonesia (06): (BA) 20090331.1247, I feel it would be worthwhile
clarifying to subscribers that 3 time separated injected doses of
rabies vaccine post-exposure (as discussed in the cases from Bali) is
the regimen only for individuals who have undergone pre-exposure vaccination.

The regimen otherwise, for previously unimmunised individuals, is 5
time separated injected doses, with rabies immunoglobulin along with
the 1st dose of rabies vaccine.

Dr Stephen Toovey MBBCh PhD FFTM RCPS(Glasg)
Burggartenstrasse 32
CH-4103 Bottmingen
Switzerland


[ProMED-mail thanks Dr Stephen Toovey for this important
clarification. Travellers to Bali should take note. - Mod.CP]

Rabies, via dog/cat butchering - Nigeria

RABIES, VIA DOG/CAT BUTCHERING - NIGERIA
****************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: 29 Mar 2009
Source: Personal communication from the Federal Ministry of
Agriculture and Water Resources Department of Livestock, Kaduna
Nigeria [edited]

Human butchering and consumption of animals potentially infected with
rabies and other zoonotic viruses is not limited to Asia. In Nigeria,
dog eating is very common in states such as Plateau, Akwa Ibom, Cross
River, Kaduna, Kebbi and Ondo. In fact, dog suya (barbequed dog meat)
is sold publicly in the dog eating areas. In some areas such as Jos,
only local and seasoned connoisseurs may easily distinguish
restaurants where dog and other conventional meats are sold. Cat
eating, though not as common as dog eating, can also be encountered,
even in cosmopolitan places such as Lagos. While human consumption of
bats is also common, there seems to have been little or no local
effort (as per the limited information available) to evaluate the
risk of rabies transmission.

Rabies is no doubt underreported and probably misdiagnosed in Nigeria
and elsewhere in Africa (Asselbergs 2007 and the references therein).
Cultural and religious beliefs will also contribute to the
underreporting of human rabies that may arise from the consumption of
infected apparently healthy dogs and cats. The [rabies-related
lyssaviruses] Lagos bat and Mokola viruses still remain
under-diagnosed in the human populace.

The paper by Ajayi, Rabo and Baba (2006) also indicates a disturbing
possibility of transmission of rabies by apparently healthy (free of
overt rabies signs) stray dogs. If their observations are confirmed,
this, in their words, "signifies a new dimension in the epidemiology
of the disease in this environment where the high-risk practices are
prevalent." What's more intriguing epidemiologically and culturally
is that their research was carried out in Maiduguri; the overwhelming
Muslim population in the city provide zero economic incentives for
dog meat restaurants. However, the dogs were slaughtered in
restaurants associated with 2 military barracks in the city.

In summary, the situation reported in Viet Nam, Nigeria, etc. only
reaffirms that rabies is more of a neglected tropical disease than
thought and which deserves attention.

References:
Ajayi BB, Rabo JS, Baba SS. Rabies in apparently healthy dogs:
histological and immunohistochemical studies. The Nigerian
Postgraduate Medical Journal. 2006 Jun;13(2):128-34.

Asselbergs M. Rabies awareness. The Veterinary Record 2007 Sep
22;161(12):4322.

[AbdulKareem Durosinloun; Federal ministry of Agriculture and Water
Resources Department of Livestock; Kaduna Nigeria]

Communicated by:
Shamsudeen Fagbo
Dept. of Tropical Veterinary Diseases
University of Pretoria South Africa

[We appreciate Dr. Fagbo updating us on this situation in countries
other than Asia. Sadly, the underreporting of rabies in animals and
people is a trend not likely to disappear any time soon. - Mod.TG]

Rabies, Wildlife - USA (02) : Arizona

RABIES, WILDLIFE - USA (02): (ARIZONA)
*************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Disease


Date: 27 Mar 2009
Source: Fox News [edited]


3 Exposed to Rabies After Wild Bobcat Terrorizes Town
-----------------------------------------------------
A total of 3 people in the central Arizona community of Cottonwood
were exposed to rabies after being attacked by a wild bobcat. It all
began when the animal attacked and scratched a woman who had gotten
out of her car after thinking she had hit it.

A short time later, Cottonwood police got a report of a bobcat acting
aggressively toward a woman outside a Pizza Hut. Then, about an hour
later, the bobcat wandered into the Chapparal Bar on Main Street
forcing patrons up on their barstools; 2 men were bitten before
police shot and killed the animal in the parking lot. Tests later
confirmed it was rabid.

Communicated by:
Claude R. Ceccon


[Most of the other rabies exposures in Arizona have been from skunks
and foxes, according to Arizona Department of Health,

which has only confirmed 35 cases, versus the 62 reported earlier.
ProMED-mail appreciates Mr. Ceccon forwarding the information. - Mod.TG]

Rabies, Wildlife - USA : (Arizona) Increased Risk

RABIES, WILDLIFE - USA: (ARIZONA) INCREASED RISK
************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Tue 24 Mar 2009
Source: KTAR [edited]


Arizona sees surge in rabies outbreak
-------------------------------------
The state of Arizona is being hit with the biggest outbreak of rabies
that it has seen in a while, according to state veterinarian Elisabeth
Lawaczeck. So far this year [2009] there have been 62 animals
confirmed with rabies, according to Lawaczeck.


[A 21-year-old] Phoenix resident learned this the hard way when she
was bitten by a rabid bat at a family get-together in Northern Arizona
[last year? -- see below. - Mod.JW]."Something flew at me, I didn't
know what it was," [she] told KTAR. "I remember fumbling with it a
lot. It was really fury. It bit me and it flew away."

[The woman] was taken to the emergency room where she was treated for
rabies. She had to undergo a series of painful shots that lasted 6
months. "The needle was really long and it was really thick. I
remember the substance that they used was pink, and that was probably
the most painful thing that I've ever had to endure," she said. [But
see comment at end. - Mod.JW]

With the current outbreak of rabies, Lawaczeck says people should take
precautions when they go hiking or camping. "When you're camping you
want to make sure you are sleeping inside a tent and not just on the
ground or on a tarp. When you're hiking on the trails you should take
a hiking stick if you are in an area where there is reported rabies in
the past," Lawaczeck told KTAR [presumably for warding off attacking
animals. - Mod.JW].

Lawaczeck also said most rabies cases occur in skunks and foxes in
Southern Arizona but there have been recent outbreaks in the Flagstaff
area as well.

[Byline: Colton Shone]

Communicated by:
Healthmaps.org

[It would have been nice if the species of the 62 animals had been
listed; were they all skunks and foxes?

This is also a perfect time for the state veterinarian to pitch having
pets, including horses, vaccinated against the disease. Whether you
take your pet camping, or a rabid animal gets into your yard, you
should have your pet current on vaccines. If you don't know, or have
doubts, if your pet is protected, please see your veterinarian.

Rabies is usually a fatal disease. Unless your animal is vaccinated it
has no chance of living, because the authorities will eventually
euthanize the animal.

Arizona needs to update their rabies vaccine. The current CDC
recommendation for both HDCV and PCECV rabies vaccines is 1.0 mL intra
muscularly in the deltoid area, one each on days 0, 3, 7, 14, and 28
only, not 6 months -- see:

- Mod.TG/JW]

[The southwestern state of Arizona can be located on the
HealthMap/ProMED-mail interactive map of the USA at
. - CopyEd.MJ]

Rabes, Canine, Human - Indonesia (05) : (Bali)

RABIES, CANINE, HUMAN - INDONESIA (05): (BALI)
**********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Wed 25 Mar 20009
Source: The Jakarta Post [edited]


The 8th victim of rabies, a 46-year-old man, died on Monday [23 Mar
2009] afternoon after being treated at the Sanglah General Hospital
in Denpasar since Sunday morning, a hospital official said Tuesday
[24 Mar 2009].

The victim was bitten in November [2008] and was a resident of
Pecatu, South Kuta district in Badung district, which had been
declared a rabies-infected area by the Bali provincial administration
late last year [2008]. "The suspect had shown acute clinical symptoms
and could not be saved," IGB Ken Wirasandhi, the secretary of the
hospital's rabies handling team, said. "We cannot confirm that [he]
positively died of rabies because the results of his blood tests are
not in yet."

The previous 7 suspected victims died after being bitten by rabid
dogs. The 1st victim was a 4-year-old child who died on 17 Sep 2008
[but see ProMED archive 20090106.0050 for a Jakarta Post article
giving his date of death as 30 Dec 2008, 6 months after being bitten.
- Mod.JW]. Other victims were [2 adults aged 32, an adult aged 45,
and 2 children aged 3 and another aged 5]. [So far, only the
45-year-old and one of the 32-year-old patients] have been confirmed
through blood tests to have suffered from rabies.

On Monday [23 Mar 2009], Ken said the 46-year-old patient showed
indications of the clinical symptoms of rabies like the past
suspected victims. "One thing is certain, the victim's diagnosis was
encephalitis," he said. The man's family has refused to divulge any
information. Head of the isolation ward, Ni Made Ratni, said Monday
that the man's wife had been hysterical since her husband was
declared a rabies suspect. "She kept on crying hysterically while her
husband was being treated," she said.

Badung Health Agency head AA Gede Agung Mayun confirmed the victim
suffered from the clinical symptoms of rabies. Ironically, the
46-year-old man had received 2 anti-rabies vaccinations (VARs) after
being bitten by a rabid dog. The 1st shot was given on 27 Nov 2008.
"Unfortunately, he did not continue with the 3rd and 4th vaccinations
after he felt much better," Mayun said. "A complete 4-shot
anti-rabies vaccination is mandatory, especially if a victim is
bitten on the arm or above." Mayun said the case was very surprising
because biting cases in South Kuta were actually decreasing, but he
did not give exact figures. Health authorities have yet to identify
which dog [bit] the deceased.

There have been proposals expressed, during various discussions on how
to handle rabies in Bali, that dog owners should be punished if their
dogs bite people. The aim is to involve the public in preventing the
spread of rabies. The health agency also said that only one of the
3-year-old children of the previous victims had shown rabies' unique
clinical symptoms, such as hydrophobia and hyper-salivation.

Meanwhile, the Badung Animal Husbandry, Fisheries and Maritime Agency
is finding it difficult to administer the booster vaccinations for
dogs, scheduled for April 2009.

[Byline: Luh De Suriyani]

Communicated by:
a correspondent who wishes to remain anonymous

[Little precise information has been reported in recent weeks
concerning the course of the outbreak of canine rabies and consequent
human fatalities in the Indonesian island of Bali. Particular
concerns have been expressed regarding the undeclared number of human
cases, the extent of the dog vaccination program and the availability
of vaccine and immunoglobulin for post-exposure treatment.

The above Jakarta Post report highlights the seriousness of the
current situation, with the declaration of 2 confirmed fatal cases of
human rabies and another 6 suspected fatal cases. Furthermore, the
program for control of canine rabies by vaccination seems to have
stalled. Intending visitors to the island of Bali should take note.

The location of the island of Bali can be found using the
HealthMap/ProMED-mail interactive map of Indonesia at:
.
A map of the island of Bali showing Denpasar region can be accessed at:
.
- Mod.CP]

Rabbies, via dog/cat butchering - Viet Nam : Probable

RABIES, VIA DOG/CAT BUTCHERING - VIET NAM: PROBABLE
***************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


[1]
Date: Tue 17 Mar 2009
Source: inthenews.co.uk [edited]


Eating dog or cat linked to rabies
----------------------------------
A new study has detailed how 2 people in Asia contracted rabies after
eating dog or cat meat.

A report published in the journal PLoS Medicine [see part (2) below]
describes how the 2 patients in Hanoi, Viet Nam, died from
laboratory-confirmed rabies. Health experts claim their symptoms
developed after butchering, preparing, and consuming either a dog or a cat.

The researchers were unable to test the butchered animals for rabies,
so could not be entirely certain the animals were the source of the rabies.

However, they caution that butchering of unvaccinated dogs and cats
in rabies-endemic countries should be considered a risk factor for
rabies transmission.

Communicated by:
ProMED-mail


******
[2]
Date: Wed 18 Mar 2009
From: Heiman Wertheim

Rabies infections highlight dangers of processing dog meat
----------------------------------------------------------
Eating dog meat is common in many Asian countries, but research
conducted as part of the South East Asia Infectious Diseases Clinical
Research Network has discovered a potentially lethal risk associated
with preparing dog meat: rabies. In research published today [18 Mar
2009] in the open access journal PLoS Medicine, Dr Heiman Wertheim
and colleagues from the National Institute of Infectious and Tropical
Diseases and the National Institute of Hygiene and Epidemiology in
Hanoi, Viet Nam, report on 2 patients admitted to hospital showing
signs of rabies infection. Neither patient was thought to have been
bitten by a rabid animal in the preceding months.

Rabies is a very serious -- and in nearly all cases fatal -- disease.
It is estimated to kill more than 30 000 people each year in Asia,
and the number of cases in China and Viet Nam is increasing. Symptoms
include agitation, severe spasms, fever, fear of water and inability
to drink liquids, and eventually death. Humans are usually infected
after being bitten by an infected animal such as a dog or bat.

When the researchers investigated whether the patients had come into
contact with infected animals in the preceding months, they found
that both had been involved in preparing and eating animals that may
have been infected. In the 1st patient's case, he had prepared and
eaten a dog that had been killed in a road traffic accident; rabid
dogs were known to inhabit the neighbourhood. The 2nd patient had
butchered and eaten a cat that had been sick for a number of days.

In both cases seen by Dr Wertheim and colleagues, it is thought that
infection occurred during the slaughtering, and not by eating the
meat, as the meal was shared by others who did not become infected.
In Asia, it is believed that eating dog meat enhances health and
longevity. It is eaten throughout the year in the 2nd half of the
lunar month, particularly in the winter months, when it is believed
to increase body heat.

In Viet Nam, dogs with rabies have been detected in dog
slaughterhouses and workers at dog slaughterhouses are vaccinated
against rabies as part of the national programme for rabies control
and prevention. However, the private slaughter of dogs is relatively
common in the country.

"We need to alert both the general public and clinicians about the
risks around butchering and handling meat," says Dr Wertheim. "People
should not handle animals that may be infected with rabies. Rabies
can be prevented with a vaccine and people exposed to rabies can be
helped with post-exposure prophylaxis, but this needs to be
administered as quickly as possible following the exposure. Once a
person shows symptoms, the disease is almost invariably fatal.

"Vietnamese doctors already consider dog slaughtering a risk factor
for rabies transmission, but it is important that other health care
workers and policy makers, both inside and outside Vie Nam, are aware
of this risk factor."

The South East Asia Infectious Diseases Clinical Research Network is
funded by the Wellcome Trust and the National Institute of Allergy
and Infectious Diseases, National Institutes of Health USA.

References
----------
1. Wertheim, H et al: Furious Rabies after an Atypical Exposure. PLoS
Medicine. 17 March 2009 [available at
].
2. The South East Asia Infectious Diseases Clinical Research Network
[SEAICRN; ] is a multinational
clinical research network that strives to advance the scientific
knowledge and clinical management of infectious disease through
integrated, collaborative clinical research in Indonesia, Thailand
and Viet Nam. The principal sources of funding for the Network are
the US National Institutes of Health's National Institute of Allergy
and Infectious Diseases, USA and the Wellcome Trust, UK.
3. The Wellcome Trust [] is the largest
charity in the UK. It funds innovative biomedical research, in the UK
and internationally, spending over GBP 600 million [approx. USD 840
million] each year to support the brightest scientists with the best
ideas. The Wellcome Trust supports public debate about biomedical
research and its impact on health and wellbeing.

Heiman Wertheim

Rabies, Canine, Human - Angola (06) : (LUANDA)

RABIES, CANINE, HUMAN - ANGOLA (06): (LUANDA)
*********************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Fri 13 Mar 2009
From: Ellicott McConnell


A comment
---------
I don't know whether or not it is of importance in the recent
outbreak in Angola, but in many parts of the developing world there
are a number of often bizarre "remedies" for rabies. It is my
understanding that only about half of rabid dogs shed the virus from
the salivary glands. Thus, half the time the remedies "work," not a
bad average for home remedies, so their use persists. Unfortunately,
by the time the failures get to valid medical assistance, it's too late!

Ellicott McConnell, Ph.D.