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

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

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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
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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)
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A ProMED-mail post

ProMED-mail is a program of the
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******
[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)
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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)
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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)
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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
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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

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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]