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)
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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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[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)
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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)
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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)
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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)
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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]