It is not uncommon for Dr. Henri Bianucci or me (Perry Jameson) to get calls at night with questions from our ER department.
Usually these conversations are regarding a patient and what are the next steps for diagnosis and therapy. However, I have learned they can be about almost anything.
A Good Samaritan came into our North Charleston ER service one Saturday several years ago with a sick squirrel. This was not a pet but a wild squirrel he had noticed was lethargic. It was so weak it allowed the man to pick it up. Concerned, he brought the squirrel to our hospital. During the car ride the animal bit the man gently on the hand.
He dropped off the squirrel, filled out some paper work and continued his vacation as he was a tourist.
Within hours of being brought in, despite our best efforts, the little squirrel died. Prior to its death, the veterinarian noted clinical symptoms consistent with a nervous system disorder, depression and ataxia.
This is what prompted her to call me. She apologized for interrupting my day but wanted advice. She explained that even though rabies is extremely rare in small mammals, should she submit a portion of the squirrel’s brain for rabies? My first thought was no, but then after thinking of the tourist who was bitten and staff members who were exposed and the fact the state will do this for us, I recommended testing.
Well, to all of our surprise, the squirrel was positive. Fortunately, we were able to track down the tourist who had not left the country yet. He and our exposed staff all underwent vaccination to prevent them from contracting rabies. Everyone is fine.
Most people’s exposure to rabies is from the book or movie “Old Yeller,” a disease seen half a century ago but not one to worry about today. Unfortunately, my squirrel story reminds me it is still a present danger.
There are still one to three human cases of rabies every year in the U.S., while 50 years ago there were 30-50.
During the 1940s and '50s, most cases of human rabies were the results of dog bites. The advent of routine vaccination and leash laws has dramatically decreased the incidence of canine rabies. In many countries where vaccination is not readily available, dogs still pose the greatest source of potential infection. Be aware of this if you travel abroad.
As canine rabies declined, the infection in bats, raccoons, skunks and foxes became more apparent.
Currently in our area, raccoons are the most commonly infected animal. However, bats have been found to be the cause of 7 out of every 10 rabies deaths in the U.S. Even though they are not the most infected animal, it appears people are less likely to be concerned about being exposed to a bat than other wildlife so less likely to seek medical attention until it is too late.
Rabies is a virus that only mammals can contract. It is transmitted when saliva from an infected animal enters the blood of an uninfected animal. This is primarily from bites and scratches but it also can enter through mucous membranes. Symptoms usually appear within 2-3 months but can be seen as early as one week or as long as one year after infection. Initially, the person has fever with pain, nerve tingling, pricking or burning at the bite location. Once the virus reaches the central nervous system, it causes inflammation of the brain and spinal cord, which is always fatal.
As with most diseases, prevention is the key. All dogs and cats should be vaccinated for rabies and this is required by state law in South Carolina. The vaccine is highly effective and safe. Even if your cat does not go outside, she should still be vaccinated. If your pet bites someone and is unvaccinated, the law requires the Department of Health and Environmental Control to be notified. Avoid all this by having your pet vaccinated.
If your pet is bitten by a wild animal or feral cat or dog, let your veterinarian know. A booster vaccine can be given that prevents your pet from developing rabies.
Avoidance of contact with wild animals is the best way to prevent exposure for yourself and pets.
Contact your local animal control officer if you see animals exhibiting unusual behavior. An example would be a raccoon outside in the middle of the day.
If you are bitten, contact your physician. Ideally the animal that bit you should be tested. It is not worth being bitten again trying to catch the animal. Also, unfortunately, the only way to test for rabies is with a brain sample, so this means the animal must be deceased.
Rabies is still a threat, but with proper vaccination and avoiding contact with wildlife and feral animals, it is also highly preventable.