RABIES (cont.) Division of Public Health Services Disease Handbook for Childcare Providers Bureau of Infectious Disease Control REVISED –January 2018 RABIES Rabies is a viral disease that attacks the central nervous system. It can be transmitted to people through contact with the saliva or brain and spinal cord tissue of a rabid animal as described below. It is a fatal disease for humans but may be effectively prevented. Rabies in certain animals, especially wildlife, is common throughout New Hampshire. What are the signs of rabies in animals? Animals may act friendly or become vicious. Animals that are usually active only at night may be found a ctive during the day. Animal behavior may be unusually aggressive. Animals infected may seem withdrawn, hide in corners or refuse food. The most important thing to remember is that a rabid animal will usually be infectious to people or other animals for a varying period of time before a change in their appearance or behavior. Who gets this disease? People can get rabies through two types of exposure: bite exposure and non-bite exposure. • Bite exposure: Any penetration of the skin by the teeth of an inf ected animal. All bites regardless of location, pose a potential risk for rabies. • Non-bite exposure: Infectious saliva, brain or spinal cord tissue from a rabid animal comes into contact with the lining of a person’s eye, nose or mouth or with a cut, abrasion or other pre-existing break in the person’s skin. What about bats and rabies? Bats are responsible for the majority of domestically acquired human cases of rabies. People usually know when a bat has bitten or otherwise exposed them to rabies. Howe ver, because bats have small teeth that may not leave obvious marks, there are certain situations when a person may be considered exposed to rabies even in the absence of an obvious bite, including: • If a person awakens to find a bat in their room • A bat is seen in the room of an unattended child, or • A bat is seen in the room of a mentally impaired or intoxicated person. People cannot get rabies from having contact with bat guano (feces), blood or urine. If an exposure is possible, and the bat is a vailable, the local animal control authority should be contacted to aid in capturing the animal for testing. What are the symptoms of rabies in humans? Symptoms of rabies in people include apprehension, anxiety , headaches, fever, tiredness, paralysis, mus cle spasm in the throat leading to fear of water, delirium /hallucinations, convulsions, and, in almost all cases, death. Symptoms are progressive and without medical intervention the usual duration is 2- 6 days; death is often due to respiratory or cardiac failure. What is the treatment? If a person is bitten or has a non- bite exposure, immediately wash the wound thoroughly with soap and water for several minutes. (NOTE: flush an exposed eye, nose or mouth with water or saline). This is extremely import ant as it may prevent the rabies virus from entering the body tissue and prevent infection. Then, the person should be seen immediately by a physician or go to an emergency department for examination and any needed treatment. If indicated, a series of shots should be given. One of the shots (Human Rabies Immune Globulin) is injected around the site of the RABIES (cont.) Division of Public Health Services Disease Handbook for Childcare Providers Bureau of Infectious Disease Control REVISED –January 2018 exposure to provide immediate protection while the rabies vaccine is given in the arm muscle. A total of 5shots ( 4 shots of vaccine and one of Human Rabies Immune Globulin- may be more than one and is based on body weight ) are given over one month. If an individual has had rabies vaccine in the past, this treatment will vary. To work best, these shots should be given as soon as possible after the exp osure. If the animal has been caught and will be tested for rabies or quarantined for 10 days (dogs, cats, and ferrets only), treatment can usually be delayed until results are available or quarantine is over. Contact the local animal control authority to aid in capturing the animal for confinement and observation or testing. Is there a cure? There is no cure for rabies once the infected person becomes ill with the disease. Appropriate rabies immunizations given before the onset of illness are effective in preventing the disease. People whose work or hobbies bring them frequently into contact with potentially rabid animals should have a series of three rabies vaccine shots before they are exposed. They will then require only two vaccine shots after exposure. How can the spread of this disease be prevented? 1. Do not handle wild animals. Teach children to avoid wildlife, strays and all other animal s they don’t know. Call the New Hampshire Fish and Game Department at (603) 271- 3361 to report dead, sick or injured animals. Call the local animal control officer for domestic animal exposures. 2. If bitten by a wild or domestic animal, seek medical attention immediately and notify the local animal control officer. 3. All bites by wild animals or contact with their s aliva or brain or spinal cord tissue should be considered as possible exposure to rabies and must be evaluated medically. 4. Keep trash containers tightly closed. Garbage attracts animals like skunks and raccoons. 5. Vaccinate all dogs and cats against rabies and make sure their shots are kept up -to- date. 6. If another animal has injured a dog, cat or other pet, handle it only with thick rubber gloves and have it examined by a veterinarian right away. Saliva from an attacking rabid animal remains infectious on t he attacked pet’s fur until it has thoroughly dried. Reportable? Yes. Rabies in animals and humans is reportable by New Hampshire law to the Division of Public Health Services, Bureau of Infectious Disease Control at (603) 271-4496.