Rabies exposure...the good and bad

A rabies exposure incident in New Jersey provides another example of some common good and bad points that come up in these situations.

Fifteen people from four families, along with a veterinarian, are receiving post-exposure treatment after contact with a rabid kitten. In the all-too-familiar scenario, a kitten was found in a cat colony outside a workplace and taken home by a well-intentioned individual. A couple of weeks later, the kitten became sick, ultimately showing signs of neurological disease. It was euthanized at a local veterinary clinic, and subsequently identified as rabid.

A sibling of the rabid kitten that was adopted by a different family is under a strict six month quarantine. As opposed to most rabies exposure quarantines, the odds of this kitten being infected are reasonable high, so the little critter is certainly a concern.

The good points:

The kitten was taken to a vet.

  • This may sound simplistic but it’s critical. If the kitten had died before being taken to the clinic, would testing have been performed? It’s hard to say but it’s much less likely. While people don’t tend to think about diagnostic testing after their pet has died, it’s important to consider what might have killed the animal and whether there are any risks to people that need to be evaluated.

Rabies testing was performed.

  • Again, maybe this seems straightforward but this is a critical step. The veterinarian has to identify the potential for rabies (pretty easy here) and explain the need for testing to the owner (or alternatively, get public health personnel involved to seize the carcass and mandate testing… a much messier approach).

The bad points:

Lots of people were exposed to the rabid kitten - a total of 15 people from four families.

  • That’s hard to prevent, in reality. Kittens attract attention. Whether all 15 individuals actually had contact worthy of calling them exposed to the virus itself isn’t clear. There’s no mention of anyone being bitten. However, given the sharp teeth and playful behaviour that can easily result in little bites (or saliva-contaminated scratches), it is much better to err on the side of calling someone exposed.

All 15 people went to an emergency room for treatment on a weekend.

  • That’s a waste of resources and ER time. Rabies exposure is a medical urgency, but not an emergency. Rarely do you need to get treatment started immediately, especially if it wasn’t a large bite to the head or neck. They could have waited until regular hours and gone to their physician or public health. Often, there’s poor communication and lack of understanding regarding the time frame for post-exposure treatment, which can lead to this.

The veterinarian was exposed.

  • That may have been unavoidable. However, a young, unvaccinated kitten adopted from a feral colony that has neurological disease is rabid until proven otherwise. Basic infection control practices can reduce the risk of rabies exposure. Maybe those were used and exposure still occurred; that’s possible, but it’s a reminder that prompt identification of rabies suspects and using good infection control practices is important.
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Comments (3) Read through and enter the discussion with the form at the end
Woodsman - November 26, 2013 11:49 PM

Due to TNR practices (trap, neuter, re-abandon), cats are now the #1 domesticated animal to transmit rabies to humans (the cats testing positive after a bite, scratch, or attack). GIVING A RABIES SHOT TO A CAT THAT ALREADY HAS RABIES DOES NOT CURE IT OF RABIES -- NOR DOES IT STOP THE CAT FROM TRANSMITTING RABIES UP TO 11 MONTHS LATER (during the last 2 weeks of its life when it might not even show any recognizable symptoms). Google for: RABID KITTEN ADOPTED WAKE COUNTY (for just one example of hundreds of vetted but rabid cats adopted from outdoors). The incubation period for rabies is, on average, from 21 to 240 days, sometimes up to 11 months, one rare case being 6 years. A vetted cat can STILL transmit rabies many months later if it was harvested from unknown living conditions with an unknown vaccination history. Either quarantine them for 6 or more months at your OWN expense (as required by national and international law), or euthanize them. Those are your only 2 options to be relatively certain you are not handing rabies to someone. Isn't reality fun?

This is why the CDC has now given the following conclusion and warnings on all TNR practices that are becoming so popular (with people who are uneducated to how vaccinations actually work and are causing rabies outbreaks in so many communities).

Conclusions on all TNR practices now direct from the CDC
onlinelibrary.wiley D0T com SLASH doi/10.1111/zph.12070/abstract

Summary

Domestic cats are an important part of many Americans' lives, but effective control of the 60-100 million feral cats living throughout the country remains problematic. Although trap-neuter-vaccinate-return (TNVR) programmes are growing in popularity as alternatives to euthanizing feral cats, their ability to adequately address disease threats and population growth within managed cat colonies is dubious. Rabies transmission via feral cats is a particular concern as demonstrated by the significant proportion of rabies post-exposure prophylaxis associated with exposures involving cats. Moreover, TNVR has not been shown to reliably reduce feral cat colony populations because of low implementation rates, inconsistent maintenance, and immigration of unsterilized cats into colonies. For these reasons, TNVR programmes are not effective methods for reducing public health concerns or for controlling feral cat populations. Instead, responsible pet ownership, universal rabies vaccination of pets and removal of strays remain integral components to control rabies and other diseases.

(end summary)

To be perfectly truthful: Even vaccinating your cat against rabies won't prevent it from finding the nearest rabid bat dying on the ground in your backyard, to rip it to shreds for its daily cat's play-toy. Then bringing back a mouthful or claws full of fresh rabies virus to you, your family, neighbors, other pets, or other animals. ANY cat, due to their need to sink their teeth into anything that moves, if allowed outdoors can transmit rabies to others, vaccinated or not.

Catherine - November 27, 2013 3:34 PM

"To be perfectly truthful: Even vaccinating your cat against rabies won't prevent it from finding the nearest rabid bat dying on the ground in your backyard, to rip it to shreds for its daily cat's play-toy. Then bringing back a mouthful or claws full of fresh rabies virus to you, your family, neighbors, other pets, or other animals. ANY cat, due to their need to sink their teeth into anything that moves, if allowed outdoors can transmit rabies to others, vaccinated or not."

This is scary and it's one of the many reasons why I think that cats should be regulated same as dogs. There should be leash laws for cats and any cats found roaming off the owner's property should be picked up, and the owner should be fined. I also believe in licensing cats, same as dogs. This way, proof of rabies vaccine can be assured. Why we have one set of laws for one species and a different standard for the other is ridiculous. Both species, wonderful as they are, can cause their own specific form of mayhem when not properly controlled.

Julie - November 27, 2013 4:16 PM

This story hits home. Early in my veterinary career I was exposed to a rabid kitten that someone had "rescued". I had to go to the ER for shots because in that locality the ER was the only place where human rabies vaccine was administered. Figuring out the "off-peak" time to go would have made it a lot more efficient because you will always be the least urgent case in the waiting room.

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