During today’s Public Health Agency of Canada webinar, part of a new webinar series on zoonoses and adaptation in a changing world, Chelsea Raybern from the Kansas State Deptartment of Health and Environment provided a report about rabies in a dog that was imported into Kansas from Egypt in 2019.
The dog had been in the US for a little under a month when it developed some vague health problems. It then started acting strangely and ate a blanket. It was taken to a veterinary clinic, where it bit a technician. It had some neurological abnormalities, but was sent to another clinic for exploratory surgery because of the blanket-eating, thinking the abnormalities may have been due to an intestinal complication. However, the dog’s neurological only got worse shortly after surgery and it was euthanized. Because a person was bitten at the first clinic, the dog was tested for rabies and turned out to be positive.
This led to an investigation of both how the dog got rabies and who was exposed along the way. The dog was part of a shipment of 26 dogs that came from Egypt. All dogs in the group had documentation of rabies vaccination and rabies serology (i.e. a blood test that verifies the animal has antibodies against the virus, indicating it responded to vaccination). However, the testing that was performed on the group suggested that most of the dogs had in fact not been vaccinated, or at least not effectively vaccinated.
Investigation of contacts with the dog resulted in 39 people from the veterinary clinics involved receiving post-exposure prophylaxis (PEP). That turned out to be overkill, but was driven by the corporation that owned the clinic(s), before public health had a chance to investigate and determine who was really at risk and needed PEP. Most people at the clinics would not have been exposed to rabies by this dog. Five rescue staff and two people from the foster family also received PEP. Twelve dogs at the foster residence were also exposed, and ended up with 45 day to 6 month quarantines, depending on their vaccination status.
The rabid dog had been at a shelter in Egypt for 3 years prior to being exported. It was allegedly quarantined at the rescue before being shipped but it was reported that the “quarantined” dogs were mixing with dogs brought in off the street. So, all of the imported dogs in this group were considered potentially exposed. They were therefore all quarantined for 4-to-6 months.
This case was the 3rd rabid dog in the US from Egypt in the past 4 years, leading the US to suspend importation of dogs from Egypt. (There is still no corresponding ban in Canada).
What does this show?
- Canine rabies is still common in some areas of the world. Travelers and dog importers need to remember that.
- Rabies vaccination is highly effective… if it’s given at the right time (e.g. before exposure) and if the vaccine is effective (e.g. not out of date, properly handled, kept cold). Unfortunately, vaccine certificates from certain countries are not always reliable.
- Importation of dogs from areas where rabies is endemic is risky. The incubation period can be weeks to months, so a rabid animal can look perfectly healthy when it arrives (or even after a short quarantine period).
- Rabies must be considered anytime a dog bites someone. It’s particularly important if the dog is from an area where rabies is endemic. Biting dogs must be quarantined for 10 days to watch for signs of neurological disease, and/or tested. Dogs can only be tested after they are euthanized, because the test requires brain tissue.