Rabies: a scary foe

My cat lives a pampered indoors-only existence. The only way she would ever come in contact with the great outdoors is if she accidentally escaped from the house, something I don’t plan to let happen. This kind of lifestyle puts her at extremely low risk of contracting rabies – yet she’s vaccinated against rabies and will continue to get her rabies shots lifelong.

Why vaccinate an animal (or a person, for that matter) against something that’s unlikely ever to be a genuine threat to them? Because rabies is an awful disease, that’s why, and I’m not willing to take even a minuscule risk.

There are any number of frightening zoonotic diseases, i.e. diseases that can be transmitted from animals to humans, and rabies is one of them. In North America, the rabies virus is endemic in the wildlife population, primarily bats, skunks, raccoons, foxes and coyotes. It’s generally transmitted through the saliva of an infected animal, namely through a bite.

Post-exposure vaccination will protect someone who’s been bitten from the possibility of developing rabies. Taking the right steps after any kind of animal bite is critical, because when left untreated, the rabies virus attacks the central nervous system and is almost always fatal. Once rabies has been allowed to progress, there’s no effective treatment for it other than supportive care.

I’d like to think most people wouldn’t get close enough to a wild skunk or raccoon to risk getting bitten. Our pets are a whole different story, though. They live with us, hang out in the yard and play with the kids. Occasionally they wander afield and perhaps tangle with a rabies-infected critter – then come home, setting the stage for possibly transmitting the rabies virus to someone in the family.

Vaccination of pet cats and dogs is in fact an important public-health strategy for buffering the human species from the rabies virus among the wildlife population. In this sense, the Humane Society of Kandiyohi County didn’t just do a good deed for animals this week by hosting a series of low-cost outreach vaccination clinics in Willmar; the neighborhood clinics also helped the community.

As scary as it is, rabies has become rare in the United States, among both pets and humans. As recently as 50 years ago, the majority of rabies cases among animals reported to the U.S. Centers for Disease Control and Prevention were among domestic animals. Now more than 90 percent occur within wildlife. At one time more than 100 Americans died of rabies each year. These days, with post-exposure vaccination available, it’s extremely unusual for this to happen. The few human deaths from rabies that do occur tend to involve undetected bat bites, as was the case with a Minnesota resident in 2007 who ultimately died.

What has happened with rabies is one of the more compelling success stories in vaccination and prevention. Great Britain has gone one better by managing to eradicate rabies, even among its wildlife. It helps, of course, if you’re an island nation – but internal policies and strict quarantines for imported animals also have played a critical role in controlling and preventing rabies in the U.K. When the Channel Tunnel, which links London with Paris and Brussels via high-speed rail, was constructed, Britons worried it would pave the way for rabies-carrying French rats to invade the country, a fear that so far has not materialized.

Rabies unfortunately remains a threat in the rest of the world, however, especially in developing countries where vaccination and surveillance are less prevalent.

When a vaccine-preventable disease isn’t very common, it can be easy to assume it’s not really a risk to us or to those around us. It can be easy to just skip vaccination altogether, using the rationale that it’s not necessary. When you weigh the risk vs. the benefit, though, I wonder how many of us would truly be willing to gamble in this fashion, whether it’s a rabies vaccination for our pets or a pertussis or Hib vaccination for our children. No matter how low the risk, many of the worst infectious diseases simply aren’t worth taking a chance on.

Image: Rabies virus. Courtesy of the Public Health Image Library, CDC

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