Rabies in animals and humans

What organization is going to characterize rabies as a neglected zoonotic dz?

World health organization

What is going to be the primary source of rabies deaths in humans?

Dogs

In the US what animals most commonly spread rabies?

Raccoons, foxes, bats, skunks, coyotes

What family does rabies exist in?

Rhabdoviridae

What does neurotropic mean?

Likes nervous tissues, causes madness

What animals are susceptible and can be infected with the any rabies virus variant?

All warmblooded mammals

Bites from what kind of animal should be considered exposure?

Bats, wilde terrestrial carnivores

What animals typically will not spread rabies?

Rodents

What animal is rarely infected and is knot known to transmit rabies to humans?

Lagomorphs (Rabbits and hares)

What is the most common source of rabies in AZ?

arizona grey fox

What animals are not reservoirs for rabies?

Cats, and dogs

When did the US become free of the canine rabies virus variant?

2007

Rabies in other countries has lead to what updates via the CDC?

Temporary import ban and updated dog importation regulation

What are a few entry requirements for dogs entering the US in low risk countries?

accompanied by a CDC dog import form only submission receipt

What are a few entry requirements for dogs entering the US in high risk countries?

Healthy upon arrival,

6m of age, microchiped prior to rabies vax,

CBC dog import form

Rabies vax doc form

What are two acceptable forms of rabies vax docs?

U.S. vaccination form/ USDA endorsed export health cert

An owner wishes to bring their dog from a high risk country and there is no rabies vaccinations on file for this dog. Are they allowed to enter?

No

How is rabies transmitted?

Direct contact w/ fresh saliva or brain/neurvous system tissue of an infected animals.

What are two major categories of direct contact?

Bite

Non-bite - (Contamination of open wounds w/ saliva from rabid animal)

Indirect contact does NOT constitute what?

Rabies expsure

What are some indirect contacts w/ a rabid animal?

Petting/ animal handling

Contact w/ blood, urine, fecies, skunk spray

saliva w/ intact skin

82% of human rabies infections acquired in the US involved what rabies variants?

Bats

What are human to human exposures of rabies?

Organ donation (16 Cases)

NOT just caring for rabies patients unless saliva is into an open wound

Dogs can start shedding rabies virus in their saliva when?

Days prior to clinical signs

What is the difference between the latent period and the incubation period of rabies?

Latent period: Infection to virus sheding

Incubation period: infection to clinical signs (usually 5 days longer than latent)

An infected animal will usually die within ___ days of clinical onset?

7

What are some things that rabies incubation periods depend on?

Sight of bite wound,

wound care

Previous vax and presence of antibodies

How long is the incubation period for rabies for humans, how long for domestic animals?

Humans less than a year

animals: 3-12 weeks

What are the steps for rabies infection?

1. Inoculation

2. replication in muscles

3. Viral binding to nicotinic acetylcholine receptors at neuromuscular juctions

4. Virus travels up the axons

5.Replication in the spinal cord and assent to the brain

6.Infection of the brain neurons w/ neuronal dysfunction

7. centrifugal spread along nerves to salivary glands skin, cornea and other organs

What are som initial clinical signs of animal rabies?

Inappitense,

difficulty swallowing,

cranial nerve deficits

abnormal behavior/ altered vocalization

Staggering ataxia, paralysis, seizures

True or false there are no effective antiviral rabies drugs?

True

If you were to see a normally nocturnal animal out during the day that was showing reduced fear of humans would you be suspicious of rabies?

Yes

What are the three stages of CNS infection?

Predromal

excitative

paralytic

What would you see in the prodromal stage of CNS infection w/ rabies?

1-3 day period characterized by behavioral changes

What would you see in the excitative stage of CNS infection of rabies?

Furious rabies 3-4 days of hyper reactive behavior to external stimuli and bite anything near by

What would you see in the paralytic stage of CNS infection of rabies?

Dumb rabies

Damage to motor neurons - incoordination and rear limb paralysis, drooling difficulty swallowing - paralysis of facial and throat muscles.

Death - respiratory arrest

Diaganosis of rabies can only be done when?

Post-mortum

What is required for testing for rabies?

Head, brain w/ brainstem for direct fluorescent antibody testing

(NOT frozen or chemically fixed)

Are there any USDA licensed antemortem tests for rabies?

no

For animals potentially exposing humans or domestic animals what must be done?

AZDHS risk assessment

What are prodrome symptoms for humans?

Photophobia

Sore throat,

Fever,

Headache,

nausea

What are acute neurological phase symptoms in human rabies?

Apprehension,

nervousness,

hallucinations,

behavioral anomalies,

salivation

perspiration

hydrophobia

photophobia

What is the fatality rate of rabies? how many survival cases are there?

99% fatality rate

14 Documented survivals

What are antemortem tests for rabies in humans?

Saliva,

serum,

spinal fluid

skin biopsy at nape of neck

What species is requried to be vaccinated in AZ?

Dogs

What is compendium of animal rabies prevention and control?

The best practices that are typically the basis for state and local law.

What are NASPHV rabies recommendations for domestic animals?

All dogs, cats and ferrets should be vax

any horses, livestock w/ frequent contact w/ humans should be vax

Regardless of the age of an animal at initial vaccination an animal should be boostered in ___?

1 year

How long after the intial vax are animals considered immune? How long after the booster?

28 Days post initial

Boostered: immediately

True or false in AZ it is illegal for a tech to give a rabies vaccination no mater what?

False, under DVM supervision it can be given

What are some things used for rabies prevention in wildlife?

Oral rabies vax in raccoons and coyotes,

True or false there is no licensed parenteral rabies vax for wild life or hybrids?

True

Regardless if a hybrid is vaccinated threw off label use or not what will happen if it bites a human and is reported?

Immediate euthanasia and rabies testing

In arizona a rabies titter is _____ as an index of immunity?

Not recognized

What is RIG?

rabies immune globulin - provides rapid passive immunity for 21 days

Any rabies vax for humans in the US must?

Stimulate active antibodies for 7-10 days and provide neutralizing antibodies persisting for several years

Rabies vax in humans should be given when?

Days 0 and 7

What is post exposure prophylaxis?

Wound tx

local infiltration of RIG

Vax

What is post exposure regimen for unvaccinated humans?

-Clean wound,

-RIG application 1/2 in bite other half IM and Rabies vax

-4 doses of Rabies vax on 0, 3, 7, and 14

What is post exposure regimen for vax humans?

Clean wound,

Rabies vax on 0, and 3

True or false post-exposure prophylaxis is medical urgency not emergency?

True

Wild mammalian carnivores, skunks, bats that are not available or suitable for testing should be ____?

Regarded as rabid

What is PEP?

Vax of exposed animals w/in 96hrs,

boostered at 3rd and 8th week

quarantined (strict) for 90 days

What is strict quarantine?

No direct contact w/ people or other animals.

How would we treat pets with documentation that are overdue?

What about undocumented overdue pets?

W/ DOC: Booster immediately and owner quarentines for 45 days

W/OUT doc: treat as unvax/ serologic monitoring if w/in 96hrs of exposure

How is prospective serologic monitoring done?

Day 0 - collect blood before booster and strict quarenting

Day 5 - Collect blood for titter

If there is an adequate response to tiering in prospective serologic monitoring what can be done?

Pet is vax and can be quarantined for 45 days

If there is an inadequate response to tiering in prospective serologic monitoring what can be done?

Considered unvaccinated and is in 6m strict quarantine

A livestock animal that is exposed to rabies must be put on a ____ hold prior to slaughter?

8month

If an animal is bitten by an owned animal what should be done?

If an animal is not owned what should be done?

Owned: - confined and observed for 10 days

Unowned: euthanized and tested immediately