Ok, what do you know about Rabies?

02/18/2011 03:09:26 PM · #1

My daughter spent last weekend on her friend's farm.

I don't have all the details yet, but here's what I know:

Apparently, two of their dogs were attacked in the woods They don't know how, but one was bloodied, and the other was hurt but not bloody.

Later, someone found and shot a coyote in the woods, which has tested positive for Rabies.

My daughter got a phone message from her friend about this, and that she has now begun a series of rabies shots. This is presumably from her touching and treating the wounded dog.

My daughter says she touched the other dog, which was also bitten, but not bloody. She didn't touch the bloody dog.

We still don't even know if the dogs were actually attacked by the coyote, or if it was something else.

Given we are going into the long weekend, and that we can't seem to touch base with her friend now, we are worried and wondering if we need to call my daughter's doctor right away.

Message edited by author 2011-02-18 15:10:08.

Covert_Oddity

Nikon D700

Nikon AF-S DX Zoom-Nikkor 18-55mm f/3.5-5.6G VR

02/18/2011 03:14:48 PM · #2

Yes, immediately, it has to be treated before symptoms start showing or it can be potentially fatal.

I would say if there's any risk at all then get in touch. I know this because I had a long lecture from a doctor on Rabies before I flew to India.

RainMotorsports

Nikon D60

02/18/2011 03:15:28 PM · #3

As a precaution she should be treated if you suspect the possibility. There are no two ways about it. She should be given the vaccine in a very timely manner. I don't wish to mention the alternative, as it is upsetting. But its hard to say from the information given if there is a real worry.

Message edited by author 2011-02-18 15:16:40.

schlef

Canon EOS-5D Mark II

Canon EF 16-35mm f/2.8L USM II

02/18/2011 03:15:42 PM · #4

//www.cdc.gov/rabies/transmission/index.html

As long as she didn't have any open wound or ingest the blood... she should be fine regardless. It's kind of like AIDS, you can't get it unless it gets inside of you. If she didn't touch the bloody dog at all, I would say you have very little to worry about.

Note, this is not any kind of medical advice as I'm not a doctor. If you have any concerns, you should stay in easy contact of a physician and seek medical advice.

Message edited by author 2011-02-18 15:16:30.

eqsite

Nikon D7100

Nikon AF-S DX Zoom-Nikkor 18-70mm f/3.5-4.5G IF-ED

02/18/2011 03:20:22 PM · #5

My understanding is that you should start the treatment within 14 days of possible contact. We had an episode with a bat last year. It was over the weekend so we couldn't get any answers from the local heath department until Monday. Their take was basically that while there was little chance of us actually having been exposed, the risks involved with being wrong were pretty high. We decided to go through the shots just for peace of mind. It wasn't fun, but on the other hand, it wasn't that bad either. The plus side is that if I am ever exposed again, all I need is a booster shot.

Regardless, you should definitely talk to your doctor or the local heath department.

ETA: Another bonus is that the county where the exposure took place should pay for the shots.

Message edited by author 2011-02-18 15:21:41.

kleski

Canon EOS-7D

Canon EF 28-135mm F/3.5-5.6 IS USM

02/18/2011 03:27:34 PM · #6

The last time I gave the rabies series of shots was in 2006 in Iraq. Any possible contact should be treated with the series. Usually we only treated if someone had been bitten but why take the risk. If I remember correctly, the series will also prevent the posibility of rabies...so it also acts as a vaccine.

NiallOTuama

Google Pixel 2

02/18/2011 03:29:52 PM · #7

Why are you asking the forum rather than calling a hospital or doctor?

scalvert

Canon EOS-5D Mark III

02/18/2011 03:33:42 PM · #8

With something like this, it may be better to be too cautious going forward than wrong in retrospect...

Canon 12x IS USM (S3 IS built-in Lens) -- 36-432mm (35mm EQ)

02/18/2011 03:35:05 PM · #9

Thanks everyone.

She has a message into the Doctor's office. We have to wait for them to call back. Tough when stuff happens (or you find it out) on Fridays, especially on a long weekend.

By the way, the farm is out of state, in Rhode Island, not New York.

Message edited by author 2011-02-18 15:36:23.

NiallOTuama

Google Pixel 2

02/18/2011 03:58:03 PM · #10

Geez. You'd've thought they might prioritise something like that, woudln't you!?

GeneralE

Canon PowerShot S3 IS

02/18/2011 04:06:34 PM · #11

Originally posted by NiallOTuama:

Geez. You'd've thought they might prioritise something like that, woudln't you!?

Private medical offices aren't open 24/7 like hospital ERs ...

It sounds like the risk of exposure is relatively low, and that there is no harm in delaying treatment (if ultimately indicated) until Tuesday.

My preferred online medical reference is emedicine.com -- now absorbed by Medscape/WebMD. If you register (free) you should be able to get to the parts directed towards medical professionals, as well as the "patient-education" materials, if you want all the scientific details.

RayEthier

Canon EOS-5D Mark II

Canon EF-S 18-55mm f/3.5-5.6 USM

02/18/2011 04:44:51 PM · #12

The question that begs to be asked is...were the dogs tested for rabies and if so what were the results?

Ray

GeneralE

Canon PowerShot S3 IS

Canon 12x IS USM (S3 IS built-in Lens) -- 36-432mm (35mm EQ)

02/18/2011 04:50:24 PM · #13

Originally posted by RayEthier:

The question that begs to be asked is...were the dogs tested for rabies and if so what were the results?

Ray

Given the time frame, I think such testing useless. The exposure would not come from the dogs' body fluids, but from residual coyote saliva present around the woulds when they were being tended. Exposure would come from saliva contacting any opening in the skin.

The incubation period for rabies is several weeks -- the dogs themselves could not be rabid yet, and presumably they've been vaccinated anyway, and should be protected.

emorgan49

Olympus E-5

Olympus 50mm f/1.8 MF Normal Zuiko

02/18/2011 05:34:22 PM · #14

Years ago when I took Immunology in medical school (not an MD) there had been only ONE person who had survived rabies in the US. They treated the anticipated symptoms in advance and the process was grueling. It is almost always fatal, that's why all the fuss. Also, to test the dogs you would have to cut off their heads and examine their brains so the owners usually opt to wait and see.

I stand corrected - Wikipedia says there are now six known cases of humans surviving rabies.

Message edited by author 2011-02-18 17:35:55.

DrAchoo

Panasonic Lumix DMC-LX5

02/18/2011 05:39:46 PM · #15

Originally posted by nshapiro:

Be a little at ease. Rabies is a very slow disease and there is no emergency (meaning hours make a difference) to be treated. Getting into the doc on Monday would be plenty reasonable. In fact, it's one of the few vaccines that actually can be helpful AFTER you have started with symptoms.

So make the appointment, but don't lose sleep this weekend.

To quote my Red Book (an authority on vaccinations and infectious disease). "Prophylaxis should begin as soon as possible after exposure, ideally within 24 hours. However, a delay of several days or more may not compromise effectiveness, and prophylaxis should be initiated if otherwise indicated, regardless of the interval between exposure and initiation of therapy."

Message edited by author 2011-02-18 17:42:44.

DrAchoo

Panasonic Lumix DMC-LX5

02/18/2011 05:47:07 PM · #16

Even more good news for you:

"Postexposure prophylaxis for rabies is recommended for all persons bitten by wild mammalian carnivores or bats or by domestic animals that may be infected. Exposures other than bites rarely have resulted in infection, but seemingly insignificant physical contact with bats may result in viral transmission even without a clear history of a bite. Postexposure prophylaxis is recommended for persons who report an open wound, scratch, or mucous membrane that has been contaminated with saliva or other potentially infectious material (eg, brain tissue) from a rabid animal."

Message edited by author 2011-02-18 17:50:06.

Nikon AF Micro-Nikkor 60mm f2.8D

02/18/2011 06:12:20 PM · #17

Well the Dr.'s office called back, and it was a nurse rather than the Dr.

She seemed to think there was nothing to worry about--so no appt was scheduled. It's of course up to my daughter whether to press on, and try to get the shots, or leave it be (she's an adult).

The exposure was last Sunday.

Jason--I told her your advice to make an appt (it would have to be Tues because of the holiday), but she doesn't really know what she would be doing there...would she be asking to be immunized? There aren't tests right? Or just to talk to the doctor?

David Ey

Nikon D80

02/18/2011 06:13:57 PM · #18

Sadly, Rhode Island Rabies is the worst possible type, expecially in northern Rhode Island.

chromeydome

Nikon D7000

Nikon AF-S DX NIKKOR 18-200mm f/3.5-5.6G ED VR II

02/18/2011 06:19:22 PM · #19

Sorry to hear of this. It does sound like you can wait until Monday if need be. Here in Washington, most providers have a "walk-in clinic" in the same facilities as the doctors' offices. So for thing where you need to see a doctor, can't wait for an appointment, but are not emergency room urgent, they work out fine.

If it were me, I know I would have a hard time "relaxing" or being patient about this--but that is just me. If there is sufficient risk to your piece of mind over the next 2-3 days, it may be worth getting in to see someone in short order, if only to have them tell you not to worry (or especially to have them tell you not to worry).

Just a side comment: I will paypal five bucks directly to you if you repeat this sentence precisely to the doctor when you go in: "I had an online consultation with Dr. Achoo." :-) Ten bucks if the doctor says "bless you" or "gesundtheit" in reply....

Message edited by author 2011-02-18 18:21:35.

snaffles

Nikon D7100

02/18/2011 06:23:29 PM · #20

To be perfectly honest I'd still press on and get the shots. Having grown up in what was once (still is?) nicknamed the 'Rabies capital of North America (or was it the world?) - yep good ol Ottawa, Ontario and environs - why take the risk? A wild animal, like the coyote, possibly acting in an odd manner and possibly attacking not one but two dogs...seems like way too many coincidences to me, even if the coyote killed, was indeed innocent.

A few years ago I saw a black squirrel staggering, as though drunk, along the side of a dirt road. I got out for a closer look, wondering if it had been hit a glancing blow and was perhaps stunned. But the damn thing came at me. Didn't make contact, it wasn't coordinated enough, but I got the hell out of there. And about a year later a muskrat wandered into the barn, lunged at and very nearly bit a fellow barn worker - good thing she was able to get out of reach, and her hubby was there and he killed it with a pitchfork. I know they sent off the carcass for rabies testing, but never heard anything more.

BTW forget about the foaming-at-the-mouth stuff as the only indicator of rabies. If I remember correctly that happens very late in the stages of rabies. It's wildlife acting weird that you need to watch out for. And stay away from!

kleski

Canon EOS-7D

Canon EF 28-135mm F/3.5-5.6 IS USM

02/18/2011 06:33:35 PM · #21

Here's the CDC's pamphlet if it helps...it's from 2009.

Rabies Vaccine Pamphlet

Strikeslip

Canon EOS-5D

Canon EF 100-400mm f/4.5-5.6L IS

02/18/2011 06:37:15 PM · #22

Originally posted by DrAchoo:

..prophylaxis...

I use a prophylaxis because we're too old to have more kids.

Nikon AF Micro-Nikkor 60mm f2.8D

02/18/2011 06:49:45 PM · #23

The coyote did test positive for rabies. My daughters friend and her family are all getting the shots.

At this point, after talking to my brother in law, an emergency room physician and professor, and he spoke to an infectious disease specialist, she's leaning towards getting the shots. Even if the chance she touched coyote saliva on the dog is very small, and the chance that she gets rabies is infinitesimal, it's still not a risk she wants to take (or that we want her to take).

It's weird though--in the US, apparently, you can only get rabies shots in the emergency room. Her friend has spent a good part of today waiting for her first shot. She's going to call ahead and see if she can 1) make sure they have vaccine in stock, and 2) find out when a good time to go is.

Personally, I'm relieved. I'd rather not worry about her! Thanks for all the helpful advice. (Well, everyone except for slippy ;) )

Message edited by author 2011-02-18 18:51:16.

David Ey

Nikon D80

02/18/2011 07:02:32 PM · #24

You can get pre-inoculated for rabies. It's only 3 shots in an arm. Too late for that but the series after the fact may give immunity for future attacks. Check with your ER. BTW, why wait until Monday?

DrAchoo

Panasonic Lumix DMC-LX5