Rabies Surveillance

Rabies is a diseased spread through animal bites. Each year in the United States, approximately 4,000 to 5,000 animals are found to have rabies, and most of them are wild animals. In Missouri, rabies is mostly found in bats and skunks, but other animals like dogs, cats, horses and cattle can have it too.

People get rabies almost always from the bite of an infected animal. In rare cases, getting saliva or brain tissue from a rabid animal into an open cut or the eyes, nose or mouth could also spread the virus. Rabies in humans is almost always deadly.

Deaths from rabies in the United States have become rare because dogs and cats have been given effective vaccines since the 1950s, public health workers test animals as needed, and doctors have effective vaccines for those exposed.

About 40,000 people in the U.S. get rabies shots each year. In Missouri, rabies cases in animals and people must be reported to the state health department.

Rabies in Animals

Rabies begins to affect animals around three to six weeks after exposure. This is the incubation period, and it varies between animals. The first sign of rabies is changes in behavior. For example, a friendly dog may become shy, or a nocturnal animal may begin walking during the daytime.

After incubation, the animal enters the "furious" stage. The animal will become aggressive. It may try to bite other animals, objects or people.

The last stage is the "dumb" stage. The animal becomes very weak or paralyzed and is close to dying. The throat becomes paralyzed too, so the animal can’t swallow and drools a lot. It may want to drink water but can’t because the throat muscles hurt and spasm. Sometimes this causes “foaming at the mouth,” but this can happen with other illnesses too.

An animal may go through all these stages or only some of them. Once signs begin, the animal almost always dies within ten days. Dogs, cats and ferrets can spread the virus in their saliva for several days before they look sick. For other animals, it is not known how long they might be contagious before symptoms appear.

Vaccination of Animals

Effective rabies vaccines are available for dogs, cats, ferrets, sheep, cattle and horses. It is important to vaccinate pets because they help protect the people who live with them. Indoor pet should be vaccinated because they can still come in contact with other animals.
All rabies vaccinations must be given by a licensed veterinarian. Pets should get their first shots and their booster shots based on what the veterinarian recommends and according to local animal control rules. There are no treatments for animals after they are exposed to rabies like there is for humans.

Testing Animals for Rabies

Animals that bite a person or another pet may be tested for rabies. To test an animal, it must be euthanized because the brain has to be examined to look for the rabies virus. All animal rabies testing is done at the State Public Health Laboratory (SPHL) in Jefferson City.

A veterinarian prepares the animal for testing and places the needed samples in a special container. The courier picks up rabies samples from local health agencies and other facilities. Test results are usually ready one day after the sample arrives at the lab. There is no cost for the shipping container, the courier service, or the test itself. More information about rabies testing can be found through the SPHL.

Bats and Rabies

Bites from bats are the main source of rabies in humans in the United States today. Most bats do not have rabies, but its illness can't be identified from just looking at it. Only lab tests can confirm rabies in bats. Bats can't give you rabies from seeing them at a distance, in an attic, in a cave or from touching bat droppings.

If a bat is out during the day, can’t fly or is in a place where bats aren't usually seen, it is more likely to be sick. These bats may be easier to approach, but you should never touch a bat.

If a bat bites you or if its saliva gets in your eyes, nose, mouth or in an open cut, wash the area and seek medical help immediately. If possible, the bat should be captured and sent for testing.

Since bat teeth are small, bites may be harder to identify. Seek medical advice if:

You wake up and find a bat in your room.
A bat is in a room alone with a child.
A bat is near someone who can’t communicate clearly, such as a person who is mentally impaired or drunk.

Rabies in Humans

It takes three to eight weeks for rabies to affect people after being bitten by an animal with rabies. However, this can vary from the bite's location and severity. After exposure, there is a several day window for shots to be administered. The shots keep a bitten person from developing rabies.

Early symptoms of rabies often include:

sensory changes at the site of the bite (numbness or tingling), fever, headache and feelings of discomfort.
Nervousness, anxiety, aerophobia (the fear of flying) and hydrophobia (abnormal fear of water).
mental confusion, paralysis, delirium and convulsions.

Once symptoms start, rabies is almost always deadly. Without treatment, death usually happens within two to six days. With medical care, a person may live a few weeks longer, but the disease still leads to death after symptoms appear.
Rabies can be hard for doctors to diagnose early because its symptoms are similar to other illnesses that affect the brain. Tests might not show rabies right away. To diagnose rabies, doctors may test saliva, blood, spinal fluid or small samples of nerve tissue.

Actions Following a Potential Rabies Exposure

Identifying the Animal

After being bitten, it is important to identify the animal.

Domestic animals: Identify and safely confine the animal. Healthy dogs, cats and ferrets may be quarantined for ten days. In some cases, the animal may be euthanized and tested for rabies. Other types of domestic animals are handled based on the situation.
Wild animals: Try to identify the animal and safely confine it if possible. Wild animals cannot be quarantined. They must be tested for rabies.

Immediate Steps After a Bite

After a bite, wash the wound right away with soap and water for 10 to 15 minutes.

Immediately visit a doctor to:

Check tetanus shots.
Determine if antibiotics are needed.
Treat the wound (stitches may be needed for serious injuries).
Complete a rabies risk check and decide if rabies shots are needed.

Anti-Rabies Series of Shots for Humans

There are several shots that can be given due to a person's circumstance. If given soon after exposure, the current series of rabies shots works very well. These shots are fewer and have fewer side effects than older treatments. They do not work once symptoms of rabies begin.

If the person has not been vaccinated before, they will receive two types of treatment:

HRIG (human rabies immunoglobulin): The dose depends on the person’s weight and is usually injected around the bite area.
Rabies vaccine: Four shots are given over 14 days.

People with weakened immune systems who have not been vaccinated before may need five vaccine doses plus HRIG.

If the person has been vaccinated before, they only need two booster shots given three days apart. No HRIG is needed.

High risks groups may receive preexposure vaccinations. A preexposure vaccination is a shot given before possibly being exposed to a disease or sickness. High risk groups include veterinarians and animal control officers. The preexposure vaccinations include three shots given over 21 or 28 days.

Preexposure shots make rabies treatment easier in the future. If exposed, treatment is simpler because HRIG isn’t needed, and fewer doses are required. It provides some protection if treatment after exposure is delayed. It also protects people who might be exposed without realizing it.

Community Prevention

Because of community protections, rabies cases have dropped across the country. These protections include:

Make sure dogs and cats are up to date on their rabies shots. Vaccines are also available for ferrets, horses, cattle and sheep.
Do not let your pets run loose. This helps protect them from wild animals that might carry rabies.
Do not touch or feed stray pets or wild animals. Never keep wild animals or mixes of wild and domestic animals as pets.
If you see a wild animal acting strangely, or if you notice stray pets in your area, report it to animal control officials.

Tips for Children

Children suffer more bites from animals, which may cause injury to the face, head and neck. To avoid being exposed to rabies and other diseases, children must:

Never touch unfamiliar or wild animals. Enjoy wild animals from afar.
Avoid direct contact with stray animals. Stray cats and dogs may not have been vaccinated against rabies.
Never adopt wild animals or bring them into the home.
Do not try to nurse sick animals to health. The animal may have rabies. Call an animal control officer or animal rescue group for help with the sick animal.
Make sure that trash cans and pet foods are secured so that they do not attract wild animals.
Do not disturb a dog that is sleeping, eating or caring for puppies.
If bitten, report the bite immediately.

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