For God's Sake, if you live here, visit here, please read this: Rabies

Hillbilly

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A.D.A.M. Medical Encyclopedia.
Rabies

Last reviewed: February 10, 2011.

Rabies is a deadly viral infection that is mainly spread by infected animals.
Causes, incidence, and risk factors

Rabies is spread by infected saliva that enters the body through a bite or broken skin. The virus travels from the wound to the brain, where it causes swelling, or inflammation. This inflammation leads to symptoms of the disease. Most rabies deaths occur in children.

In the past, human cases in the United States usually resulted from a dog bite, but recently, more cases of human rabies have been linked to bats and raccoons. Although dog bites are a common cause of rabies in developing countries, there have been no reports of rabies caused by dog bites in the United States for a number of years due to widespread animal vaccination.

Other wild animals that can spread the rabies virus include:

Foxes

Skunks

Very rarely, rabies has been transmitted without an actual bite. This is believed to have been caused by infected saliva that has gotten into the air.

The United Kingdom had once completely eradicated rabies, but recently, rabies-infected bats have been found in Scotland.
Symptoms

The actual time between infection and when you get sick (called the "incubation period") ranges from 10 days - 7 years. The average incubation period is 3 - 7 weeks.

Symptoms may include:

Anxiety, stress, and tension

Drooling

Convulsions

Exaggerated sensation at the bite site

Excitability

Loss of feeling in an area of the body

Loss of muscle function

Low-grade fever (102 degrees F or lower)

Muscle spasms

Numbness and tingling

Pain at the site of the bite

Restlessness

Swallowing difficulty (drinking causes spasms of the voicebox)

Signs and tests

If an animal bites you, try to gather as much information about the animal as possible. Call your local animal control authorities to safely capture the animal. If rabies is suspected, the animal will be watched for signs of rabies.

A special test called immunofluorescence is used to look at the brain tissue after an animal is dead. This test can reveal whether or not the animal had rabies.

The same test can be used to check for rabies in humans, using a piece of skin from the neck. Doctors may also look for the rabies virus in your saliva or spinal fluid, although these tests are not as sensitive and may need to be repeated.
Treatment

Clean the wound well with soap and water, and seek professional medical help. You'll need a doctor to thoroughly clean the wound and remove any foreign objects. Most of the time, stitches should not be used for animal bite wounds.

If there is any risk of rabies, you will be given a series of a preventive vaccine. This is generally given in 5 doses over 28 days.

Most patients also receive a treatment called human rabies immunoglobulin (HRIG). This is given the day the bite occurred.

Call your doctor right away after an animal bite or after being exposed to animals such as bats, foxes, and skunks. They may carry rabies.

Call even when no bite took place.

Immunization and treatment for possible rabies are recommended for at least up to 14 days after exposure or a bite.

There is no known effective treatment for people with symptoms of a rabies infection.
Expectations (prognosis)

It's possible to prevent rabies if immunization is given soon after the bite. To date, no one in the United States has developed rabies when given the vaccine promptly and appropriately.

Once the symptoms appear, the person rarely survives the disease, even with treatment. Death from respiratory failure usually occurs within 7 days after symptoms start.
Complications

Untreated, rabies can lead to coma and death.

In rare cases, some people may have an allergic reaction to the rabies vaccine.
Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if an animal bites you.
Prevention

To help prevent rabies:

Avoid contact with animals you don't know.

Get vaccinated if you work in a high-risk occupation or travel to countries with a high rate of rabies.

Make sure your pets receive the proper immunizations. Dogs and cats should get rabies vaccines by 4 months of age, followed by a booster shot 1 year later, and another one every 1 or 3 years, depending on the type of vaccine used.

Follow quarantine regulations on importing dogs and other mammals in disease-free countries.

References

Rupprecht CE, Briggs D, Brown CM, et al. Centers for Disease Control and Prevention (CDC). Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the advisory committee on immunization practices. MMWR Recomm Rep. 2010 Mar 19;59(RR-2):1-9. Erratum in: MMWR Recomm Rep. 2010 Apr 30;59(16):493.
Bassin SL, Rupprecht CE, Bleck TP. Rhabdoviruses. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 163.
 

AlterEgo

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Jan 9, 2009
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Good info Hillbilly, especially with all the street dogs in DR. They're usually pretty passive, but all it takes is one.

The past few years I've noticed an incredible number of bats in trees too!! Both in my in-law's yard in Santo Domingo, and out in the campo.
 

young seniors

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Hillbilly, thanks so much for that information, and I will have to try and find out how that guy that contacted rabies is doing. My daughter-in law is a neuro nurse in icu, at that hospital. she should know.
 

dv8

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rabia is not all that common in DR, majority of all the cases in the world happen in india, actually. but still...

the body responsible for dealing with rabies infection is DR is salud publica. they are the one conducting tests and administering vaccinations. what to do in case of a bite from unknown or not vaccinated animal: report to salud publica ASAP to get the shots. painful injections in the stomach are no longer used but the amount of vacuna depends on the weight so a large adult may get quite a few shots. localization of the bite is very important too, rabies travels via the nervous system (albait very slowly) so the close to the head the bite is the worst it is and the sooner you need to be injected. generally an immidiate vaccination is 100% effective. the vaccine is rather expensive too.

what to do if your animal presents the symptoms of rabies: isolate immediately taking care not to get bitten and call a vet. some diseases may present similar syptoms so there is no way of telling for sure. definitive testing for rabia in animals involves dissecting the brain (although animals that do not present symptoms can be quarantined, observed and have their saliva tested). so you either wait for your animal to recover or to die or kill it straight away. once dead the body HAS to be taken to salud publica to be tested. it is very important because any outbreak of rabies is very dangerous and needs to be contained.

the best thing to do: vaccinate all your animals, including those that do not go out since you may always get univited guests (all bloody cats in our neighbourhood come to our house). better safe than sorry. people also can get vaccinated so you may want to consider that, especially if you volunteer in any animal charity or simply live/work in the area with many street dogs. it is worth noting that rats and mice do not get rabies thou.
 

EllaTO

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Thanks for all this great information. Interesting that symptoms can take up to 7 years to appear!!

I haven't been able to stop thinking aout the poor guy who must be suffering so horribly...

Ella
 

dv8

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when i was bitten in the hand by my unvaccinated kitten (turned out she had epilepsy) i was told i had plenty of time to take the vaccine. vet said to keep an eye on a cat and it case it died to freeze the body (if night or weekend) and take it to the salud publica. if the person was bitten in a leg, and was a large individual it would take a really long time to present symptoms. hence my note that suspected animal should be isolated (especially if it is your own loving pet) and observed. there would still be plenty of time for taking shots. of course i would not risk the same with a small child - better to vaccinate them ASAP.

personally i have attended to many street cats and dogs, never been bitten or attacked so far. but i do not approach them lighly either. come to think of it i may take a vaccine because i am partial to saving street animals...
 

dv8

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only if you work with animals, really. getting all shots for all diseases you may get in DR is too much. sometimes it is better to treat that to prevent. rabies is 100% treatable if you get your post-exposure shots. chances of encountering infected animal are slim. remember that dominicans are not so concerened about animal wellfare: if there are case present in any neighbourhood all animals running free will be killed, no one will think twice about it.

there are many illnesses in DR but there is no reason to panic. look at dr1esrs who have lived here for many years, they did not die of infectious diseases. the chances of exposure to health hazards of poeople who are well off, educated and knowledgable are low. i would assume that gringos generally know what to do do avoid infection and have resourses to prevent or treat those kind i problems.
 

Hillbilly

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Jan 1, 2002
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Trainman!!! NO NO NO!!! Vaccination only if bitten or touching playing with a rabid carcass.

People, rabies is endemic in the DR. We have mongooses, rats, cats, feral pigs, dogs and farm animals that can carry rabies.

If you do have animals they really must be given vaccinations or booster shots. If you come upon a dead animal, please don't get all First Worldy on us and go "Aaaah, the poor thing, let me put it in this bag or bury it"....Leave it there!!! Pour some kerosine or gasoline on it and burn it!!

Be serious about this and think...


HB
 

frank recktenwald

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Jun 18, 2007
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Bookmark and Share

A.D.A.M. Medical Encyclopedia.
Rabies

Last reviewed: February 10, 2011.

Rabies is a deadly viral infection that is mainly spread by infected animals.
Causes, incidence, and risk factors

Rabies is spread by infected saliva that enters the body through a bite or broken skin. The virus travels from the wound to the brain, where it causes swelling, or inflammation. This inflammation leads to symptoms of the disease. Most rabies deaths occur in children.

In the past, human cases in the United States usually resulted from a dog bite, but recently, more cases of human rabies have been linked to bats and raccoons. Although dog bites are a common cause of rabies in developing countries, there have been no reports of rabies caused by dog bites in the United States for a number of years due to widespread animal vaccination.

Other wild animals that can spread the rabies virus include:

Foxes

Skunks

Very rarely, rabies has been transmitted without an actual bite. This is believed to have been caused by infected saliva that has gotten into the air.

The United Kingdom had once completely eradicated rabies, but recently, rabies-infected bats have been found in Scotland.
Symptoms

The actual time between infection and when you get sick (called the "incubation period") ranges from 10 days - 7 years. The average incubation period is 3 - 7 weeks.

Symptoms may include:

Anxiety, stress, and tension

Drooling

Convulsions

Exaggerated sensation at the bite site

Excitability

Loss of feeling in an area of the body

Loss of muscle function

Low-grade fever (102 degrees F or lower)

Muscle spasms

Numbness and tingling

Pain at the site of the bite

Restlessness

Swallowing difficulty (drinking causes spasms of the voicebox)

Signs and tests

If an animal bites you, try to gather as much information about the animal as possible. Call your local animal control authorities to safely capture the animal. If rabies is suspected, the animal will be watched for signs of rabies.

A special test called immunofluorescence is used to look at the brain tissue after an animal is dead. This test can reveal whether or not the animal had rabies.

The same test can be used to check for rabies in humans, using a piece of skin from the neck. Doctors may also look for the rabies virus in your saliva or spinal fluid, although these tests are not as sensitive and may need to be repeated.
Treatment

Clean the wound well with soap and water, and seek professional medical help. You'll need a doctor to thoroughly clean the wound and remove any foreign objects. Most of the time, stitches should not be used for animal bite wounds.

If there is any risk of rabies, you will be given a series of a preventive vaccine. This is generally given in 5 doses over 28 days.

Most patients also receive a treatment called human rabies immunoglobulin (HRIG). This is given the day the bite occurred.

Call your doctor right away after an animal bite or after being exposed to animals such as bats, foxes, and skunks. They may carry rabies.

Call even when no bite took place.

Immunization and treatment for possible rabies are recommended for at least up to 14 days after exposure or a bite.

There is no known effective treatment for people with symptoms of a rabies infection.
Expectations (prognosis)

It's possible to prevent rabies if immunization is given soon after the bite. To date, no one in the United States has developed rabies when given the vaccine promptly and appropriately.

Once the symptoms appear, the person rarely survives the disease, even with treatment. Death from respiratory failure usually occurs within 7 days after symptoms start.
Complications

Untreated, rabies can lead to coma and death.

In rare cases, some people may have an allergic reaction to the rabies vaccine.
Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if an animal bites you.
Prevention

To help prevent rabies:

Avoid contact with animals you don't know.

Get vaccinated if you work in a high-risk occupation or travel to countries with a high rate of rabies.

Make sure your pets receive the proper immunizations. Dogs and cats should get rabies vaccines by 4 months of age, followed by a booster shot 1 year later, and another one every 1 or 3 years, depending on the type of vaccine used.

Follow quarantine regulations on importing dogs and other mammals in disease-free countries.

References

Rupprecht CE, Briggs D, Brown CM, et al. Centers for Disease Control and Prevention (CDC). Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the advisory committee on immunization practices. MMWR Recomm Rep. 2010 Mar 19;59(RR-2):1-9. Erratum in: MMWR Recomm Rep. 2010 Apr 30;59(16):493.
Bassin SL, Rupprecht CE, Bleck TP. Rhabdoviruses. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 163.
In the early eighties when I lived in Canada I was always told that rabies was very common among raccoons.
 

young seniors

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Apparantly the guy from Toronto who remains in hospital, contacted rabies in DR. It is unclear how at this point. He was a bartender for a few months, sought out help a couple of times but kept getting worse and came back home. Medical authorities, after testing, determined that it definetly came from DR. This particular strain is common to dogs and bats. Dominican Republic has been notified by Health Canada. Last I heard he was still in ICU
 

EllaTO

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Mar 16, 2012
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Actually, according to the CBC, the strain this guy has is found in dogs and mongoose, not bats. Rabies is more commonly found in foxes and coyotes in Canada while also found to a lesser degree in racoons. There is another more dangerous zoonotic bacteria found in racoon feces to be aware of which can be transmitted to dogs and cats as well...but since that has nothing to do with the DR, I will stop there :tired:

Toronto rabies patient likely infected abroad - Toronto - CBC News

Ella
 

dv8

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wiki says than mongoose live in PR and caribbean (introduced) but i have never seen them buggers.

seems like no news have been released about infected guy but his chances are very slim. still, as long as he is alive there is hope.
 

young seniors

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Feb 1, 2012
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Actually, according to the CBC, the strain this guy has is found in dogs and mongoose, not bats. Rabies is more commonly found in foxes and coyotes in Canada while also found to a lesser degree in racoons. There is another more dangerous zoonotic bacteria found in racoon feces to be aware of which can be transmitted to dogs and cats as well...but since that has nothing to do with the DR, I will stop there :tired:

Toronto rabies patient likely infected abroad - Toronto - CBC News

Ella
you`re right Ella, meant to say mongoose
 

EllaTO

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Mar 16, 2012
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wiki says than mongoose live in PR and caribbean (introduced) but i have never seen them buggers.

seems like no news have been released about infected guy but his chances are very slim. still, as long as he is alive there is hope.
The hospital where this poor guy is refuses to confirm as of yesterday whether or not he is still alive...due to the usual confidentiality reasons... But one would think if he has passed, news would leak out pretty quickly.

I had to google a mongoose to even see what it was... Funny catlike little boogers! Hope I never see one in real life!!
 

EllaTO

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Mar 16, 2012
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With the upside of surviving being the potential for profound neurological damage, I am afraid one might hope not....