Rabies remains a critical public health issue
In July 2017, a kitten in Carroll County, Ill., was initially diagnosed with rabies. Subsequent testing at the Centers for Disease Control and Prevention (CDC) ruled out rabies, and the University of Illinois Veterinary Diagnostic Laboratory confirmed feline infectious peritonitis as the likely cause of death.
This recent attention regarding rabies has prompted the College of Veterinary Medicine to work with the Illinois State Veterinarian, the Illinois Department of Public Health (IDPH), and the Veterinary Diagnostic Laboratory to provide this resource for veterinarians.
FAQS for DVMs
How can I prevent rabies exposure to myself or my staff?
- Train staff in how to properly restrain and handle animals and have the most experienced staff handle fractious animals, animals with signs of rabies, or animals who are new to the clinic and have unknown temperaments
- Consider obtaining the rabies pre-exposure vaccine for staff members, especially those who handle animals with signs of rabies, and fractious or unknown rabies vaccine status animals; then, if a rabies exposure occurs, the treatment regimen is much simpler and less expensive (only two booster doses of rabies vaccine)
- If you have been vaccinated, have your titers checked every two years to determine if you are due for a routine booster dose
- Remember to keep rabies on your differential list when appropriate, and take the necessary preventive measures to ensure that you and your staff are not bitten by the animal and do not come in contact with the patient’s saliva or nervous system tissue
- For more information visit: https://www.cdc.gov/rabies/specific_groups/veterinarians/staff.html
Facts about Rabies and Rabies Vaccines
- Rabies kills over 50,000 people each year in developing nations.
- The first rabies vaccine was administered in 1885.
- All dogs, cats, horses, and ferrets should be vaccinated against rabies. Illinois law requires all dogs 4 months of age and older to be vaccinated.
- Sheep and cattle can also be vaccinated, and this is recommended if the animals are valuable or will be exposed to large groups of people, such as at fairs or petting zoos.
- 30 days after initial vaccination, peak rabies antibody titers are expected and the animal can be considered immunized.
- A booster vaccination should be administered one year after the initial vaccine.
- After initial vaccination, booster vaccinations should be administered according to the manufacturer’s label.
How many animals test positive for rabies each year in Illinois?
- At least 46 confirmed cases of rabies (all bats) as of September 13, 2017
- In 2016, IDPH confirmed 63 cases: 62 bats and 1 barn cat
- Before 2016, the most recent year in which a cat tested positive for the virus was 1996
Have any humans recently died of rabies in the United States?
- 23 deaths have been reported by the CDC from 2008 to 2017
- Bat teeth are small and bites may not be noticed or could happen when someone is asleep in the room with a bat
- Because victims didn’t know they were bitten or did not known bats carry rabies, they did not seek post-exposure treatment
- It is recommended that post-exposure treatment be obtained by any persons who are bitten by, have physical contact with, or wake up in a room with a bat that can’t be tested negative as well as by a small child, someone with dementia, or other party who is not able to say whether they were bitten is known to have been in a room unobserved with an untested or positive bat
What do veterinarians need to know about reporting exposed persons or suspected rabid animals?
- Any humans with suspected exposure to a rabid animal should be reported immediately to the local health department
- Any humans who are bitten by an unvaccinated domesticated animal, or any animal with an unknown vaccine history (including all wildlife) should contact their healthcare provider immediately
- Veterinarians should not provide advice on whether rabies treatment is needed for an exposed person but should refer exposed persons to their physicians and local health department for advice
- Illinois Department of Agriculture requires that any animals suspected of having rabies be reported immediately
- Alert your local animal control and health department to facilitate a timely submission of the animal for rabies testing with the appropriate submission form. Animals can be tested at one of four laboratories in Illinois (Veterinary Diagnostic Laboratory in Urbana and public health laboratories in Chicago, Springfield, and Carbondale)
- Suspected animals should be overnighted on ice or hand delivered on ice to the diagnostic laboratory for prioritized testing
- After-hours testing is available; however, this must be approved by the IDPH Communicable Disease Control Section before submitting the animal
What are the procedures for rabies testing at the University of Illinois?
- In January 2017, the Veterinary Diagnostic Laboratory started offering direct fluorescent antibody (DFA) testing for rabies
- Euthanasia should be accomplished in a way as to maintain the integrity of the brain so the laboratory can identify the anatomic parts
- Fresh refrigerated or fresh frozen (unfixed) tissues are required for DFA rabies testing and diagnosis
- Frozen samples should be used only when shipping fresh or refrigerated samples on dry ice is not possible
- Chemical fixation (e.g., formalin) of tissues should be avoided to prevent substantial testing delays and because it might preclude reliable testing
- In Illinois, biting dogs and cats who do not have signs of rabies and are euthanized and not confined for the required 10 days should be tested at the Veterinary Diagnostic Laboratory, not at an IDPH laboratory
How much does rabies testing cost at the Veterinary Diagnostic Laboratory?
- $28 for brain removal
- $25 for DFA test
- $4 dollar submission fee
- Total = $57
What tests are performed to diagnose rabies in animals?
- DFA is the gold standard
- Only performed on brain tissue post-mortem
For what animal cases should I add rabies to my differential list?
- Any mammalian wildlife displaying neurological symptoms
- Any unvaccinated domestic animal displaying neurological symptoms including: lethargy, fearfulness, aggression, excessive drooling, difficulty swallowing, difficulty walking, paralysis, seizures or death
- Rabies in a vaccinated animal is rare, although it can occur in an animal that has only had one rabies vaccine in its lifetime and has an overwhelming exposure.
What should I advise clients if their pet has bitten someone?
- Recommend the bitten person seek medical care immediately
- Report the bite to the local health department and animal control
- Confirm that the animal is up to date on rabies vaccine
- Regardless of vaccination status, all biting domesticated animals must be confined or placed in isolation for monitoring. The Animal Control Administrator will advise whether or not the confinement can be in the home environment or at a veterinary clinic or hospital. If the animal has signs of rabies, euthanasia and testing may be needed.
- After the mandated observation period, vaccinate the pet for rabies if it is not up to date
What should I advise clients if their pet has been bitten by, or has been in an area with (e.g., cat or dog alone in house with a bat), high-risk wildlife that has not been tested for rabies ?
- Report the exposure to animal control authorities
- If the pet was exposed to a bat, ideally ask the client to safely contain the bat under a container for pick up by animal control. The person should avoid any physical contact with the bat. If they do not feel comfortable with this, they can close the door to the room where the bat is present. However, when animal control comes, it may not be possible to find the bat in the room. Testing the bat is critical. If the wild animal tests negative, the pet was not exposed to rabies.
- In Illinois, when circumstances indicate animals were bitten by a rabid animal:
- Immediate humane destruction is preferred if the animal is unvaccinated.
- If not euthanized, the bitten dog, cat, or ferret not officially vaccinated more than 30 days prior to exposure, shall be vaccinated immediately and be placed under strict confinement for a 6-month period. If the exposed dog, cat, or ferret is apparently normal at the end of 5 months of the confinement period, it shall be revaccinated against rabies at that time and then remain in confinement for another 30 days.
- If the bitten dog, cat, or ferret had been officially vaccinated more than 30 days prior to exposure, and within the recognized period of immunity, it shall be revaccinated and confined for 45 days.
What wild animal species are considered high risk for rabies in Illinois?
- Bats, skunks, raccoons, fox, coyote
- An exposure to an untested animal or a rabid animal is considered to be a rabies exposure
- Although there have not been cases of rabies identified in some of these species in Illinois for years, there is not random routine surveillance testing of these species, so pockets of rabies could exist in the species.
What are low-risk species for rabies?
- Vaccinated domestic animals
- Small rodents and rabbits Note: Exposures to untested animals in this group are not considered rabies exposures.
- Compendium of Animal Rabies Prevention & Control, 2016, Journal of the American Veterinary Medical Association (AVMA)
- Infographic from AVMA on Rabies in the United States
- Rabies FAQs for Pet Owners
Compiled by Dr. Ashley Mitek