Rabies Scare

I'm a sucker for a furry face and when this little cat came around one evening, claiming to be hungry and in desperate need of a pat I fed him and scratched his ears and stroked him.

I should have paid attention because when he saw one of my other cats he got worried, growled and bit me. My fault really, he did warn me.

I didn't think much of it. I've been around cats all my life. In the city, rabies is not a very big risk and I'd never thought much about it. All the cats I looked after outside and in were vaccinated. There had not been any rabies in Southern Ontario for several years.

My finger swelled up almost immediately after I was bitten. It was not even particularly sore. The swelling was a inflammation reaction. I put some ice on it. I had cleaned my finger with alcohol and iodine and put antibiotic cream on.

My one concern was infection. Cat Scratch Fever is nasty and very dangerous so when the finger was a bit red around the puncture points the next day I decided to see my doctor.

I dropped in the office and they saw me right away. The rules are clear, any bite by an unknown animal that can carry rabies must be reported to Public Health and treated seriously and quickly. If I had been able to verify that the cat had been vaccinated then I would not have had to have rabies treatment.

Unfortunately for me some rabid raccoons had been reported a few of months earlier near Hamilton Ontario, not very far from here. This caused a great deal of consternation, and sealed my fate. I would need preventative treatment.

Ideally they would have liked to catch the cat and keep it under observation for 10 days, but Mr. Pussy had wandered off and since I live in quite a rural area there was not much chance of finding him. He is even possibly someone's cat and he might have been found comfortably curled up on someone's couch.

The doctor did not loose any time, she quickly gave me a tetanus shot since my last vaccination was almost due to be renewed. I also got a prescription for antibiotics for potential cat scratch infection.

Rabies preventative treatment and vaccine

There are 3 levels of exposure risk as defined by the World Health Organization. I fell into the third and most dangerous exposure group because I had been bitten and bled.

Within a couple of hours, Public Health who had been informed, called me to verify my weight and delivered both a round of immunoglobin serum as a preventative medicine and vaccine, to my doctors.

In the meantime I had consulted Mr.Google who had referred me to the World Health Organization. Rabies is a serious problem in many regions of the world and they have well established procedures. It looked like I was in for a somewhat unpleasant afternoon.

The first part of the treatment consists of actual human antibodies distributed in several needles injected in and as near as possible to the site of the bite. Other shots are also administered at a distance from the bite.

Everyone has heard of the many painful injections in the abdomen. This is a thing of the past.

For me, these consisted of 5 shots of Rabies Immune Globulin, a concentrated dose of human rabies antibodies. The dose is based on my weight. This provides immediate antibodies to fight the rabies virus. That's why it needs to be as close to the bite as possible since the antibodies must come in contact with the Rabies virus.

In my case, my finger, "the site", was a mightily swollen finger which was however only moderately tender, that would soon change. The doctor did her best to inject 2 needles in the affected finger, first trying one way, then the next. This was difficult because of the swelling. It caused quite a lot of bleeding and increased the already balloon-like finger. It was also quite painful.

Since the cat had also scratched me on the arm, I got another couple of needles there. The fifth shot went in my butt muscle.

The serum itself is not particularly painful but trying to inject a useful quantity in a full to capacity finger was a difficult task.

By the end of that procedure my finger looked like it was ready to burst and very tender.

The antibodies need to contact the virus before they get in to the nerves and start making their way to the brain.

There was loads of blood and stuff that had leaked out of the finger from the several holes she had punched in me. I had a full audience of nurses who later told me I "was a trouper!"

After that experience I was a little limp, but I was not out of trouble yet.

The next step was to administer the first of a series of rabies vaccines. The recommended procedure is to administer a first dose as soon as possible and on the same day as the immunoglobin serum, this first day is considered day 0. I then need to get 3 more shots on day 3, 7, and 14. Anyone who is deemed to have a compromised immune system also gets a 5th shot on day 28. These are administered in muscles, but not in the butt because of the fat layer which might delay vaccine effect. In my case the arm that did not get the tetanus and serum.

It was almost pleasant to get a tiny, not painful needle after the serum. The following day I was quite sore where the vaccine had been injected but my finger had reduced in size and no cat scratch infection was present. I had antibiotics for a week.

I dutifully went back for 3 more shots to complete the vaccination. Immunity lasts for quite a long time, the World Health Organization claims it's about 10 years. I think if I was bitten again by an other suspected rabid animal I would have the pleasure of getting the vaccine regimen once again though. The immunoglobin injections are not repeated if infected at a later date.

Public Health kept tabs on me and called me to make sure I had the full treatment and that I felt fine. They also asked about the cat and I was glad to report that the little Creep had been showing himself and he looked JUST FINE, thank you very much.

We named the cat "Enemy" and if I tell the cats that Enemy is out there they look out and snarl.

RABIES

Rabies is such a serious disease that drastic action to prevent the disease must be taken in any uncertain case. Once symptoms appear you are done for. I was lucky, the cat was not likely to be rabid and I had ready (and free) access to good medical care.

There has only been about 10 cases worldwide, of confirmed rabies, only one in the US, that is of a girl who actually developed the symptoms and who is known to have survived. YouTube documentary on this rabies survivor.

Rabies is 100% deadly. No fooling around.

Rabies symptoms can appear as quickly as one week or up to 3 year. Once symptoms appear, death is certain.

Rabies is a disease that affects the nervous system and brain. It is caused by a virus.

Rabies is transmitted by the saliva, milk and other secretions, of an infected animal. Usually when an infected animal bites. It is also possible to get rabies from contact of saliva (or other body fluids) onto mucus membranes, such as the eyes or throat or lungs.

Link to Wikipedia article on Rabies

Here is a very informative YouTube video on Rabies. It's made for instruction in India and quite detailed, quite grim, be warned if you watch. The details have an Asian focus.

In North America the main vector for rabies is bats. Most mammals can be infected however. It's interesting to note that opossums are rarely victims of rabies because their body temperature is lower than ideal for rabies virus.

Conclusion

If you are planning to do some animal rescue, will come in contact with bats or are commonly working with potentially un-vaccinated animals, get vaccinated. It beats having to go through the whole prevention treatment!

Vaccinate your animals, it's good for them and for you!