What You Must Know About Rabies

By Richard DiMaggio

I am going to place the word “rabies” with a small list of other diseases like the “plague” that scares the living daylights out of me. It evokes images of the dog frothing at the mouth and bats swooping down and making a nest in our hair.

In fact, I recently had an encounter with a bat—yes, swooping down to make a nest in my hair—that made me study this virus, and yes, also undergo the rabies vaccine. Because the vaccine itself was the treatment of lore, it evokes images of huge needles in your stomach and a mortality rate almost as high as rabies itself.

Here’s a few reasons I got the vaccine, with a confirmed bat encounter, but not a confirmed bite:

1. We usually do not know when we’re bitten by a bat. Their fangs are so small, detection of a bite is difficult at best, and we usually feel nothing at all;

2. The incubation period of rabies is the difficult part. The “minimum” time is 10 days. The average time is 85 days. There is no maximum. That means, you could have been bitten two years ago and still develop rabies in the future. I decided to get the treatment rather than live through a waiting period up to several years to see if I die.

3. The first treatment must be received before the first symptom. If you have a symptom –a single symptom like a headache or flu–before the first shot, rabies has a one hundred percent kill rate. The virus incubated and has started taking over your nervous system and there is no stopping it.  (There is experimental treatment going on called the Milwaukee Protocol. In 2004, a young teenager by the name of Jeanne Giese began suffering symptoms without the first treatment. Her doctors induced her into a coma to keep the virus from ravaging her brain, and then treated the disease. She has since graduated from college. In 2008, an 11 year old boy became the second to be treated this way. On June 12, 2011, an eight year old girl became the third. Numerous others were unsuccessful).

4. The first symptoms seem uneventful. You can have a headache, a fever, or think you’re coming down with the flu. When this starts, the average kill time is three weeks.

My Story

A few weeks ago, I was walking my dog around the block at 8 o’clock at night when all of a sudden, something hit me in the back of the head and fluttered.

It was pitched black out, and I couldn’t even see what it was. I said to my friend, Joan, “Stupid bat just flew into my head and fluttered.” I knew it was a bat. There was a little bit too much umpf behind the wings to be a moth.

I was ready to continue our discussion about solving the world’s problems when Joan cut me off. “Uh-oh,” she said. “You need to have the rabies vaccine now.” She went on to explain that bats are one of the biggest carriers of the rabies virus in the United States, and every encounter with a bat requires the rabies vaccine. She also advised me to call the County Health Department.

At the time, I thought this was the most ridiculous thing I ever heard.

Then I researched it.

Most of the Time You Don’t Know When a Bat Bites You

Bats are not the big carrier worldwide, dogs are. But that is an unfair equation, because dogs in the United States receive rabies shots. (If you’re not sure if your dog is current on her shots, call your Vet immediately).

In the United States, recent testing shows that approximately 1/15 bats carry the rabies virus.

And the problem with bats is you don’t know when you’ve been bitten. Their teeth are so small, a bite is invisible to the eye and usually painless. You may not even feel a scratch.

If a mad dog or raccoon or fox chomps on your leg, you’ll know it. If a bat bites you, you won’t.

Every encounter with a bat needs the rabies vaccine, confirmed bite or no bite. That means a bat in your tent, a bat in your house, touching a bat. If you open your eyes and see it fluttering in your bedroom, assume it has been snacking on a body part while you were sleeping.

Every year, 55,000 people worldwide die of rabies, because the vaccine is so difficult to get in some parts of the world. Deaths in the United States are rare, because of treatment options available. But you need to get treated, even if you don’t think you’ve been bitten. If you touched a bat, woke up with one in your room or tent, assume it bit you.

Rabies as a Virus

Rabies is a virus that is spread through the saliva of an infected animal. Not only must the animal bite you, it must actually pass the saliva to you. The transference of saliva is the reason there’s never been a transmission from one person to another. It is technically possible, but would require an infected person on their death bed to bite someone, and this has never occurred.

The virus has an incubation period, and then it gets carried through your nervous system until it kills you. Rule not to forget: The first shot must be received before the first symptom.

The Nasty Incubation Period

The treatment lies in understanding the incubation period. Herein lies the key: The incubation period is minimum 10 days (or though shorter incubation periods have been noted) and an average of 85 days, with no maximum. Again, the first shot must be received before the first symptom.

The Center for Disease Control Reports:

“The number of rabies-related human deaths in the United States has declined from more than 100 annually at the turn of the century to one or two per year in the 1990′s. Modern day prophylaxis has proven nearly 100% successful.

“In the United States, human fatalities associated with rabies occur in people who fail to seek medical assistance, usually because they were unaware of their exposure.”

http://www.cdc.gov/rabies/location/usa/index.html

Rabies in Your Pets

ALWAYS get your pets caught up on rabies shots. If a rapid animal bites your pet, the pet will bring it home. An exposed dog, for example, must be quarantined for up to six months and then inoculated.

Treatment

There’s two types of shots: Pre-exposure, which people like Veterinarians would receive who are at high risk coming in contact with infected animals; and post-exposure, like me, those who may have been bitten but have not received a pre-exposure shot. The post exposure treatment is called post-exposure prophylaxis (PEP). We are talking simple shots, no more railroad spikes through the stomach.

PEP used to be a series of about twenty painful injections through your stomach. This is what I expected. In fact, it was a series of shots no worse than an ordinary tetanus shot. The regimen is human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a fourteen-day period.

Altogether, I received ten shots, and they go like this:

The first six shots were of the human rabies immunoglobulin (HRIG).  This is not the actual vaccine, but helps the body produce immediate antibodies. It is a thicker, syrupy fluid and if it’s given in a single dose, will give the recipient a large bubble. To prevent this from happening, the doctor will break the dose into several. The dosage is based on height and body weight, and since I’m a pretty big guy, my dosage was broken up into six shots of the globulin: three in the left hip muscle, three in the right hip muscle (all at once).

This did make me a tad sore.

The seventh shot, the same day, was the actual vaccine, in the arm.

Thereafter, the three remaining rabies shots are given at day 3, 7 and 14.

The only side effect was extreme tiredness, which my wife will vouch may not have been a side effect at all.

I almost didn’t want the treatment. But rabies is a terrible way to go (not that there’s any good ways). It is a three week period of hell, starting with the flu, to hallucinations, anxiety, depression, convulsions, and death.

The County Health Department said there was a 1/100 chance the bat was rabid, and another 1/100 chance it passed saliva to me.

The odds: 1/100,000

It was either get the treatment, or live in fear for two years waiting to get the flu, and then, if the 1/100,000 odds came in, die a terrible death.

The treatment is there, and there’s a reason rabies kills 55,000 worldwide but just a small few a year in the United States. Those that die here either didn’t know they were bitten, or assumed “not me.”

I was hit by lightening once, and survived (true).

I have the rarest blood type on earth.

The odds are on my side.

Where’s my winning Lotto numbers, though?