Visiting Veterinarian : World Rabies Day
On July 4, 1885, in the Alsace region of the French-German border, a 9-year-old boy named Joseph Meister was knocked to the ground by a dog belonging to the local grocer, Theodore Vone. When he was lifted from the ground, covered in blood and saliva, there were at least fourteen bite wounds on the child's hands, legs and thighs. Mr. Vone killed the dog, which was quickly determined to have been rabid. Joseph's mother witnessed the attack and knew what it meant. Her son would almost certainly contract rabies and die a horrible death. But Ms. Meister was a determined woman. She and Mr. Vone gathered Joseph up and sought the help of a scientist who had recently gained renown for developing a method to prevent fatal anthrax infection in sheep and cattle. Ms. Meister had heard that he was experimenting with similar techniques for rabies in dogs. His name was Louis Pasteur.
"As the death of this child appeared inevitable," Mr. Pasteur wrote, " I decided, not without deep and severe unease, as one can well imagine, to try on Joseph Meister the procedure which had consistently worked in dogs." Mr. Pasteur was taking a huge risk. He was not a licensed physician. The legal and ethical ramifications could have been enormous, but like Ms. Meister, Mr. Pasteur was no shrinking violet. According to Alex Munthe, one of his contemporaries, "Pasteur was absolutely fearless. Anxious to secure a sample of saliva straight from the jaws of a rabid dog, I once saw him with the glass tube held between his lips draw a few drops of the deadly saliva from the mouth of a rabid bull-dog, held on the table by two assistants, their hands protected by leather gloves." Mr. Pasteur decided to inoculate the little boy, reporting "On July 6, at 8 in the evening, 60 hours after the bites of July 4, and in the presence of Drs. Vulpian and Granter, one [doctor] inject under a fold of skin...one-half syringe of spinal cord of a rabbit dead of rabies." Over the next ten days, Joseph received thirteen more injections. He survived the first hurdle. The shots didn't kill him. Now the question was whether the treatment would keep him from coming down with rabies. Four months later, Mr. Pasteur presented the "Method for Preventing Rabies after a Bite" to the French Academy of Sciences. Joseph had survived, the first human to receive successful post-exposure rabies prophylaxis.
This Sunday, Sept. 28, 2008, is World Rabies Day. The mission of the day is to raise awareness about the impact of rabies, how easy it is to prevent, and how to eliminate the main global sources. More than a century after Mr. Pasteur saved Joseph, rabies still kills one person every ten minutes. 55,000 people die every year. Most cases occur in Africa and Asia but people die of rabies right here in the U.S. If rabies is now completely preventable, why have 25 Americans succumbed to the disease since 2000? Well, to begin with, effective treatment depends entirely on medical attention immediately after exposure. If you wait until symptoms appear to seek help, it's too late. There is only one reported case of a person with clinical rabies surviving. (In 2004, an adolescent girl in Wisconsin was put in a drug-induced comma and successfully treated.) Clearly, when it comes to this terrifying virus, prevention is the goal.
The majority of human cases in the U.S. have been linked to the bat strain of virus, although many victims had no recollection of contact with a bat. Some later recalled tiny bite wounds they initially assumed were from an insect or spider. Some had a history of physical proximity, such as bats living in their chimneys. Bats are not the only culprits. Around 7,000 cases of animal rabies are reported annually in the States. Most involve wild animals, especially skunks, raccoons, bats, and foxes, but many mammals are at risk. Cats- dogs- goats-cows. Just last month a horse at the Missouri State Fair got sick and died two days later of rabies. Signs can be variable, making early diagnosis difficult. Horses may act like they are choking or colicky, show an abnormal stiff gait, neurologic abnormalities, or act aggressively. Cows tend to bellow. Pigs may be hyper excitable and uncoordinated. In any species, rabies can present in the "furious" form with nervous, agitated, aggressive behavior, or the "dumb" form with a stupor us, dull demeanor. The classic description is "mad dogs and friendly foxes," but any unusual behavior can be considered consistent. In livestock, multiple animals may be affected, as living in the close proximity of a herd or flock can lead to simultaneous exposure, like at one farm where several curious cows in a field gathered around a rabid skunk, who proceeded to bite all their noses. Among house pets, cats are more likely to be infected than dogs, probably because fewer cat owners vaccinate and cats tend to spend more unsupervised time outside interacting with wildlife.
In September 2007, the Center for Disease Control announced that the canine strain of rabies has been eliminated from the United States. A direct result of years of legally required vaccination, this is great news. It does not mean, however, that our pups can't get rabies. There are still plenty of other strains of the virus here, which can infect dogs. And do not be complacent because you live on Martha's Vineyard. I can tell you stories. The rabid puppy on the Nantucket ferry. The woman who brought a raccoon from New Hampshire (where raccoon rabies is epidemic) and let it run loose in Chilmark. The West Tisbury cats who caught a rabid bat at their winter home in Connecticut. Outside of the States, dog rabies is still a significant threat, so be aware when traveling abroad. Wanna pat that stray dog in the streets of Bangkok? There's a 10 percent chance he has rabies. Wherever you live or travel, teach children not to get close to unfamiliar animals, especially wild mammals. If you see an animal acting strangely, report it to the authorities. Vaccinate your pets. In the words of the slogan of World Rabies Day: Help make rabies history.