Lecture 27: Rabies in Animals and Humans

Question 1

how many people die from rabies each year

Answer 1

60,000 (40% children)

Question 2

what family is rabies from

Answer 2

rhabdoviridae

Question 3

what are the wildlife reservoirs for rabies in U.S.

Answer 3

all warm blood mammals
raccoons, skunks, foxes, bats

Question 4

are dogs and cats reservoirs for rabies

Answer 4

no!

Question 5

outside the U.S. what is the primary rabies variant

Answer 5

canine rabies (making imported dogs an ongoing concern)

Question 6

what did CDC put in place to protect U.S. from canine variant of rabies

Answer 6

2021: temporary import ban

Question 7

when was canine specific rabies eradicated in U.S.

Answer 7

2007

Question 8

how is rabies transmitted

Answer 8

direct contact with fresh saliva or brain/nervous system tissue

Question 9

what are two major categories of direct contact transmission routes

Answer 9

bite or non-bite

Question 10

what is a non-bite transmission route for rabies

Answer 10

contamination of open wounds with saliva from rabid animal

Question 11

can indirect contact (i.e. petting or handling animal, contact with blood, urine feces, or saliva with intact skin) cause rabies

Answer 11

no!

Question 12

between 2000-2020 what percent of human rabies infections were acquired from bat associated variants in U.S.

Answer 12

82%

Question 13

any direct contact with a bat should be considered

Answer 13

potential exposure unless bat tested negative

Question 14

how can rabies be transmitted from human to human

Answer 14

organ transplants

Question 15

what does incubation period of rabies depend on

Answer 15

site of bite wound/inoculation, wound care, and previous vaccination/presence of antibodies

Question 16

what is the range for incubation period for rabies in domestic animals

Answer 16

3-12 weeks

Question 17

what is the pathogenesis of rabies

Answer 17

1. virus inoculated
2. viral replication in muscle
3. virus binds nACHR’s at NMJ
4. virus travels on axons in retrograde fashion
5. replication spinal cord and rapid ascent to brain
6. infection of brain neurons
7. centrifugal spread along nerves to salivary glands, skin, cornea

Question 18

what are the clinical signs of rabies in dog

Answer 18

aggression or unusual behavior, excessive salivation, choking or gagging, cranial nerve deficits, ataxia, paralysis, seizures

Question 19

how would rabies present in a normally nocturnal animal

Answer 19

active during day or showing reduced fear of humans

Question 20

what are the three stages of CNS infection

Answer 20

1. prodromal
2. excitative “furious rabies”
3. paralytic “dumb rabies”

Question 21

what is prodromal phase

Answer 21

1-3 day period characterized by behavioral changes

Question 22

what is the excitative ohase

Answer 22

3-4 days of hyperactivity to external stimuli and bite anything near

Question 23

what is the paralytic phase of rabies

Answer 23

damage to motor neurons causes incoordination/paralysis in hind end, drooling and difficult swallowing, death caused by respiratory arrest

Question 24

how do you test for rabies

Answer 24

postmortem examination of brain via DFA

Question 25

what are the prodromal clinical signs in humans for rabies

Answer 25

nausea, headache, fever, sore throat, photophobia

Question 26

what are the acute neurological phase in humans

Answer 26

apprehension, nervousness, hallucinations, behavioral, anomalies, salivation, perspiration, hydrophobia, photophobia

Question 27

what is CFR in humans for rabies

Answer 27

>99% (survival has been documented in 14 cases)

Question 28

what are some antemortem testing in humans for rabies

Answer 28

saliva, serum, spinal fluid, and skin biopsy at nape of neck

Question 29

which species is required by AZ law to be vaccinated against rabies

Answer 29

rabies

Question 30

what is required for cats and dogs to enter arizona

Answer 30

CVI certificate proving vaccinated against rabies

Question 31

when are animals considered immunized post rabies vaccine

Answer 31

28 days

Question 32

when are boosted animals considered immunized post rabies vaccine

Answer 32

immediately

Question 33

what is the typical vaccination schedule for rabies in dogs, cats, ferrets

Answer 33

initial vaccine at 3 months of age booster one year later booster every 3 years

Question 34

what is a common injection site reaction in cats

Answer 34

sarcomas

Question 35

where should you avoid injecting vaccines in cats

Answer 35

dorsal neck, high on hindleg, cranial to scapula/chest

Question 36

where are recommended sites for injecting vaccines in cats

Answer 36

low on fore and hindlimbs or tail

Question 37

what type of rabies vaccine is labeled use in raccoons and coyotes

Answer 37

oral rabies

Question 38

what is the vaccine protocol for wolf dogs or wild cat/domestic cat hybrids

Answer 38

no approved parenteral vaccines exist in U.S. use of licensed vaccines is considered off label

Question 39

what is the protocol for a hybrid pet that has been exposed to rabies or bites a human

Answer 39

no established quarantine periods so immediate euthanasia and rabies testing required despite vaccination history

Question 40

in arizona is a ribers titer recognized as an index of immunity

Answer 40

no!

Question 41

what is the protocol for pre-exposure vaccine prevention for humans

Answer 41

two days of RV on day 0 and day 7

Question 42

how often should serologic testing and booster be done

Answer 42

every 10 years and booster accordingly

Question 43

what is the protocol for post-exposure prophylaxis in humans

Answer 43

wound treatment, local infiltration of RIG, vaccination

Question 44

what is the post exposure protocol for those humans unvaccinated against rabies

Answer 44

thorough wound cleaning, RIG (half at bite site, half IM) four doses of RV: day 0, 3, 7, and 144

Question 45

what is the post exposure protocol for humans vaccinated against rabies

Answer 45

thorough wound cleaning, two doses of RV on days 0 and 3

Question 46

post-exposure prophylaxis is considered a medical ___ not ___

Answer 46

urgency not emergency

Question 47

where should questions regarding possible rabies exposure to pet be directed

Answer 47

state or local public health authorities

Question 48

what animals are not suitable for rabies testing and should be regarded as rabid

Answer 48

wild mammalian carnivores, skunks and bats

Question 49

what protocol was established in texas for post exposure prophylaxis

Answer 49

no USDA licensed biologics but in texas PEP prevent 100% of deaths with vaccination within 96 hours, booster at 3 and 8 weeks and strict quarantine for 90 days

Question 50

which state specifically allows for PEP in animals

Answer 50

texas

Question 51

what is protocol for currently vaccinated animal exposed to rabid animal

Answer 51

revaccinate immediately and keep under owner control and observation for 45 days

Question 52

what is protocol for currently unvaccinated animals exposed to rabid animal

Answer 52

euthanize immediately, if owner unwilling immediately vaccinate and place in strict quarantine at owners expense for 4-6 months

Question 53

what is protocol for animals overdue for booster WITH documentation but have been exposed to rabid animal

Answer 53

booster immediately and keep under control and observation for 45 days

Question 54

what is protocol for animals overdue for booster WITHOUT documentation

Answer 54

treats as unvaccinated or prospective serologic monitoring

Question 55

what does prospective serologic monitoring entail

Answer 55

day 0: collect blood before booster, booster and put animal into strict quarantine day 5: collect blood sample for titer (> 0.5IU/mL) adequate response: considered vaccinated and put in 45 day observation inadequate response: considered unvaccinated and put into 6 month strict quarantine

Question 56

unvaccinated livestock exposed to rabies should be...

Answer 56

euthanized immediately

Question 57

vaccinated livestock exposed to rabies should be

Answer 57

revaccinated and observed for 45 days

Question 58

how long is commercial slaughter prohibited in exposed animal

Answer 58

8 months

Question 59

does cooking and pasteurization inactivate rabies virus

Answer 59

yes!

Question 60

what is protocol for owned dogs, cats and ferrets who bite humans

Answer 60

confirmed and observed for 10 days, regardless of vaccination status, do not vaccinate during this time period if no signs, no rabies exposure if clinical signs, euthanize and test immediately

Question 61

what is protocol for strays or unwanted animals that bite humans

Answer 61

should be euthanized and tested immediately