Your Health: Rabies a cause for awareness, not alarm

Two bats with rabies have recently been found in a Scotts Valley neighborhood. Is this cause for alarm? Not really, but it calls for a heightened awareness of what rabies is, how it is transmitted and what needs to be done for a known exposure.
Rabies is an infection caused by a virus. It is usually passed on to humans through the bite of a rabid (that is, rabies-infected) animal. Rarely, it can be transmitted if the saliva of an infected animal comes in contact with a break in the skin, such as a scratch, or with mucus membranes, such as the eyes, mouth or nose.
Once the virus enters a body, it travels along a nerve to the spinal cord and brain, where it causes encephalitis (brain infection). Once this happens, it is usually 100 percent fatal. That’s what makes this such a serious, although thankfully rare, disease. Although it might take one to three months for symptoms of rabies to show up, immediate treatment is necessary.
Rabies causes as many as 35,000 deaths worldwide each year, mostly in developing countries. Due to effective animal control and vaccinations begun in the 1940s, the incidence of rabies in our domestic animals in the U.S. has decreased dramatically. Dogs and cats now account for only 3 percent of animal rabies. Contrary to common thinking, cats are more rabies-prone than dogs. However, the incidence of rabies among wild animals has increased and poses our greatest concern.
To show how rare this disease is, the last case of human rabies reported from an exposure in California was in 2003. Although any mammal could be infected with rabies, in California, it is usually found in bats, skunks and, to a lesser extent, foxes. It is extremely rare in rodents, such as squirrels, rats, mice and chipmunks.
If you have been bitten by a possibly rabid animal, wash the wound immediately with soap and water. Then get professional treatment.
In Santa Cruz County, the only option for immediate treatment is a visit to the Dominican Hospital emergency room. This facility stocks a medication called “human rabies immune globulin,” which is an injection that must be given as soon as possible after a rabies exposure to protect your body from developing the infection. At the same time, you will be given the first of five necessary rabies vaccines, which will continue over the course of a month. These shots are given in the arm. This is a vast improvement from the much-feared older method of giving 20 to 30 shots in the abdomen.
After the initial emergency room treatment, I would advise that you immediately call your health insurance provider to see if the next four vaccine shots will be covered by insurance, and if so, you could go to most any urgent-care clinic for the necessary treatment.
For those without insurance, the local county health clinic on Emeline Avenue also stocks the necessary post-exposure vaccine. They charge $215 for each of the four injections and a nominal nursing visit charge to give the injection. The county clinic just needs an order from a physician for the clinic nurse to give the shots. Call 454-4114 to arrange this treatment, and remember that the timing is critical.
My next column will discuss how animal bites are reported to the authorities and what pet owners need to know if their pet has bitten someone or has been bitten by a possibly rabid animal.
Signs an animal might have rabies
**A wild animal seems unusually tame or unafraid and approaches you.
**A nocturnal animal, such as a bat or skunk, is found outdoors during the daytime.
**A pet develops difficulty eating, drinking, walking, or acting unusually strange.
**A bat is unable to fly or has been caught by a domestic dog or cat.
Terry Hollenbeck, M.D., is an urgent-care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley. A doctor with 36 years’ experience, he invites you to view his previous columns at his website, valleydoctor.wordpress.com. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.