Important information on syrup of ipecac

Bites and Rabies



How do you get rabies?
Rabies is caused by a virus that is transmitted by bites or scratches contaminated with saliva of an infected animal. A rabid animal licking an open wound is considered a possible source of exposure. Inhalation of dried feces from an infected animal can also be a source of rabies exposure. (An example is exploring areas like caves that have large amounts of bat feces.)

Petting a rabid animal or skin contact with the blood, urine or feces of a rabid animal is not considered a rabies exposure and does not require treatment. But to be safe, if there is any chance that an animal may have rabies, keep away and do not handle it with bare hands. Bats are especially prone to be carriers of rabies. After any exposure with a bat, contact your physician.

What is the incidence of rabies?
Only 0-5 people a year contract rabies in the entire United States, making rabies in humans a very rare condition. Rabies is not common in California due to an aggressive vaccination program in domesticated animals.

What animals are likely to be rabies carriers?
Bites from skunks, bats, foxes, coyotes, bobcats, raccoons and unvaccinated cats are sources of rabies. In California, skunks are the most likely to have rabies. In fact, about 38% of skunks, 31% of raccoons, 14% of bats and 4% of foxes carry rabies. In Northern California, raccoons are the main source of rabies. In Southern California, along the United States-Mexico border, rabies is common in dogs. Mice, rats, squirrels, groundhogs, guinea pigs, gerbils, chipmunks, hamsters and rabbits are unlikely to transmit rabies. Contact your county public health department to determine which animals are high incidence carriers of rabies in your area.

What should we watch out for in animals that may have rabies?
If an animal is showing unusual or aggressive behavior and bites without being provoked, rabies should be considered. Animals sick enough to bite people usually die within 10 days. If a healthy animal bites as a result of being fed, teased or abused, the bite is in self-defense and rabies is unlikely to result. An unprovoked bite or attack from a vicious dog in non-rabies areas can cause serious injury but is not likely to result in rabies.

What are the symptoms?
The incubation period for rabies averages 20-40 days, but may be as short as 12 days. Rabies in humans is a three-stage disease.

Stage One: Symptoms include fatigue, lack of appetite, vomiting, low-grade fever, headache, irritability. These symptoms last a couple of days to two weeks.

Stage Two: In this stage, the nervous system is involved. Symptoms last two to seven days and include restlessness, agitation, difficulty swallowing, difficulty speaking and hallucinations.

Stage Three: The final phase lasts seven to 10 days. In this stage, the patient has painful muscle contractions in the throat, which causes a fear of swallowing. In the past, this was interpreted as a fear of water and rabies was called "hydrophobia." As the disease progresses, seizures, paralysis, breathing problems, coma and death occur.

How is rabies treated?
Because rabies is a life-threatening disease, treatment is essential for any questionable exposure. Treatment of rabies no longer consists of painful injections administered by long needles into the stomach every day for 14 days. The new vaccine is more potent and causes fewer side effects. The new rabies treatment only requires a total of five injections that are given on days 0, 3, 7, 14 and 28. Vaccine shots are given in the arm to adults and in the thigh to small children.

After a bite from a wild animal, call your physician. Rabies is not the only danger: If the wound is deep or large, stitches may be needed. Infection prevention and wound care is essential as well. A tetanus shot may be needed if the bite victim hasn't had a tetanus shot in the past 10 years.

How soon do you need to start treatment?
Treatment should be started as soon as possible after the bite. But there is no specific time limit for the treatment to be started. Obviously, the sooner treatment is started, the better. Domestic animals such as dogs and cats, if caught, can be observed for 10 days to see if symptoms of illness develop. If symptoms do not develop, it is unlikely that the animal had rabies. When there is a bite from an uncaptured wild animal with a high incidence of rabies, treatment should be started right away.

NOTE: Cat bites are unlikely to be a source of rabies but they do cause a high incidence of infection. Up to half of bites from cats can result in an infection due to the puncture wound. In case of a cat bite, it is a good idea to contact your physician for possible antibiotics.

Human bites are also a cause of infection. The human mouth is filled with bacteria and a bite can result in a nasty infection as well as a deep bite wound. Always see your physician after a human bite that breaks the skin.

 

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