2007 Rabies Risk

The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild carnivores (raccoons, skunks, and foxes) and bats, but any mammal can get rabies. Small rodents (such as squirrels, rats, mice, hamsters, guinea pigs, gerbils, and chipmunks) and lagomorphs (such as rabbits and hares) are almost never found to be infected with rabies and have not been known to cause rabies among humans in the United States. However, from 1985 through 1994, woodchucks accounted for 86% of the 368 cases of rabies among rodents reported to CDC. Exceptions abound in the natural world.

Risk: In the1990's, the number of rabies-related human deaths in the United States was only one or two per year. The precise number of rabies postexposure prophylaxis (PEP) treatments in the United States is unknown, but is estimated to be approximately 40,000. Therefore, the estimated risk of dying from rabies in the United States is very small.

Although non-bite exposures to rabies are very rare, we put ourselves at risk by handling roadkill animals which we do not know is infected, say in a hide-tanning class. It is possible that our scratches, abrasions, open wounds, or mucous membranes (i.e., eyes, nose, mouth) could become contaminated with saliva or other potentially infectious material (such as brain tissue) from a rabid animal. Other contact, such as petting a rabid animal or contact with the blood, urine or feces (e.g., guano) of a rabid animal, does not constitute an exposure and is not an indication for prophylaxis.

According to the Centers for Disease Control and Prevention (CDC), rabies virus infects the central nervous system, causing encephalopathy and ultimately death. Early symptoms of rabies in humans are nonspecific, consisting of fever, headache, and general malaise. As the disease progresses, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of symptoms.

Here's the rub... There is no approved treatment for rabies after symptoms of the disease appear. You must determine ahead of time if there is a possible exposure and the need for postexposure prophylaxis. 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.

There is a new experimental treatment recently discovered for individuals that do not get the PEP shots in time. This treatment requires a very risky week long or more induced coma to allow the human immune system to catchup with the virus without the brain activated systemic shutdown that normally kills the patient. But, there is only one person who has been treated in this way and it was by chance this treatment was discovered.