Tag Archives: Rabies

Things not to do with racoons

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From Scott Weese’s Worms and Germs Blog:

I’ll hold back and just classify this as “not a great idea.”

At least 21 people in Macon, GA, are undergoing rabies post-exposure prophylaxis after having contact with a rabid raccoon.

How do that many people get exposed to a single raccoon?

Step 1: Take a wild raccoon and try to make it into a pet

Bad idea and illegal most places (including Ontario).

Step 2: Take it to a “Raccoon or kitten event” (whatever that is) where the public gets to play with it.

That’s it.  But should be followed up by…

Step 3: Talk to your insurance company because tens (or  hundreds) of thousands of dollars of treatment may be required.

Thirty-seven (37) people who visited the event had been contacted at last report, and 33 were considered potentially exposed to rabies through contact with this raccoon. Twenty-one (21) are undergoing post-exposure prophylaxisso far, and presumably (hopefully) the rest will be treated soon. That’s why standard guidelines say that rabies reservoir species like raccoons should never be used for public contact events.  Wildlife should be left in the wild.

Travel-related foodborne illness

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A few years ago, my family and I embarked on a trip an all-inclusive resort in Mexico, a little get away from the hectic day to day musings in our lives. First day I decided to go for a jog  and was bitten by a wild dog travelling in a pack. I was shipped off to Cancun to start rabies postexposure prophylaxis. Second day, contracted norovirus. Third day almost left.

Colette Crampsey of the The Daily Record reports:

Reece Russell and John English both fell ill after eating at all-inclusive resorts in Cancun.
Two holidaymakers have told of their ordeals after being crippled by food poisoning bugs in Mexico.
Reece Russell, 28, was infected with salmonella, which led to inflammation around his heart.
And John English, 51, ended up in hospital with bacterial gastritis. He has been left with long-term health problems and has had to give up being a football coach.
Both men fell ill after travelling to all-inclusive resorts in Cancun.
Reece, from Dunfermline, went to the resort with his parents and sister in June.
He said: “About a week after I came home, I started falling very ill. I woke up at 1am with chest pains. In hospital, a blood test showed I had a high level of protein in my blood caused by possible heart attacks.”
Reece was diagnosed with myopericarditis –inflammation of the membrane and muscle around the heart. Tests showed salmonella was to blame.
He said: “The doctors implied that if I hadn’t gone to hospital when I did, it would have been significantly worse.” 
Engineer Reece, who stayed at the Bahia Principe, had to miss two weeks of work. He is seeking compensation from travel firm TUI.
John stayed at Moon Palace hotel with wife Janice and their two children in July.
After eating at a Brazilian restaurant, the Scottish Gas worker was violently sick and was whisked to hospital.
John said: “They told me my magnesium levels were very low. If that happens, your organs can shut down and you can die. It was quite frightening.”
The couple had to fork out £4000 for treatment and a further £1500 on John’s release the next day.
He said: “I’ve lost 2st and doctors have told me my blood pressure is through the roof. I could be on tablets for the rest of my life.
“I’m having to give up football coaching, which is very hard for me.”
A Thomas Cook spokesman said: “We are sorry to hear Mr English became ill. We advise customers to tell their rep or hotel staff immediately if they are unwell so they can get the right support.”
A spokesman for TUI said: “We will be contacting Mr Russell directly to review the matter.
“We regularly audit all of the hotels we feature in respect of health and safety, including hygiene.”

Rabies (maybe) from bats living in a sorority house, Indiana, 2017

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In February 2017, the Indiana State Department of Health (ISDH) was notified of bat exposures at a university sorority house. The initial complaint was made to ISDH because of concerns for food sanitation. Bats had been routinely sighted in shared living areas and hallways. ISDH, in consultation with the U.S. Centers for Disease Control, collaborated with the university and sorority to assess residents and staff members for potential rabies risk. In 2016, 4.3% of all bats tested in Indiana were positive for rabies. The longest incubation period recorded for indigenously acquired bat rabies is 270 days (1); therefore, out of an abundance of caution, ISDH conducted interviews with 140 students and eight employees who resided or worked in the sorority house during the preceding 12 months, all of whom were considered to have possibly been exposed. A web-based survey was administered in February to collect information about bat exposures, which was used to categorize all respondents into having a low, medium, or high risk for rabies exposure per CDC guidance (2).

Persons who reported a bite, scratch, or direct skin contact with a bat were categorized as having a high risk. Persons were categorized as having moderate risk if they reported waking and finding a bat in the same room where they were sleeping. Persons who reported no bat exposure were categorized as having a low risk. Respondents categorized as having a high or moderate risk had follow-up interviews in person or by telephone.

Among the 148 possibly exposed persons, 100 (68%) responded to the questionnaire, including 92 (66%) students and all eight employees; 94 respondents reported ever having seen a bat in the sorority house. Among those 94 persons, 70 (74%) reported having seen a bat within the previous 12 months, and 34 (36%) reported seeing a bat ≤1 month ago. Among respondents who reported ever having seen a bat in the sorority house, 13 (14%) were identified as having a moderate or high risk for rabies exposure, including 11 sorority members, one university employee, and one nonsorority member student. After follow-up interviews, nine of these 13 persons were reclassified as having a low risk for rabies exposure. The remaining four persons were considered to have a high (three persons) or a moderate (one) risk. All four persons received a recommendation for postexposure prophylaxis (PEP), which consists of human rabies immune globulin and a series of 4 doses of rabies vaccine. Two persons completed the PEP series during March 20–April 18, and two declined PEP because of a perceived lack of risk. No respondent had developed clinical rabies as of February 2018.

ISDH learned that bats had been roosting in the building for approximately 30 years. Commercial wildlife operators conducted an environmental investigation in March and identified multiple small openings between the house’s exterior wall and doorframe, which can serve as points of ingress or egress for bats. In addition, certain students reported hearing scratching behind a wall inside the house’s common space. This wall was scheduled to be removed as part of a house remodel during summer 2017. A commercial wildlife control operator repaired the openings and completed building remediation during this time. Students returned to the house in August 2017. No bat sightings have been reported since students returned.

This is the first reported instance of a mass bat exposure in a fraternity or sorority house. Multiple high-risk rabies exposures occurred in this sorority house, attributable to bat colonization of the building. The initial complaint to ISDH related to concerns for food sanitation, rather than rabies, is consistent with previous reports indicating an underappreciation of the health risks associated with indoor bat exposures (3). ISDH communicated the risk for rabies exposure at meetings with students and university housing directors. All bat exposure events should be reported immediately to public health officials, who can provide advice about rabies risk assessments and determination of the need for PEP.

Notes from the Field: Assessment of Rabies Exposure Risk Among Residents of a University Sorority House — Indiana, February 2017

Morbidity and Mortality Weekly Report; February 9, 2018; 67(5);166

Betsy Schroeder, DVM; Alex Boland, MPH; Emily G. Pieracci, DVM; Jesse D. Blanton, PhD; Brett Peterson, MD; Jennifer Brown, DVM

https://www.cdc.gov/mmwr/volumes/67/wr/mm6705a4.htm?s_cid=mm6705a4_e

Corresponding author: Betsy Schroeder, BSchroeder@cdc.gov, 814-248-5774.

1Epidemic Intelligence Service, CDC; 2Indiana State Department of Health; 3Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

References

De Serres G, Dallaire F, Côte M, Skowronski DM. Bat rabies in the United States and Canada from 1950 through 2007: human cases with and without bat contact. Clin Infect Dis 2008;46:1329–37. CrossRef PubMed

CDC. Assessment of risk for exposure to bats in sleeping quarters before and during remediation—Kentucky, 2012. MMWR Morb Mortal Wkly Rep 2013;62:382–4. PubMed

DeMent J, Trevino-Garrison I. Investigation of potential rabies exposure while attending a camp, Barton County, June 2010. Topeka, KS: Kansas Department of Health and Environment; 2010. http://www.kdheks.gov/epi/download/Bats_at_Camp_Final_Report.pdf

Rabid bat in salad: LGMA said anything?

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On April 3, 2017, two Florida residents consumed part of the same prepackaged salad before reportedly discovering the partial remains of a bat carcass in the salad. Bats are known reservoirs for rabies virus, which causes rabies disease in both animals and humans (1). The persons who ate the salad contacted the Florida Department of Health (FLDOH), which notified CDC’s Poxvirus and Rabies Branch. CDC and FLDOH determined that the immediate concern was for potential rabies virus exposure, because approximately 6% of bats submitted to U.S. public health departments annually test positive for rabies virus (2,3).

Grey Headed Flying Fox (Pteropus poliocephalus)

(This is an Australian flying fox, left; everything is bigger here.)

Although percutaneous exposures are more likely to result in successful transmission of rabies virus to humans (1), transmission can occur when infectious material, such as saliva or nervous tissue from an infected animal, comes into direct contact with human mucosa (2). Infection with rabies virus causes an acute, progressive encephalitis that is nearly always fatal once clinical signs have begun. The disease is preventable if exposed persons receive timely postexposure prophylaxis (PEP), which includes human rabies immunoglobulin and 4 doses of inactivated rabies vaccine administered over 14 days (4).

FLDOH submitted the bat carcass to CDC for rabies virus testing on April 4. Polymerase chain reaction and direct fluorescent antibody tests were inconclusive because of the deteriorated condition of the carcass. However, because the cranium of the bat was intact, exposure to brain material by the persons who consumed the salad was unlikely, although exposure to the bat’s organs or peripheral nervous tissue was possible. PEP was recommended because laboratory test results were inconclusive and exposure to nervous tissue could not be ruled out.

The salad was purchased from a company A store location. After being notified of the investigation, company A removed the lot of prepackaged salad from all store locations on April 5. Company B (the prepackaged salad supplier) recalled the affected lot of salads on April 8. CDC advised consumers to contact their local health department for PEP evaluation only if the consumer had eaten a recalled prepackaged salad and had found animal material in the salad. CDC was not notified of any other reports of dead bats in prepackaged salads.

To identify where the bat might have been introduced into the prepackaged salad, CDC performed genetic analyses on the bat to determine its subspecies. Based on morphology and phylogenetic analyses (Bayesian inference and haplotype network analyses) of mitochondrial DNA sequence data (Cytb and D-loop), the bat was identified as a Mexican free-tailed bat (Tadarida brasiliensis mexicana), which is found throughout the southwestern United States. It is genetically distinct from T. brasiliensis cynocephala, which occurs in the southeastern United States (Figure) (5).

The investigation determined that cutting and harvesting of greens for the recalled salad occurred in fields in the west and southwest United States before they were transported to a processing plant in Georgia. At the processing plant, the greens were washed with chlorinated water and packaged. Given the physical condition of the bat (e.g., decomposed, bisected) and the geographic location of the fields and the processing plant, along with the genetic identification of the bat, investigators concluded the bat most likely came into contact with the salad material in the field during harvesting and cutting and was then transported to the processing facility.

Several factors likely reduced the risk for rabies virus transmission to the two Florida consumers. No rabies virus was detected in the specimen, the bat’s cranium was intact, and the salad was rinsed before packaging, thereby diluting any potential virus. In addition, mucosal membrane exposures have rarely been proven to result in rabies disease, and rabies virus does not survive more than a few days outside a host (2). Although this exposure was likely of low risk, this investigation was an example of effective industry and government collaboration to remove a product of concern from the marketplace rapidly to protect consumers.

‘Notes from the Field: Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containing a Bat Carcass — Florida, 2017

Weekly / October 27, 2017 / 66(42);1154–1155, Vikram Krishnasamy, MD1,2; Matthew R. Mauldin, PhD3; Matthew E. Wise, PhD2; Ryan Wallace, DVM3; Laura Whitlock, MPH2; Colin Basler, DVM2; Clint Morgan, MS3; Dana Grissom4; Sherry Worley4; Danielle Stanek, DVM5; Jamie DeMent, MNS5; Pamela Yager3; William Carson3; Rene E. Condori, MS3; Yoshinori Nakazawa, PhD3; Claire Walker3; Yu Li, PhD3; Christopher Wynens, DVM6; Allison Wellman, MPH6; James Ellison, PhD3; Emily Pieracci, DVM

https://www.cdc.gov/mmwr/volumes/66/wr/mm6642a7.htm?s_cid=mm6642a7_w

‘We meet all standards’ Fresh Express uses Pinto defense after dead bat found in salad

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The U.S. Centers for Disease Control and Prevention (CDC) are working with the Florida Department of Health and the U.S. Food and Drug Administration (FDA) to support an investigation of a dead bat that was found in a packaged salad purchased from a grocery store in Florida. Two people in Florida reported eating some of the salad before the bat was found. The bat was sent to the CDC rabies lab for laboratory testing because bats in the United States sometimes have been found to have this disease. The deteriorated condition of the bat did not allow for CDC to definitively rule out whether this bat had rabies.

Transmission of rabies by eating a rabid animal is extremely uncommon, and the virus does not survive very long outside of the infected animal. CDC is supporting Florida local and state health officials in evaluating the people who found the bat in the salad. In this circumstance, the risk of rabies transmission is considered to be very low, but because it isn’t zero, the two people who ate salad from the package that contained the bat were recommended to begin post-exposure rabies treatment. Both people report being in good health and neither has any signs of rabies. CDC is not aware of any other reports of bat material found in packaged salads.

On April 8, 2017, Fresh Express issued a recall of a limited number of cases of Organic Marketside Spring Mix. The salads were sold in a clear container with production code G089B19 and best-if-used-by date of APR 14, 2017 located on the front label. The recalled salads were distributed only to Walmart stores located in the Southeastern region of the United States. All remaining packages of salad from the same lot have been removed from all store locations where the salad was sold.

The company said in a statement it worked quickly with officials to remove the entire batch of salads from store shelves, and only one line of its products had been affected.

“Fresh Express takes matters of food safety very seriously and rigorously complies with all food safety regulations including the proscribed Good Agricultural Practices.”

Maybe install bat filters as the lettuce goes through a wash?

Stress relief? Couldn’t uni kids just have sex? Who decided a bear cub that bit students should be part of a university petting zoo?

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Oh Missouri, how I do not miss you, and your petting zoos that feature a bear cub.

Former student and future veterinarian Gonzalo said next it will be petting zoos with skunks, raccoons and bats, because they are all cute.

bear.cub(There’s been a dead flying fox, or bat, decomposing on the road where daughter Sorenne and I walk every day and it has provided many a moment for us to discuss zoonoses.)

The Missouri take on this story is that a bear cub that nipped students at Washington University was not rabid and will not be euthanized, officials of the St. Louis school said Friday.

The 18 students who sustained skin-breaking bites have been notified they will not need rabies vaccinations.

The petting zoo had been allowed on campus as a stress reliever for students during finals week. Besides the small bear, named Boo Boo, it included a variety of animals, such as goats and a baby pig.

Several students held and cuddled the bear. It nipped at some of them, university spokeswoman Susan Killenberg McGinn said Friday.

The bear was born in the wild and was part of a petting zoo operated by Cindy’s Zoo in Moscow Mills, Missouri. A message left Friday with owner Cindy Farmer was not returned.

Famous Fox bitten by rabid cat

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My friend and hockey playing rival, Scott Weese (I played goalie, he could score) has gotten the hang of combining pop culture with the topics of interest when writes in his Worms & Germs Blog about former British pop star and I’m a Celebrity-Get Me Out of Here reality TV character Samantha Fox, who was bitten by a rabid cat while vacationing in Thailand. Fox was feeding stray cats near a restaurant and was attacked.

"The treatment for rabies makes you feel sick and horrible, though, really fluey and shaky." Usually, the post-exposure treatment isn’t too bad (I can speak from experience here) and current rabies vaccines tend to have a much lower rate of side effects than older vaccines. Fear of adverse effects shouldn’t be a deterrent to proper treatment of this almost invariably fatal disease.

Montana mom brings rabid bat to school, 90 kids to get rabies shots

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About 90 children at Stevensville Elementary School in Montana have started a series of six shots of anti-rabies vaccine after a local schoolmom gave show-and-tell-and-touch presentations in five classrooms involving a dead bat.

The bat was subsequently confirmed to be diseased.

School officials say they will use liability insurance to pay up to $70,000 for the exposed children to be vaccinated. The overall cost could surpass $150,000.

The school has since set a policy requiring that anyone visiting the school obtain a visitor pass.

Rabies outbreak in Toronto

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Reuters is reporting that a rabies alert was sent across Canada Monday after a puppy sold at a Toronto-area flea market tested positive, the first outbreak of rabies in the Toronto area in more than 20 years.

Toronto health officials said the eight-week-old border collie, which has died, was from a group of 12 puppies at the market. The other 11 dogs are under quarantine.

The mother of the border collie, from a farm in Eastern Ontario, has also died after contacting the virus from a rabid skunk.

Howard Shapiro, associate medical officer of health at Toronto Public Health, said at least 80 Toronto-area people, who came in contact with the animals, have had to get rabies shots. More than 900 people have contacted a hotline set up since the disease was found in one of the animals.