New Mexico DOH: Novel Strain Of Rabies Detected In Rabid Fox

Credit - Rabies surveillance in the United States during 2009

 

# 10,070

 

 

Although it is less than comforting to think about, all viruses mutate.  Some - like influenza viruses - just do it faster than others. 

 

So we shouldn’t be terribly surprised to learn that a rabid skunk that bit a woman in New Mexico last April turns out to have carried a new strain of rabies, likely acquired from a bat. 

 

First the statement from the New Mexico Department of Health, after which I’ll return with a bit more on the diversity of rabies viruses in North America and around the world.

 

 

Rabid Fox from Lincoln County Has New Rabies Strain

May 19, 2015 - Zoonotic Disease - Disease

---

The New Mexico Department of Health (NMDOH) announced today that a rabid fox from Lincoln County that bit a woman on April 20 had a strain of rabies that has never before been identified. The genetic sequencing of the virus was done in the Rabies Laboratory at the Centers for Disease Control and Prevention (CDC) in Atlanta. The woman received a series of rabies vaccinations that has prevented her from developing rabies, which is usually fatal.

The “Fox Involved in Attack Tests Positive for Rabies” press release went out after initial testing on the fox at the NMDOH’s rabies laboratory was positive.

“We are working with the New Mexico Department of Game and Fish (NMDGF) and the CDC to increase surveillance in Lincoln County,” said Department of Health Cabinet Secretary Retta Ward, MPH. “We’ll be collecting dead foxes and bats found on the ground in Lincoln County and testing them for rabies. This new strain is related to other rabies strains found in bats.”

Children should be reminded that they should never touch a bat or other wild animal and that they should always report any contact with bats to their parents immediately. Rabies is fatal in humans but if you have been exposed to a rabid animal, it can be prevented with immediate treatment.

(Continue . . . )

 

Although only one or two people die each year in the  United States due to rabies, it remains a major killer around the globe, with the World Health Organization estimating that:

 

• Infection causes tens of thousands of deaths every year, mostly in Asia and Africa.
• 40% of people who are bitten by suspect rabid animals are children under 15 years of age.
• Dogs are the source of the vast majority of human rabies deaths.
• Immediate wound cleansing and immunization within a few hours after contact with a suspect rabid animal can prevent the onset of rabies and death.
• Every year, more than 15 million people worldwide receive a post-exposure vaccination to prevent the disease – this is estimated to prevent hundreds of thousands of rabies deaths annually.

With aggressive pet vaccination in the United States, dogs are no longer the most common route for exposure here.  Instead, in the Eastern United States raccoons are the biggest risk, while in the Southwestern states skunks, foxes, coyotes are more likely to carry the virus.

Medscape’s excellent overview of Rabies by Sandra G Gompf, MD, FACP, FIDSA further explains:

 

The only rodent in the United States that can carry rabies long enough to transmit it to humans is the groundhog. Other small rodents (eg, squirrels, chipmunks, rats, mice) and lagomorphs (eg, rabbits, hares) usually die before being able to transmit rabies virus to humans, and human disease has not been documented from these mammals.

 

A bit surprisingly, American opossums are considered to be at low risk for carrying rabies, as their lower body temperatures inhibit virus replication.  Who knew?  The article also addresses the ability of the rabies virus to mutate and adapt:

 

Rabies continues to adapt to new hosts and evolve transmissibility in previously “dead-end” hosts. In Arizona 2001, a mutated bat strain was confirmed to have developed both pathogenicity and transmissibility in both foxes and skunks, which previously were not seriously affected or contagious upon infection. Human encroachments into natural areas, as in suburban development, have been associated with the spread of rabies strains in the past.^[3]

 

The Arizona `mutated strain’  was well documented in the 2006 EID Journal Dispatch Bat-associated Rabies Virus in Skunks, which found:

 

Rabies was undetected in terrestrial wildlife of northern Arizona until 2001, when rabies was diagnosed in 19 rabid skunks in Flagstaff. Laboratory analyses showed causative rabies viruses associated with bats, which indicated cross-species transmission of unprecedented magnitude. Public health infrastructure must be maintained to address emerging zoonotic diseases.

 

In 2009, 8 years after its discovery, the National Geographic carried a report (see New, Fast-Evolving Rabies Virus Found -- And Spreading) was still spreading passively among the skunk population in Flagstaff. 

 

For more on all of this, including steps you can take to protect yourself and your pets, the Humane Society maintains an excellent resource on rabies (see Understanding Rabies), as does the CDC, which maintains an extensive Rabies Information Website.

France: MOH Issues Rabies Alert

Credit WHO

 

# 7929

 

Earlier this summer Taiwan announced the detection of rabies on that island, ending its rabies-free status which was declared in 1961 (see Taiwan’s Rabies Outbreak). Since then, the number of rabid animals detected has grown rapidly, numbering now well over 100.  

 

Similarly, France has been more-or-less rabies-free (with a 2 year suspension starting in 2008 due to a dog, imported from Morocco, that infected other dogs) since 2001 – at least in non-flying mammals (bats). The CDC’s Yellow book states: Bat lyssaviruses have been reported throughout Europe, including areas that are reportedly free of rabies in other wild mammals.

 

Today we are learning  that a rabid kitten has been discovered in Argenteuil, near Paris,  and that 5 people exposed are receiving rabies shots. An appeal has been made by France’s Le ministère des Affaires sociales et de la Santé (Ministry of Social Affairs and Health) for anyone who may have had contact with this kitten to immediately seek medical aid.

 

 

Cases of animal rabies in the Val d'Oise - search people and animals in contact

November 1, 2013

The Pasteur Institute confirmed October 31, 2013 a case of rabies in a kitten found on 25 October 2013, rue Marguerite in ARGENTEUIL. The animal died October 28, 2013.It's a kitten about 2 months tricolor: white, black and Tan (see photo).

An epidemiological inquiry has been initiated to identify and support the people who could have come into contact with this kitten between October 8 and October 28, included. This period corresponds to the period during which he could transmit the disease.

 

Five people who had been in contact with the kitten have already been identified.

 

They have been supported and directed to a rabies centre for preventive treatmen

• People who have been bitten, scratched, scratched or licked on mucous membranes (mouth, eyes...) or a skin injured by this kitten

• or that the animal would have been in contact with this kitten, between October 8 and October 28, 2013 included

must call soon 08 11 00 06 95

accessible local number between 10 H 00 and 18 H 00 hours from 1 November 2013-

• Similarly, anyone who would have information to give about this kitten or his eventual owner is invited to contact this number. |

It is extremely important to find all persons, including the owner, or the animals that were in contact with the kitten, the mother and the other kittens of the scope.

The France being free of rabies since 2001, this kitten here parent were imported from another country, not free.

Rabies, a disease that should be treated quickly.

Rabies is a fatal disease if not treated in time. It is transmitted for about 15 days before the appearance of the first symptoms of the disease in the animal.

In humans, the preventive treatment of rabies human, administered after contact with the carrier animal, but before the onset of symptoms, is very effective.

Reminder of important recommendations

• Any dog or cat or other carnivore having bitten or scratched a person, must be presented to a veterinarian by its owner within 24 hours of the injury.

The animal is the subject of a health surveillance by the veterinarian for 15 days;

• If bitten, immediately clean the wound with SOAP and water, rinse thoroughly and apply an antiseptic solution. It is essential to quickly consult a doctor, who will be able to according to the context guide the person bitten to a rabies centre.

• do not manipulate the wild animals or stray especially when they are found sick or wounded

 

Despite the availability of rabies prophylaxis and treatment shots, about 60,000 people die each year from the virus – mostly in Asia.   This from the World Health Organization’s  Rabies Fact Sheet.

 

Rabies

Fact Sheet N°99
Updated July 2013

---

Key facts

• Rabies occurs in more than 150 countries and territories.
• More than 55 000 people die of rabies every year mostly in Asia and Africa.
• 40% of people who are bitten by suspect rabid animals are children under 15 years of age.
• Dogs are the source of the vast majority of human rabies deaths.
• Wound cleansing and immunization within a few hours after contact with a suspect rabid animal can prevent the onset of rabies and death.
• Every year, more than 15 million people worldwide receive a post-exposure vaccination to prevent the disease– this is estimated to prevent hundreds of thousands of rabies deaths annually.

Queensland: Rare Australian Bat Lyssavirus Infection

Fruitbats In Australia – Credit Wikipedia

 

 

# 6939

 

 

Rabies - the best known of the Lyssaviruses - is believed responsible for roughly 55,000 deaths each year around the world.  

 

According to the World Health Organization rabies FAQ,  ` . . . rabies still poses a significant public health problem in many countries in Asia and Africa where 95% of human deaths occur even though safe, effective vaccines for both human and veterinary use exist’.

 

In Greek mythology, Lyssa was the Goddess of rage or madness, hence the adoption of name Lyssavirus for the genus that includes rabies, and others including the Australian bat lyssavirus (ABLV), Duvenhage virus, European bat lyssaviruses 1 and 2, and Lagos bat virus.

 

Australia is somewhat unique in that it is one of the few regions in the world where rabies has never been detected.  Others include New Zealand, Iceland, and the Hawaiian islands, while elsewhere rabies has been eliminated in a number of other countries.

 

Australia does have Australian Bat Lyssavirus (ABLV), which is a close cousin to the rabies virus.

First identified in 1996, ABLV is known to be carried by at least four varieties of flying foxes/fruit bats and one species of insectivore microbat in Australia (see MMWR  1996 Dispatch Encephalitis Caused by a Lyssavirus in Fruit Bats in Australia).

 

Up until this past week, only two human infections with ABLV have been reported, both fatal, and both in Queensland.  In one of those cases, symptoms did not appear until two years after the bat exposure, a phenomenon that has rarely been reported with rabies as well.

 

This week, we learn of a third case, an 8-year old boy who is in a coma in a Queensland hospital.

 

 

Queensland child critical after contracting deadly bat lyssavirus

• From: AAP
• February 15, 2013 3:28PM

AN eight-year-old Queensland boy is critically ill with a bat-borne virus that causes fits, paralysis and death.

 

(Continue . . .)

 

 

According to this article, this latest case, on top of the infrequent outbreaks of Hendra virus (see Queensland: A Hendra Watch & A New Vaccine) has already led to renewed calls for the culling of bats, a highly divisive topic in Australia.

 

There are many who fear that the indiscriminate culling of bats would simply increase human exposure to bat-borne viruses, and the loss of native bats could upset the ecological balance.

 

For now, the Australian government advises:

 

The best protection against being exposed to the virus is for members of the community to avoid handling any bat or flying fox.

 

The Australian Government’s Immunization Handbook has some extensive information on ABLV, its prophylaxis, and treatment.

 

3.1 Australian bat lyssavirus infection and rabies

Virology

Australian bat lyssavirus (ABL) and rabies virus are members of the family Rhabdoviridae, genus Lyssavirus. There are 7 known genotypes within the genus Lyssavirus; ABL (genotype 7) is more closely related to rabies virus (genotype 1) than any of the other 6 genotypes.

Clinical features

Based on the 2 recognised human cases of ABL infection, it has to be assumed that ABL has the same clinical features as rabies. The incubation period of rabies is usually 3 to 8 weeks, but can range from as short as a week to, on rare occasions, several years. The risk of rabies is higher, and the incubation period shorter, after severe and multiple wounds proximate to the central nervous system (such as on the head and neck) and in richly innervated sites (such as the fingers).

Typically, in the prodromal phase of rabies, which lasts up to 10 days, the patient may experience non-specific symptoms such as anorexia, cough, fever, headache, myalgia, nausea, sore throat, tiredness and vomiting. Paraesthesiae and/or fasciculations at or near the site of the wound may be present at this stage. Anxiety, agitation and apprehension may also occur.

Most rabies patients present with the furious or encephalitic form. In the encephalitic phase, objective signs of nervous system involvement include aerophobia, hydrophobia, bizarre behaviour, disorientation and hyperactivity. Signs of autonomic instability such as hypersalivation, hyperthermia and hyperventilation may occur.

 

The neurological status of the patient deteriorates over a period of up to 12 days, and the patient either dies abruptly from cardiac or respiratory arrest, or lapses into a coma. Rabies is almost invariably fatal.

Epidemiology

Rabies is endemic throughout much of Africa, Asia, the Americas and Europe, where the virus is maintained in certain species of mammals.

Australia, New Zealand, Japan, Papua New Guinea and Pacific Island nations are free of endemic rabies but it must be remembered that this can change at any time. For example in 2008, rabies was reported in dogs on the island of Bali, Indonesia. Prior to this, Bali was considered to be free of rabies although rabies was known to occur in other areas of Indonesia. Human rabies characteristically follows a bite from a rabid animal, most frequently a dog, but in some parts of the world, other animals, such as jackals and bats, are important sources of exposure. In countries where rabies vaccination of domestic animals is widespread (North America and Europe), wild animals such as raccoons and foxes are important reservoirs.

Cases of rabies after animal scratches, the licking of open wounds or saliva contact with intact mucous membranes are very rare. Cases have been recorded after exposure to aerosols in a laboratory and in caves infested with rabid bats, and cases have been reported following tissue transplantation from donors who died with undiagnosed rabies.

(SNIP)

In Australia, 2 cases of a fatal rabies-like illness caused by ABL have been reported, one in 1996 and the other in 1998.6 Both patients had been bitten by bats. Evidence of ABL infection has since been identified in all 4 species of Australian fruit bats (flying foxes) and in several species of Australian insectivorous bats. It should therefore be assumed that all Australian bats have the potential to be infected with ABL.