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Disease is rare because of public health prevention and follow-up

A southern Missouri man has died from rabies after being bitten by a bat in mid-October, the Missouri Department of Health and Senior Services reported today.

According to the department the man was reportedly bitten on the left ear by a bat. He did not seek treatment or report the incident at the time, and became ill November 19. Rabies was suspected after doctors were informed about the patient’s bite history and he began to show symptoms consistent with the disease. On November 25, specimens sent to the Centers for Disease Control and Prevention were confirmed positive and typed as a variant of the rabies virus associated with silver haired and eastern pipistrelle bats. The 55-year-old man died November 30. Rabies in humans remains rare, however rabies is almost always fatal once symptoms begin.

State health officials are working closely with the local health department to identify other individuals who might have had contact with the rabid bat or close contact with the patient. Rabies is not spread among people by casual contact. There are no documented cases of person-to-person transmission of rabies in the United States other than a small number of cases associated with organ and corneal transplants. Currently, five individuals who might have had contact with the bat or the patient are receiving rabies treatment to prevent rabies.

“Unfortunately this sad case is an important reminder that people need to avoid contact with wild animals, and need to report wild-animal bites to health officials to determine if they are at risk,” said Dr. Howard Pue, State Public Health Veterinarian.

Pue said that while the disease is very rare in humans, it is not uncommon in wild animals in Missouri, particularly in bats and skunks. He said that Missouri has seen a larger number of rabid wild animals this year. So far in 2008 the department has reports of 61 rabid animals: 55 bats, five skunks, and one horse. That compares to an average of 54 total animals as of this date over the past 5 years, with an average of 42 bats and 10 skunks for the same time period.

The last human rabies case recorded in Missouri was in Pulaski County in 1959, according to Pue. He said that aggressive follow-up by public health officials of people bitten by animals, effective control of stray and wild animals by animal-control agencies, vaccination of dogs and cats against rabies, and a more effective anti-rabies regimen available for use by medical professionals have all helped to make rabies in people so rare. The United States has about one to three cases of rabies in people each year.

“It is important that anyone bitten by a wild animal or a domestic animal, particularly a stray, should report the incident to their medical provider to receive appropriate wound care, antibiotics and tetanus vaccination as needed, as well as a rabies risk assessment,” Pue said. He said the anti-rabies series of shots is very effective in preventing rabies if administered before symptoms begin. However, once the person bitten shows signs of rabies, death is almost a certainty.

Pue said people need to take precautions to prevent animal bites and possible exposure to rabies, including:

· Vaccinating dogs and cats against rabies.
· Reporting wild animals exhibiting unusual behavior and stray pets to animal-control officials.
· Keeping pets under control and not allowing them to come in contact with wild animals.
· Avoiding direct contact with wild animals and stray pets.
· Preventing bats from entering occupied spaces in homes, churches, schools, and other similar areas, where they might come in contact with people and pets. A bat found inside a home should not be released or discarded, particularly if it was present in a room where people were sleeping or in the same room with children or adults who, due to their health or age, may not be able to describe the extent of their exposure. Instead, an attempt should be made to confine the bat to the room in which it was discovered and the local health department or animal control agency should be contacted to get information regarding what to do with it.