Rabies: Officials urge vaccination

The puppies never had a chance, and the family did only what they could do.

"In all our years on the farm, we've never seen so many skunks," said the warp-speed, always-on-the-go rural woman whose family of five was forced this summer to undergo vaccinations for rabies after a rabid skunk attacked newborn puppies.

The ordeal started when their mama dog went into labor, and in the pen, "Deb" (not her real name) and her husband discovered a dead skunk that the mother dog had obviously just killed, and several brand-new puppies.

"Three puppies had puncture wounds," Deb said, and their veterinarian told them to dispose of the puppies immediately. The mother dog continued to have seven more puppies.

Three weeks later, on one of the hottest days of the summer, one of the puppies appeared to be in distress. "It was hot, hot," Deb said. "So we thought the puppy might be dehydrated. But it couldn't walk and kept falling to the left. It had a funny squeak, but it couldn't bark."

She took a deep breath, sighed, "It was so sad."

Deb took the puppy to the vet, where it was put down and tested for rabies. "In less than 24 hours, it tested positive," Deb sad.

The vet told the family that all the puppies had to be put down, Deb said, even those not born when the skunk was in the pen and alive. The rabies virus is transmitted through saliva, Deb said, and the infected puppy had shared nipples with and slobbered on its siblings. There's no definitive test to check for the presence of rabies, she said. Vets can quarantine the possibly-affected animal, monitor the blood work and watch for changes, she said.

Deb's nephew's puppy suffered the same fate as Deb's litter. He got in a fight with a skunk (at a different rural area of Southwest Nebraska). The skunk tested positive for rabies and the family was almost certain that the puppy -- too young to have had his rabies vaccine yet-- had been bitten, although they couldn't find puncture wounds.

"They were pretty sure that he had been bitten," Deb said, "because he came back to them and was afraid of the skunk after that." The puppy would have had to have been quarantined for six months to rule out exposure to rabies through a bite and saliva. "No human contact whatsoever for six months ... " Deb said. " ... coveralls, leather gloves ... absolutely no human contact." To a family who loves its dogs, that method bordered on cruelty to an active, lovable pup, Deb said, so her nephew's family put the puppy down rather than quarantine him for six months.

Deb's puppies were also too young to have been vaccinated, or quarantined, so they had to be put down, Deb said. One of her daughters was especially fond of the puppies, spending hours with the little critters; she was devastated by having to put the puppies down.

Mama and daddy dog have had their rabies vaccinations, so they are safe from infection. But, for a time, they still have to be quarantined when anyone other than the family comes onto the farmstead, Deb said.

The next big skunk-scented blow came when the family learned that anyone who had come in contact with the litter of puppies would have to undergo a series of rabies vaccinations. "Luckily, it was just our immediate family," Deb said.

The family's doctor contacted the state department of health, which, because of a shortage of vaccine, determines if exposure circumstances warrant receiving the vaccine, Deb said. "The state approved our receiving the vaccine," she said.

As outpatients at the hospital, family members each received one dose of human rabies immunoglobulin (HRIG) and five doses of rabies vaccine (dosage determined by patient's weight) over 28 days. The first dose of rabies vaccine must be given as soon as possible after exposure.

The vaccinations weren't as bad as the family feared. "They're not really that bad," Deb said. They're administered in the butt or thigh, not with a long needle in the stomach as in the past, she said.

The vaccinations cost the family $40,000, all but $11,000 covered by insurance.

"It's a huge expense," Deb said, a big advocate for rabies vaccinations for puppies as young as possible. "Think about it -- such an inexpensive vaccinations to prevent a lot of trouble. Compare an inexpensive vaccine to $40,000 ... "

The family's vet told they couldn't have done things much differently. "The puppies were just born," Deb said. "And skunk puncture wounds are so very tiny."

"He said we could have put the whole litter down immediately," she said, eliminating the transfer of the virus among the puppies and ultimately to the family.

"The whole thing has been a huge awakening," she said.

"We've killed 11 skunks this year," Deb said. "We've never seen so many in all our years on the farm -- within a mile of the house, in broad daylight, by the house, in the pasture, on the road. We've never seen skunks like this before."

"Skunks are becoming so aggressive," she said.

She chuckled, "It's been great practice for 4-H shooting sports."

Dr. Wayne Watkins, a McCook veterinarian but not the one consulted by Deb's family, said that cats and raccoons are also common carriers of rabies. "Lots of cats are loose. They're roamers, hunters; their chances of being exposed to rabies are greater," Dr. Watkins said. "Our dogs are generally well protected, and penned up, yet they still need to be protected from rabies."

All family pets, especially cats and farm pets who are exposed more often to wild animals, need to be vaccinated against rabies, he said. Dr. Watkins strongly encourages rabies vaccinations even for kittens and cats whose owners intend them to be "indoor-only cats." "At a minimum, an indoor cat needs a rabies vaccination," he said.

Puppies and kittens can get their first rabies vaccinations, good for one year, at 12 weeks. After another vaccination at one year, protection from rabies is good for three years.

Dr. Watkins also warns parents to tell their children not to try to befriend a stray or ferrel cat. "Be cautious. You don't know what its vaccination status is," he said.

Dr. Watkins repeated Deb's caution. "It's a very inexpensive vaccine. And rabies is a non-treatable virus."

According to the Centers for Disease Control and Prevention, rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The vast majority of rabies cases reported to the CDC each year occur in wild animals like raccoons, skunks, bats, and foxes. Domestic animals account for less than 10% of the reported rabies cases, with cats, cattle, and dogs most often reported rabid.

Rabies virus infects the central nervous system, causing encephalopathy and ultimately death. Early symptoms of rabies in humans consist 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, hyper-salivation, difficulty swallowing and hydrophobia (fear of water). Death usually occurs within days of the onset of symptoms.

The CDC reports that the first symptoms of rabies may be flu-like -- lack of energy, fever or headache -- and may last for days. There may be discomfort or paresthesia (abnormal sensation or prickling) at the site of the bite or scratch, progressing within days to symptoms of cerebral dysfunction, anxiety, confusion and agitation progressing to delirium, abnormal behavior, hallucinations and insomnia. The acute period of disease typically ends after two to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal.

To date, only six documented cases of human survival from clinical rabies have been reported.

The Rensselaer County, New York, county health department has developed this list of ways people can protect themselves and their family pets against rabies:

* Be sure pet dogs, cats and ferrets are up-to-date on their rabies vaccinations. Vaccinated pets serve as a buffer between rabid wildlife and man. Vaccines for dogs, cats and ferrets at three months of age are effective for a one-year period. Revaccinations are effective for up to three years.

* Pets too young to be vaccinated should be kept indoors.

* Keep family pets indoors at night. Don't leave them outside unattended or let them roam free.

* Don't feed, touch or adopt wild animals, stray dogs or cats. Don't try to separate fighting animals.

* Don't attract wild animals to your home or yard. Keep your property free of stored bird seed or other foods that may attract wild animals. Feed pets indoors. Tightly cap or put away garbage cans. Board up any openings to your attic, basement, porch or garage. Cap your chimney with screens.

* Encourage children to immediately tell an adult if they are bitten by any animal. Tell children not to touch any animal they do not know.

* If a wild animal is on your property, let it wander away. Bring children and pets indoors, and alert neighbors and law enforcement officers or wildlife control officer.

* Report all animal bites or contact with wild animals to your county health authority, law enforcement officials and health care professionals. Try to capture/restrain an animal that has possibly exposed someone to rabies.