Thursday, October 25, 2007

Rabies on the Rise in Minnesota?

From a communication via the MN Dept. of Health...
Sent: Thursday, October 25, 2007 12:22 PM
To: Barbara Bishop
Subject: Minnesota Department of Health Eliminating Health Disparities Initiative Grantees 2006-2007 Update

Time-sensitive : Rabies death (#22485)

Oct 23, 2007 1:56:48 PM

Time-sensitive:Rabies death
Forward this information on to healthcare providers, clinics, and hospitals in your jurisdiction.

Minnesota's second case of human rabies in seven years has prompted state health officials to remind Minnesota residents to seek immediate medical attention if they have had contact with a bat. A man in his 40s who was exposed to a bat in north-central Minnesota in mid-August died Saturday, Oct. 20, the Minnesota Department of Health (MDH) reported today.

Officials at MDH believe the man was infected with the rabies virus after being bitten by a bat sometime in mid-August; although he reportedly felt a "needle-prick," he did not believe he was bitten because no blood was drawn. He did not seek medical care immediately following the incident.

The diagnosis of rabies was confirmed Thursday, Oct. 18, based on testing done by the Centers for Disease Control and Prevention (CDC) in Atlanta.

MDH is working with several health care facilities where the man was given care to evaluate whether any health care workers may have been exposed to his saliva and need prophylaxis to prevent rabies infection.

Rabies in humans is rare in the U.S., with only one to three cases reported each year. The CDC confirmed three human cases in 2006.

Only four other cases have been reported in Minnesota during the past century. Previous cases occurred in 1917, 1964, 1975, and 2000; all were fatal.

"Two deaths in seven years is too many," said Ruth Lynfield, State Epidemiologist and Medical Director for Infectious Disease at MDH. "What is most saddening about these deaths is that they could have been prevented with prompt medical attention following exposure."

The number of rabies-related human deaths in the U.S. has declined from more than 100 annually in the early 1900's to one to three per year more recently. Modern day prophylaxis has proven nearly 100 percent effective at preventing the disease. However, treatment must be started before symptoms of rabies appear; once a person develops symptoms, the illness is almost always fatal.

This most recent Minnesota case underscores the importance of seeking prompt medical attention if you are bitten by or may have been exposed to an animal that could be infected with rabies, according to MDH officials.

Bat exposures pose a special problem because bat bites are difficult to see and may not be noticed. If you have any physical contact with a bat, the bat should be captured and tested for rabies and medical advice should be sought. Additionally, if a bat is found in a room with an unattended child, a sleeping person, or anyone who cannot reliably communicate what happened, the bat should be captured and tested for rabies. Most recent cases of rabies in humans in the U.S. have been due to bat bites that were not recognized or reported.

People who may have been exposed to the rabies virus are given an injection of rabies immune globulin, and five doses of rabies vaccine, given over a one-month period. Treatment is unnecessary if the suspect animal can be captured, tested, and found to be free of the virus. In the case of dogs, cats or ferrets, treatment can often be avoided if the animal is held for observation, and remains healthy for 10 days following the bite.

Dr. Joni Scheftel, State Public Health Veterinarian, is also reminding people that they should get their household pets immunized against rabies. Rabies shots are available for dogs, cats and ferrets.

People with concerns about possible exposure to rabies, or questions about the disease, can call MDH at (651) 201-5414 during normal business hours.

Mitchell Davis, Jr., Director
Office of Minority and Multicultural Health
MN Department of Health
625 N. Robert Street
St. Paul MN 55164-0975
(P) 651.201.5818
(F) 651.201.4986