World Rabies Day '09

September 28th is World Rabies Day Organisations around the world will be aiming to raise awareness and understanding about the importance of rabies prevention on the third annual World Rabies Day on 28 September.

Having had to go through the injections after my brush with a bat in UK behaving strangely that l was handling at work, there is rabies in some bats in the UK, and seen a dog shot back in Rhodesia when l was growing up. The dog was unknown on the tea plantation and so it’s was a risk. I am aware of the risks involved with rabies and they scare me.

What shocked me was the statistics of human deaths over 55000/year. At least 100 of the 150+ death a day are children.
Here are some personal stories of those who have had contact with rabies some died and others survived after post exposure treatment.

The following is from the BVA website.

“While we are used to discussing the risks of rabies to pets, most vets probably know much less about the risks of rabies to humans,” says Zoe Belshaw, a member of the BVA Overseas Group. “World Rabies Day is an ideal time to promote understanding of this devastating but preventable disease.”
It aims to dispel some common misconceptions – such as that a deep bite is necessary for the disease to be contracted. ‘A lick on broken skin or mucous membranes or a scratch from an infected animal is sufficient,’ it points out.

Rabies kills at least 55,000 people each year, half of whom are children under the age of 15. “Rabies is primarily a disease of children, who are particularly at risk from this terrible disease, due to their close contact with dogs, the major global source,” said Dr Deborah Briggs, Executive Director of the Alliance for Rabies Control. “Children are more likely to suffer multiple bites and scratches to the face and head, both of which carry a higher risk of contracting rabies. Children are often unaware of the danger that dogs transmit rabies and may not tell their parents when a bite, lick or scratch has occurred from an infected animal.” Many animals carry rabies not just dogs but it is dogs that people tend to focus on.

The World Rabies Day Alliance for Rabies Control initiative aims to bring together relevant partners in an effort to address rabies prevention and control. “This is a coordinated effort to let the world know that this disease can be readily prevented through education, pet vaccination and increased human awareness of proper wound management and administration of rabies vaccination after an exposure has occurred,” added Dr Briggs.

Very scary just how prevalent rabies is. The sites give info on how to deal with suspected contact and on just how it affects lives daily around the world. If you do not get post exposure treatment, rabies has a single outcome once it has manifested, and to get there is hell.

Remember that your family and friends are often jetting off to affected countries on trips and volunteer programmes, it may just affect you.

The gentleman depicted died from rabies in 1959, soon after the photo (courtesy of US CDC ) was taken.

Rabies

This is a rant. I ended my locum job yesterday for a medical reason that started about 3 years ago.

I went to my Dr to get a rabies vaccine course as l handle bats in the course of my work. In UK there is some rabies in the bat population, amount unknown but it is there in small pockets. I was told tough there is no vaccine available in the country until at least October. As it was February l had to shrug and leave it.
It was made clear by the nurse that l was not entitled to it anyhow and l would have to pay over £100 when it was, that is a lot of money when things are tight so l left it. Ok my fault for not pushing and demanding it free which other veterinary staff gets from their Dr’s but l dislike the people at my drs so l did not pursue it, l sort of felt my temper exploding and being banned from there so common sense (or not) made me back off.

Fast forward to 90 nights ago I was dealing with an injured bat. I had silicone gloves on but the bat was behaving “weirdly”. It launched it’s self in a furious attack at my finger not the normal fear attack l am used to. I dropped the blanket and bat on the floor and it attacked its self screaming.
I scrubbed my hands with soap and water and we put the bat to sleep. I shoved it into a sample bottle and l started to track down what to do in a possible rabies situation, as we had no protocol.

At 22:00 this is not easy but l did it, l have to admit l am impressed. Many thanks to The Health Protection Agency Manchester for getting the vaccine couriered from Liverpool to my local A & E, National Veterinary’s Labs (emergency line) The Consultant l rang at 23:30 (wont mention her name) but she had been involved in a Rabies case and was very helpful also gave me her name as a battering ram if l need to knock on doors or people. And several other emergency lines for phone numbers to ring.

And a raspberry to the idiot consultant at the Manchester Infectious Diseases Control who seriously told me that it was top secret on what needed to be done and l would have to go in while they assessed me. I am the one that told you where to place your head after it was boiled in a vat of overripe sewage then slammed the phone down.

Anyhow l had to have 3 injections on day “0” 2.5ml/thigh and one in the arm. The nurse then pressed the drug indications leaflets into my hands. The “thigh” one said human immunoglobin has been checked for, Aids/HIV, Hepatitis, gooney bird disease, and everything else (you see how the fun is getting going).
The arm vaccine was a different one that could cause from hives to anaphylactic shock, paralysis, death shock etc etc a wonderful list. Given the choice of possible rabies or them guess what l chose?

At regular intervals l have been back to have the arm vaccines (The 2 thigh ones were only needed once)I had one bad reaction with fever and badly swollen arm, another time a swollen arm. I go to A & E who were holding the vaccine at about 6:30am as it is quiet.

Last night due to working down Kenilworth l did not get there till 21:00 after a wonderful trip up the M6 in heavy traffic. The A & E was freezing the doors seemed stuck on open. The coffee machine was bust and the loo out of order. I decided to get a Dr Pepper l know it was a refrigerated machine but out comes a Dr Pepper zero, loaded under the normal Dr Pepper button. I can not stand zero or special sweeteners it is full fat and healthy or nothing. I slumped on the chair reading another Kelly Armstrong book.

Eventually l get called through and given a little cubicle at least it was warmer than the “arctic” the worried face of the sister dealing with it says “You did say the fridge in here minor injuries”?
“Yesss, well that’s where it was before but l did have the last 2 in the main section, l suppose they could have moved it”
Off she shot to look…. Nope not there, we looked at each other blankly. Off she went like a spaniel after a partridge.
Back she came again and said l rang the head pharmacist and she says it changed you only need 5 injections since 2007. I waved the insert leaflet. She read it muttered “you’re right 6” Off she sailed and l trudged along.

By now the 3 way conversation was going on passing me the phone passing it back to her talking to the head pharmacist. Upshot was the HP rang London infectious diseases control who said it was now 5 just the inserts had not been changed.
If they were wrong would l get a phone call and be told you have to have the whole lot again? I do not think the bat was rabid as NLA have never got back to anyone, they usually say if they do not then it is fine. Nice and vague you would think they would put peoples minds at rest.

I insisted get in writing l did not need inj. Number 6. (or 8 if you include the 2 in the thigh) and names of who said what. Nowadays l want pretty much everything in writing as l have a low opinion of the human race. I finally left for home at 23:30.

There is also the matter of one days pay lost and the feeling l let them down leaving a day early.
Yesterday just before we closed for the day they gave me a lovely card all signed and a bottle of South African wine. I had been there 2 months and they had become work family l was all dew eyed and lumpy throated.
3 traffic jams on the M6, freezing cold for 2 hours in A & E, no toilet, no Dr Pepper.

The A & E staff and HPA have been great, my rant is at the A & E Dr who confirmed l had to come back for 6inj. he should have checked as they did not know and had never in 10 years the sister had been there dealt with my situation
The people at my dr’s who said l basically did not count as important enough to have the vaccine when l was a priority and putting me at a lot more risk.
And finally at me for not doing my normal and chasing things down to the end degree and demanding the vaccine instead of getting caught out like l was.

I have applied and received paperwork through to see what’s involved in becoming an official bat handler. I do like them despite them causing a screw up in my life. Now l may as well do more to help the little gits!