Animal Bites

Rabies is a viral disease that causes progressive and fatal inflammation of the brain and spinal cord. The disease is rare in humans in the United States, with fewer than 10 deaths reported each year. Still, rabies poses a serious public health threat, because of its high death rate in people. 

In the United States, more than 90% of reported cases of rabies in animals occur in wildlife. Contact with infected bats is the leading cause of human rabies deaths in this country; at least 7 out of 10 Americans who die from rabies in the US were infected by bats.

The animals most often found with rabies in the U.S. include:

• bats
• raccoons
• skunks
• foxes

Transmission
Rabies is spread when an infected animal, usually wild, bites or scratches other animals or people. The virus is usually carried in saliva or mucus and spreads through broken skin.

The Infectious Path of Rabies Virus

1. Raccoon is bitten by a rabid animal.
2. Rabies virus enters the raccoon through infected saliva.
3. Rabies virus spreads through the nerves to the spinal cord and brain. 
4. The virus incubates in raccoon's body for approximately 3-12 weeks. The raccoon has no signs of illness during this time. 
5. When it reaches the brain, the virus multiplies rapidly, passes to the salivary glands, and the raccoon begins to show signs of disease. 
6. The infected animal usually dies within 7 days of becoming sick. 

Signs & Symptoms

After a rabies exposure, the rabies virus must travel to the brain before it can cause symptoms. This time between exposure and the appearance of symptoms is the incubation period, and it may last for weeks to months.

The first symptoms of rabies may be like the flu, including weakness or discomfort, fever, or headache. There also may be discomfort, prickling, or an itching sensation at the site of the bite. These symptoms may last for several days. Usually, severe disease appears within two weeks of the first symptoms, when the rabies virus causes brain dysfunction. Common signs include anxiety, confusion, agitation, and hallucinations.

Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.

More Information: Centers for Disease Control (CDC)

Post-exposure prophylaxis
For people who have never had a rabies vaccine, rabies PEP consists of wound washing, a dose of human rabies immune globulin (HRIG), and a rabies vaccine given at the time of the first medical visit. Then, it includes a dose of vaccine given again on days 3, 7, and 14 after the first dose.

What to do after a possible exposure
If you are exposed to a potentially rabid animal, wash the wound thoroughly with soap and water, and seek medical attention immediately. A health care provider will care for the wound and will assess the risk for rabies exposure. The following information will help your health care provider assess your risk:

• The geographic location of the incident
• The type of animal that was involved
• How the exposure occurred (provoked or unprovoked)
• The vaccination status of animal
• Whether the animal can be safely captured and tested for rabies

Steps taken by the health care practitioner will depend on the circumstances of the bite. Your health care practitioner should consult state or local health departments, veterinarians, or animal control officers to make an informed assessment of the incident and to request assistance. The important factor is that you seek care promptly after you are bitten by any animal.

Keep vaccinations up-to-date for all dogs, cats and ferrets. This requirement is important not only to keep your pets from getting rabies, but also to provide a barrier of protection to you, if your animal is bitten by a rabid wild animal.
Keep your pets under direct supervision so they do not come in contact with wild animals. If your pet is bitten by a wild animal, seek veterinary assistance for the animal immediately.

Call your local animal control agency to remove any stray animals from your neighborhood. They may be unvaccinated and could be infected by the disease.

Spay or neuter your pets to help reduce the number of unwanted pets that may not be properly cared for or regularly vaccinated.

Avoid direct contact with unfamiliar animals
Enjoy wild animals (raccoons, skunks, foxes) from afar. Do not handle, feed, or unintentionally attract wild animals with open garbage cans or litter.

Never adopt wild animals or bring them into your home. Do not try to nurse sick animals to health. Call animal control or an animal rescue agency for assistance.

Teach children never to handle unfamiliar animals, wild or domestic, even if they appear friendly. "Love your own, leave other animals alone" is a good principle for children to learn.

Prevent bats from entering living quarters or occupied spaces in homes, churches, schools, and other similar areas, where they might come in contact with people and pets.

When traveling abroad, avoid direct contact with wild animals and be especially careful around dogs in developing countries. Rabies is common in developing countries in Asia, Africa, and Latin America where dogs are the major reservoir of rabies. Tens of thousands of people die of rabies each year in these countries. Before traveling abroad, consult with a health care provider, travel clinic, or your health department about the risk of exposure to rabies, pre-exposure prophylaxis, and how you should handle an exposure, should it arise.

Why should I learn about bats and rabies?
Most of the recent human rabies cases in the United States have been caused by rabies virus from bats. Awareness of the facts about bats and rabies can help people protect themselves, their families, and their pets. This information may also help clear up misunderstandings about bats.

When people think about bats, they often imagine things that are not true. Bats are not blind. They are neither rodents nor birds. They will not suck your blood -- and most do not have rabies. Bats play key roles in ecosystems around the globe, from rain forests to deserts, especially by eating insects, including agricultural pests. The best protection we can offer these unique mammals is to learn more about their habits and recognize the value of living safely with them.

How can I tell if a bat has rabies?
Rabies can be confirmed only in a laboratory. However, any bat that is active by day, is found in a place where bats are not usually seen (for example, in a room in your home or on the lawn), or is unable to fly, is far more likely than others to be rabid. Such bats are often the most easily approached. Therefore, it is best never to handle any bat.

What should I do if I come in contact with a bat?
If you are bitten by a bat -- or if infectious material (such as saliva) from a bat gets into your eyes, nose, mouth, or a wound -- wash the affected area thoroughly and get medical advice immediately. Whenever possible, the bat should be captured and sent to a laboratory for rabies testing (see: How can I safely capture a bat in my home?).

People usually know when they have been bitten by a bat. However, because bats have small teeth which may leave marks that are not easily seen, there are situations in which you should seek medical advice even in the absence of an obvious bite wound. For example, if you awaken and find a bat in your room, see a bat in the room of an unattended child, a sleeping, mentally impaired or intoxicated person, try to safely contain the bat using the safety precautions listed below. This is a potential exposure and should be reported. To report a bat exposure use the bite form or call our office during business hours. If the bat has died, use gloves to put it in a secure container and keep it cool but not frozen so it can be tested for Rabies. Seek medical advice.

People cannot get rabies just from seeing a bat in an attic, in a cave, or at a distance. In addition, people cannot get rabies from having contact with bat guano (feces), blood, or urine, or from touching a bat on its fur (even though bats should never be handled!).

What should I do if my pet is exposed to a bat?
If you think your pet or domestic animal has been bitten by a bat, contact a veterinarian or the Environmental Health Division for assistance immediately and have the bat tested for rabies. Remember to keep vaccinations current for cats, dogs, and other animals.

How can I keep bats out of my home?
Some bats live in buildings, and there may be no reason to evict them if there is little chance for contact with people. However, bats should always be prevented from entering rooms of your home. For assistance with "bat-proofing" your home, contact an animal-control or wildlife conservation agency. If you choose to do the "bat-proofing" yourself, here are some suggestions. Carefully examine your home for holes that might allow bats entry into your living quarters. Any openings larger than a quarter-inch by a half-inch should be caulked. Use window screens, chimney caps, and draft-guards beneath doors to attics, fill electrical and plumbing holes with stainless steel wool or caulking, and ensure that all doors to the outside close tightly.

Additional "bat-proofing" can prevent bats from roosting in attics or buildings by covering outside entry points. Observe where the bats exit at dusk and exclude them by loosely hanging clear plastic sheeting or bird netting over these areas. Bats can crawl out and leave, but cannot re-enter. After the bats have been excluded, the openings can be permanently sealed. For more information about "bat-proofing" your home, contact Bat Conservation International.

Things to remember when "bat-proofing"
During summer, many young bats are unable to fly. If you exclude adult bats during this time, the young may be trapped inside and die or make their way into living quarters. Thus, if possible, avoid exclusion from May through August.

Most bats leave in the fall or winter to hibernate, so these are the best times to "bat-proof" your home.

Standards for Quarantine Facilities
The Wisconsin Administrative Code chapter ATCP 13 defines the requirements for local rabies control programs. Waukesha County operates its state-approved program under this code. Isolation facilities (shelters) used by the Waukesha County Rabies Control Program have to meet several requirements.

The Isolation Facility
Any facility designated by the Environmental Health Division, which is equipped with a pen or cage that isolates the animal from contact with other animals or the public can serve as a shelter. Visitors are not allowed, except in a medical emergency.

Upon arrival, the quarantined animal needs to be immediately placed in an isolation kennel. The kennel shall have a cage marker identifying the animal and a sign noting it as a quarantined animal. The quarantined animal must be kept away from other animals and the public for the entire quarantine period.

The Division advises shelters to limit the number of staff who will handle quarantined animals and provide current rabies pre-exposure prophylaxis for these staff. Standard shelter sanitation practices are to be used.
Any unusual behavior or other concerns regarding the animal should be immediately brought to the attention of the Environmental Health Division staff and overseeing veterinarian. The Division will submit rabies suspect samples to the Wisconsin State Laboratory of Hygiene as needed.

The Paperwork
All bites by a dog, cat or ferret that break the skin of a human need to be reported immediately to the Environmental Health Division. The Environmental Health Division can advise you about bites involving other species, as well as animals bitten by other animals.

As a standard policy, a copy of the bite report, along with basic shelter intake information, should be retained by the shelter. Bite case files must be kept where all shelter staff having contact with the animal can easily access the paperwork.

Before animals are released from the shelter, usually 10 twenty-four hour periods after the bite, their owner needs to show proof of rabies vaccination and have a current animal license. (prepaid, if not already obtained). The owner should be instructed to take the animal directly to their veterinarian for a quarantine release. The animal is considered under quarantine until the veterinarian signs the quarantine release papers. The veterinarian can give a rabies vaccination at this visit, if the animal is not current with the vaccination. The vet will then fax the completed quarantine paperwork to the county.

It should be noted that the length of quarantine can be extended beyond 10 days. Situations such as the animal showing any unusual medical signs, the animal receiving rabies vaccination during the quarantine period, a bite by the same animal during the quarantine, or ordered extensions by the overseeing veterinarian or rabies program staff can prolong the quarantine period.

If an animal is euthanized in the shelter at the end of quarantine, the shelter staff needs to have the overseeing veterinarian for the rabies control program sign off on the quarantine order paperwork. This needs to be done after the ten 24-hour quarantine period and then faxed to the Environmental Health Division by the shelter staff. The veterinarian must sign before euthanasia is performed.