TORONTO – The city’s health
department confirmed on Monday night that a man has been diagnosed with rabies. They haven’t determined whether he caught it abroad. Authorities have informed health officials in another country – which
they won’t identify – to see if his contacts there need treatment against
rabies.
GlobalNews.ca asked Toronto Public Health to shed light on a once
well-known disease.
Global News: What exactly is
rabies?
Toronto Public Health: Rabies is a
disease caused by a virus that affects the central nervous system (brain and
spinal cord) of all mammals, including humans. Once symptoms of rabies appear,
there is no cure or effective treatment, and the disease is almost always
fatal.
GN: How can rabies enter your body?
TPH: Rabies is a viral disease, transmitted through saliva,
from a bite from an infected animal. According to the Centers for Disease
Control in the United States,
there are no documented cases of confirmed human-to-human transmission. There
has been the rare exception for transplants.
GN: What symptoms should people look for?
TPH: If you are bitten by a wild animal or an animal you
are not familiar with, and are concerned, visit your physician immediately –
not just because of potential rabies exposure, but because of other potential
infections such as tetanus. Waiting until symptoms appear is too late.
If exposed, or if there is a potential of exposure to rabies due to an
animal bite, a person will be vaccinated. In Ontario, normal treatment isfive doses over 28 days. The first dose is
accompanied with rabies immunoglobulin – which is an injection containing
antibodies against rabies. It takes
approximately 24 – 48 hours to test and confirm rabies in humans. Once rabies
symptoms begin, it is almost always fatal.
GN: How does it affect your body? How is it fatal?
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TPH: Rabies causes
inflammation of the brain (encephalitis) causing death.
GN: What is the treatment?
TPH: If the animal is available and healthy, it can
be observed for 10 days by the health department. This is done since the
likelihood of rabies is very low in Toronto.
If the animal is unknown or if there is a suspicion that the animal
may be rabid, treatment with rabies vaccine may be recommended. Rabies vaccine is not effective once the patient
starts showing symptoms of rabies.
GN: Give us a sense of the time one has between rabies
diagnosis and the start of treatment. When does it become too late?
TPH: It is never too late to receive preventative treatment for a rabies exposure (i.e. a
bite) unless the symptoms of rabies are present. Once rabies symptoms are
present the disease progresses very quickly and is almost always fatal.
There is a new experimental treatment for rabies in people but its effectiveness
is not known and those few who have survived experience long-lasting and significant brain damage.
GN: How many rabies cases were there 100 years ago as
opposed to now?
TPH: The last confirmed human case of rabies in:
Toronto was in 1931 in a
three–year–old
boy.
Ontario was in 1967 in a
four–year-old girl
from the Ottawa
valley area.
In the last 12 years, there have been
three Canadian cases of human rabies in other provinces, all of which were
acquired domestically as a result of direct contact with bats. These cases
occurred in Quebec (2000), British
Columbia (2003) and Alberta
(2007).
To date, there has been one imported human rabies case in Canada, which occurred in Quebec in 1984.
Rabies is very rare in Canada.
Part of the reason is due to pet vaccination programs.
GN: Culturally, rabies is not acknowledged the way
tetanus or hepatitis is. With this first case in 81 years, is it time to start
thinking about rabies publicly again?
TPH: The appearance of this one case is a good reminder
that rabies is still a risk. This is especially true for incidents involving
bats in Ontario
and for many kinds of animals when traveling. One should always be careful
when interacting with animals that are not known to you (whether they are wild
animals or strays).
GN: What are some myths about rabies?
TPH: The treatment is almost as bad as the disease. Years ago the
treatment for rabies was a series of painful shots in the stomach. The current
treatment is a regular needle in the arm like any other vaccine. It is
very safe and highly effective.
All animals are a risk for rabies. Certain animals are an
extremely low risk for rabies. These include most rodents (mice, rats, gerbils,
squirrels) and rabbits. Usually rabies vaccine is not recommended for bites
from these animals unless the animal was acting very strangely or appeared
sick.
If an animal is foaming at the mouth it has rabies. An animal
can be foaming at the mouth for many different reasons, only one of which is
rabies. It is also true that many rabid animals do not foam at the mouth.
I can wait until I am sick to get treatment. Rabies is most effectively
treated by preventing infection by getting vaccinated quickly after being
exposed. Once symptoms of rabies are present,
it is too late to receive effective treatment.
According to The Canadian Press, it is
unknown whether the person is being treated with the Milwaukee Protocol. It is
a treatment regime involving a drug-induced coma. The first rabies survivor is
a girl named Gina Giese, who was treated with the protocol in Milwaukee in 2004. She recently graduated
from university.
A small number of people have
subsequently survived due to this treatment. However, rabies is still the most
fatal infection in the world.
With files from The Canadian Press.
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