Why We Vaccinate: Rabies in 2014

By:  Dr. Hilary Slaven

 World Rabies Day:  September 28.

Since 2007, the Global Alliance for Rabies Control (GARC) has been promoting the annual World Rabies Day, in the hopes of raising awareness of the highly fatal virus.

 

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Rabies:  The Disease

Rabies is a zoonotic disease, meaning that it is passed from infected animals to people.  It is considered to be a 100% preventable disease, with a highly effective vaccine that has been available for animals for over a century.

Unfortunately, according to the World Health Organization, the statistics show that over 55,000 people worldwide die every year (one person every 10 minutes) from virus exposure and subsequent illness.  Most of these deaths are centered in underdeveloped nations in Asia and Africa (>95%).  While a treatable disease, the treatment is expensive and futile once clinical signs develop.  This means that once a person starts to show signs of illness, treatment is almost always ineffective and the patient is likely to die.

In the U.S., rabies is primarily found in the wild in bats, raccoons, foxes, skunks, and coyotes.  These animals act as reservoirs for the disease, meaning that they can pass it along to pets (dogs, cats, and ferrets) or infect humans directly.  Bats are the source of most human deaths in the Americas.  In Asia and Africa, all human deaths can be traced to deep wounds or bites by rabid dogs.

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The Infectious Path of the 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 apporximately 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 the disease.  The virus can be transmitted to other mammals days before the raccoon shows signs of disease.
  6. The infected animal usually dies within 7 days of becoming sick.

(cdc.org)

People who are infected by rabid animals can be treated with a series of injections (called post-exposure prophylaxis, or PEP).  When given before a person develops signs of rabies, the efficacy rate is high for PEP injections.  Symptoms of rabies infection include fever and pain at the wound site.  It can take 1-3 months for these signs to develop.  Over 40,000 PEP injections are given every year in the U.S.

 

Table: Categories of contact and recommended post-exposure prophylaxis (PEP) (cdc.org)

Categories of contact with suspect rabid animal Post-exposure prophylaxis measures
Category I – touching or feeding animals, licks on intact skin None
Category II – nibbling of uncovered skin, minor scratches or abrasions without bleeding Immediate vaccination and local treatment of the wound
Category III – single or multiple transdermal bites or scratches, licks on broken skin; contamination of mucous membrane with saliva from licks, contacts with bats. Immediate vaccination and administration of rabies immunoglobulin; local treatment of the wound

“All category II and III exposures assessed as carrying a risk of developing rabies require PEP. This risk is increased if:

  • the biting mammal is a known rabies reservoir or vector species;
  • the animal looks sick or has an abnormal behaviour;
  • a wound or mucous membrane was contaminated by the animal’s saliva;
  • the bite was unprovoked; and
  • the animal has not been vaccinated.

In developing countries, the vaccination status of the suspected animal alone should not be considered when deciding whether to initiate prophylaxis or not.”  (cdc.org)

 

Rabies in the U.S.

In the U.S., we have fought this virus for decades, with all states requiring dogs as pets to be vaccinated for the disease.  Hawaii carries a ‘rabies-free’ status.  While it is now a rare cause of death, prevention and monitoring of the disease is necessary to prevent future problems.   For most of us, this means:

  1. Vaccinate dogs, cats and ferrets for rabies with boosters given appropriately according to your veterinarian.
  2. Keep pets supervised.
  3. Report stray animals to animal control.
  4. Report dog bites to your local veterinarian and seek treatment from your physician.  Dogs should be quarantined for 10 days following a bite.
  5. Neuter and spay in tact pets.

Some people are good candidates for preventive rabies vaccination (those who work with pets and/or travel to rabies-endemic areas).

The estimated cost for this maintenance nationwide is $300 million a year.

 

Rabies Worldwide

Rabies continues to be a serious public health issue in underprivileged parts of the world, and statistics are showing that it may be on the rise.

people-dogs

Children account for >40% of worldwide rabies victims. (who.int)

It is a challenge to prevent rabies in these parts of the world for many reasons.  These areas are remote, therefore difficult to get an assessment on number of deaths and get programs started to address the issue.  The populations here are poor (often earning just a few dollars a year, literally) and cannot afford dog vaccinations or rabies PEP.

The way to address the problem, both medically and financially, is through vaccination programs.  While a single canine rabies vaccine costs just a few dollars, post-exposure vaccinations can cost over $10,000 per person.  With more than 15 million people worldwide receiving PEP vaccinations every year, this is a costly venture.  According to the GARC, “A study published last year found that rabies currently costs the world’s poor $124 billion but could be prevented for just $6 billion.”

WHO supports targets for elimination of human and dog rabies in all Latin American countries by 2015 and of human rabies transmitted by dogs in South-East Asia by 2020. In this latter region a five-year plan (2012–2016) aims to halve the currently estimated number of human rabies deaths in endemic countries.  (www.who.int)

 

What this means for us:

Maintain our vigilance with rabies protocols here in the U.S. to help prevent any future endemic with this disease in our country.  Be responsible with pets and help to remove stray animals from the streets.  Prevent overpopulation of pets with spay/neuters.

Be informed.  Check out the CDC website for information on how you can help:  http://www.cdc.gov/rabies/resources/get-involved.html

www.worldrabiesday.org

www.cdc.gov/rabies

http://www.who.int/mediacentre/factsheets/fs099/en/

 

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How Much Does it REALLY Cost to Own a Pet?

By:  Dr. Hilary Slaven

“Mom, Billy’s dog just had a litter of puppies!  They are the cutest puppies I’ve ever seen!  Could I please have one?  PLEASE.  It’s all I’ve ever wanted.  I will take care of it, I swear.  I will feed it and play with it and he can sleep with me and everything.  You won’t have to do a THING.”

Hank the Puppy

Many of us have been there (sometimes it’s US, not our children!)  Getting caught up in the excitement of a new pet can lead us to make quick decisions about adding that responsibility to ourselves.  Children often do not understand the time and care required to properly take care of a new dog in the family, much less the financial burden.  The cost alone of adding a pet can take anyone by surprise.

We’re going to give you the big picture today on typical recommended veterinary care and the cost behind the care.

Just like any member of your family, dogs require yearly examinations to keep them healthy. Maintaining your pet’s health means planning ahead, preventing potential problems before they occur, and preparation for the unexpected.

Having said all of that, we firmly believe that a beloved pet can be a wonderful investment for your family and can thoroughly enrich your life!

So let’s look at some real numbers.

Adoption

Shelter:  Typical adoption fees range from $50-200. Often include first vaccines, deworming and spay/neuter.

Breeder:  Variable; dependent upon breed. $50-3000. Often includes first vaccines and deworming and can include an initial exam by a veterinarian.

 

Food

Variable, dependent upon type of food fed.  Recommended to feed the highest quality food that you can afford.

Example: Hill’s Healthy Advantage Canine Formula, dry kibble

Chihuahua: $13/month ($0.44/day)

Border Collie: $ 25/month ($0.88/day)

Labrador Retriever: $ 47/month ($1.50/day)

Great Dane:  $57/month ($1.90/day)

Keep in mind that most dogs need only a quality dry kibble for their complete diet. (Occasional snacks are ok!) This is estimated cost only, based on 2014 prices.

 

Veterinary Care

Routine Care:

Exam plus puppy vaccines/physical exam (Initial plus boosters) est. $ 350

Yearly vaccines/physical exam: $ 100-150

Spay: $150-250

Neuter: $100-150

Emergency Care:

The typical after-hours visit runs $100-150 for an exam, with other treatments as an additional cost.

Sick Care:

Examples of these include the broken leg, the cold virus that is picked up at the kennel, the development of allergies, etc.

These are difficult (if not impossible) to predict, and can be isolated events or ongoing issues.

Each veterinary visit typically costs between $35- 60, and any medications are at an additional cost.

 

Parasite control

Monthly flea/tick/heartworm/internal parasite prevention is recommended for all dogs. This protection is available in a variety of forms, including:

  1. Monthly flea control/internal parasite prevention pill plus tick collar = $150-$300/year (dependent upon weight of dog)
  2. Monthly pill for heartworm and internal parasite prevention plus monthly pill for tick prevention = $310-370/year
  3. Monthly topical for flea/heartworm/internal parasite prevention = $170-210/year

 

The above costs are generalized and based on current prices in our area of the country.  The veterinary recommendations also vary between regions.

All in all, making an informed decision about your future pet and health care can help to set yourself up for success!  And, like any investment, will help you to reap the rewards of a lovely new family member.