Rabies is pretty damn scary--but please learn what animals carry rabies where you live.
I've seen people freak out because they've seen a raccoon in the daytime and think (1) raccoons are nocturnal so this one is acting strange, and (2) raccoons are rabies carriers, and so it is probably acting strange because it is rabid.
In fact in this part of the country (western Washington) from 1988-2020 rabies has not been found in any wild terrestrial mammal. The only mammals found to have rabies over that time have been 530 bats, 2 cats, 1 horse, and 1 llama.
There's a nifty map here [1] showing what animal populations have rabies in which states.
So what does it mean when you see a raccoon in the daytime in western Washington? It almost always means they aren't finding enough food at night so have to put in overtime foraging.
This is quite common around breeding time. The pregnant females need more food than normal and often will have to go out during the day to get it.
BTW, I believe it is not known why rabies is not found in wild terrestrial mammals here.
For squirrels there are at least three theories. (1) Squirrels are safely asleep in their nests when bats are out, so don't get bitten by bats and if they get bitten by something else that something else is probably big enough that the encounter is fatal for the squirrel, (2) maybe squirrels have strong natural immunity so don't get it even if they do get bitten, or (3) maybe squirrels are particularly vulnerable to it so if they get bitten by a bat they quickly die before they can spread it and since we don't do autopsies on random dead squirrels we come across we never find out about the briefly rabid squirrels.
For raccoons, I don't think it is clear why they aren't picking it up from bats here.
Somewhat tangentially related to people being afraid of Racoons carrying rabies, a Racoon risk people should actually be aware of is inhaling a parasite from their feces by mistake (i.e. sweeping/leaf blower, or children playing in a sandbox or yard where racoon does their business)
Thank you for this. I didn’t even know raccoons don’t carry rabies where I live. We’ve always worried about the raccoons that come over and try to eat our cat food from an abandoned house nearby. Now I don’t need to fear.
> please learn what animals carry rabies where you live... In fact in this part of the country (western Washington) from 1988-2020 rabies has not been found in any wild terrestrial mammal. The only mammals found to have rabies over that time have been 530 bats, 2 cats, 1 horse, and 1 llama.
Well that was the easiest research for my local area that I've ever done, thanks for the info!
I noticed the mongooses too, and went Googling. Here's why they are there [1]:
> The first successful introduction of mongooses to the Caribbean region was back in 1872. They were intentionally brought to the islands to control rats that were destroying sugarcane crop. From Jamaica, they were taken to other islands, between 1877 and 1879, Puerto Rico, St. Cr4iox [sic] and St. John for the same rat-control purpose. In 1883, Jamaican mongooses were imported by sugar growers on the Big Island of Hawaii, and then were later taken to the other Hawaiian Islands.
I read some time ago that a rabies infection can be dormant for years.
I'm not sure of the reliability of this source.
"But studies have shown it lying dormant for five days to several years before the symptoms kicked in. So not only won't you know you have the disease, it might not come to bite you in the ass for a couple of years, long after the animal that caused it has laughed itself to death."
This doesn't answer my question, sadly. From the article we see that two of the people that died knew they touched a bat. How many don't know they touched a bat?
Rabies can be split in terrestrial mammals and bats. Terrestrial mean wild and domestic: A fox can have rabies, but a horse or a camel can have rabies also.
Grouping it in this way is important because terrestrial mammals can be vaccinated easily.
Has been done with success in central Europe just drone seeding a zone with meat baits with oral vaccines on them. 90% of the foxes and jackals in an area can be vaccinated really fast with this system and then you repeat it each year to include also the new cubs. Then you stop messing seriously with the population to avoid empty territories and new animals moving to the area. Is perfectly doable if you have the political will of vaccinating and -not- culling the vaccinated population. Culling increases the probability of having rabies in the area.
Dogs and cats can be (or are required to be) vaccinated, so is not a big problem either. You just need to watch for stray cats and dogs and use the baits again.
Bats can't be vaccinated easily and they are big travelers, so still are the main reservoir in Europe. We still don't have a solution for this problem
Ooook, now I understand why nobody is keeping bats as pet. Just think how much the vaccination costs each and every year for both the bat and the owner (and the bystanders screaming in fear, potentially).
I went on a wikipedia + YouTube walk on human rabies last month, and it is truly terrifying.
> The period between infection and the first symptoms (incubation period) is typically 1–3 months in humans. This period may be as short as four days or longer than six years, depending on the location and severity of the wound and the amount of virus introduced. Initial symptoms of rabies are often nonspecific such as fever and headache. Death usually occurs 2 to 10 days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care.
Luckily odds of actually getting it seem pretty low overall given the CDC increase referencing 3 deaths as an increase. But still, one of those terrifying ways to go.
On a positive note, the act of being alive is also a ticking time bomb that inevitably leads to death as well, so there is that!
>> Only x number of people have died in the U.S. in the past x years. Rabies is really rare.
> Yes, deaths from rabies are rare in the United States, in the neighborhood of 2-3 per year. This does not mean rabies is rare. The reason that mortality is so rare in the U.S. is due to a very aggressive treatment protocol of all bite cases in the United States: If you are bitten, and you cannot identify the animal that bit you, or the animal were to die shortly after biting you, you will get post exposure treatment. That is the protocol.
> Post exposure is very effective (almost 100%) if done before you become symptomatic. It involves a series of immunoglobulin shots - many of which are at the site of the bite - as well as the vaccine given over the span of a month. (Fun fact - if you're vaccinated for rabies, you may be able to be an immunoglobulin donor!)
> In countries without good treatment protocols rabies is rampant. India alone sees 20,000 deaths from rabies PER YEAR.
Those shots are not cheap either. We found a bat had been in our bedroom at night when we visited my in laws and I saw it fly over us several times.
They didn’t catch it so we didn’t know if the bat had rabies. We hadn’t been bitten, but you can get the virus dropped in your eyes or nose and it is basically 100% fatal.
With those odds, you go through the 3 shot protocol. It was basically $1k per shot for each of us. We have solid insurance but they were not covered because they are so rare.
That sounds ridiculously cheap. I got bitten by the squirrel and went to the emergency room only to be told that they don’t do rabies shots after squirrel bites. The price I paid for 15 min visit? - $3,500.
To what end then is it useful to drum up public fear of rabies in bats, if what actually leads to deaths seems to be economical problems? People only react stupidly to fear mongering. If you want a delightful read, the Merlin Tuttle Bat Conservancy has collected stories about how Fauchi's baseless, "idk, probably bats" reasoning has led to the extermination of entire populations. https://www.merlintuttle.org/
If you truly must live your life in fear of dying, look no further than heart disease and car accidents.
If you truly must live your life in fear of dying, look no further than heart disease and car accidents.
Those are not as scary because there are plenty of survivors, in various states of health. Rabies is notable for being a very binary and decisive disease with little advance warning or treatment.
I think, some creatures are just trouble for our species. Mosquitoes are the deadliest for us, but it seems that bats, with high instances of rabies, and things like covid, are right up there too.
It is sadly funny that we manage to extinct the useful, and mostly beneficial creatures around us, but our "enemies" just exist rampantly and laugh.
Unfun fact: the rabies immune globulin shots are by far the most painful shot I've ever experienced and being the size that I am, I received what I think was 7 of them in quick succession.
I also got the 4-shot vaccine series, which felt like any other vaccine (basically painless), but the RIG was like having liquid fire injected into my Forrest Gump region.
Huh. I had immunoglobulin shots ("It's just like maple syrup!" the nurse told me) in my butt back in college, and I don't remember it hurting at all. It was just an odd sensation of so much heavy fluid being injected so slowly.
Mostly, I remember it being funny every time I went back and presented my bare butt to the nurse.
I got bit on my finger tip by a feral cat and had to get the first dose injection in the fingertip. It was not pleasant. The rest of them were in the butt which was not great but nothing compared to the fingertip. The cat did die and my parents were able to send it in and luckily the tests for the cat came back negative after a couple of days and I did not have to get all the doses.
Weird. I had the immunoglobulin shots, two in the legs, two in buttocks. Despite the syringes being larger than ones I usually see for vaccine it was nothing too memorable. The intramuscular shots (J&J for covid and Tdap honestly hurt more). The ~$17k bill the hospital sent me was the most painful part of the rabies post-exposure process to deal with, not any of the shots.
I had immunoglobulin + rabies vax in my arms and butt and it was just a standard vaccination kind of discomfort. I don't remember thinking "omg pain" at all.
You can, especially if traveling to a region where it’s endemic and common. I got the series at a Kaiser travel clinic just by asking when I was planning out a long international trip. You still need post-exposure shots, though fewer (and maybe no immune globulin, if I remember correctly).
The rabies vaccine needs fairly frequent renewal (more than once a year). People likely to contract it (vets, pest control, zookeepers, etc) get them. Others get post exposure treatment that is very effective.
People who work with bats or are otherwise at risk of coming in contact with rabies are actually getting the vaccination like they get others (note: in Germany).
I bet you could make a lot of money advertizing an elective rabies vaccine to people searching for rabies on YouTube. They might not ultimately need it, but if they're willing to pony up some money for peace of mind, why not?
As mentioned in the previous comment,its less because the odds are low and more becuase the US treats basically every animal bite as a rabies case. It takes a very extreme containment method to achieve low deaths
The sole caveat to this is the Milwaukee Protocol, which leaves most patients dead anyway, and the survivors mentally disabled, and is seldom done - see below
I was curious, and thought that would be something gruesome involving power tools, so I looked it up and it's apparently an induced coma with heavy doses of antiviral drugs, which has a very low success rate.
less scary than prion diseases like mad cow... imagine eating a burger ten years ago and dying from it. there was a notable case recently where a woman in a lab accidentally pricked her finger a long time ago and died from it. I believe it was in france. thankfully it is fairly rare.
Prions are doubly terrifying because it's not a typical disease. From what I understand it's proteins folding in a different way that come into (the prions can be dead or alive) and the healthy proteins will take on the new form. It's scary because typical sterilization (high heat) for surgery does not work guarantee it and the heat required is not currently practical.
The shakes from that cannibals get are prions. I also though I saw a link to a subset of alzehimer cases but can't find it.
"...in 1985 when the Colorado Division of Wildlife tried to eliminate CWD from a research facility by treating the soil with chlorine, removing the treated soil, and applying an additional chlorine treatment before letting the facility remain vacant for more than a year, they were unsuccessful in eliminating CWD from the facility."
There seems to be some kind of species barrier making it difficult for deer prions to infect humans, because people are certainly being exposed to it frequently, especially in areas like the midwest where CWD is rampant. But we're in deep trouble if that ever changes. Imagine people dying of CJD because deer peed in a field somewhere decades ago, the prions bound to the soil, then bound to a seed planted in the soil, then you ate whatever crop happened to be grown there. It'd be inescapable.
Imagine developing untreatable cancer and dying next year. Much more likely than either prion disease or rabies. You can't go through life afraid of "what if" we are all dead in the end anyway.
We had a bat in the house years ago. In my 3am stupor I tried to let it out until Dr. Spouse berated me and said we must catch it. Darn thing disappeared. Animal control came and couldn't find it. That's when I started reading about rabies. Freaked me out. Up until that point I had the attitude that if something felt off, just go to a doctor. Nope. Omae wa mo shindeiru.
We had booked 2 adults and 2 diaper-age kids for PEP shots when I took the day off and turned the house upside down trying to find the bat. Eventually I found the dumb thing stuck to a glue trap for mice. No rabies.
But yeah, people were looking at me like I was bonkers for scheduling the shots. "Did it bite you?" No idea! But I'm not going to take my chances on being the second person ever to come out not quite dead from a drug-induced coma after symptoms set in.
Well at least you are dead within a few days but as an insomnia sufferer FFI (Fatal Familial Insomnia) really scares the shit out of me - you die due to being unable to sleep - not even propofol helps.
Wow. These days, details are given (eg, proof of dog having shots), or the dog is taken, killed, and brain examined for rabies.
At least that's the way it is where live.
And that doesn't even get into "if a dog bites, the owner can be criminally charged" side of things, and often is. Even mild cases of biting, may mean the animal is put down.
Only exception is if the victim was engaged in a criminal act.
My nephew died from rabies from a bat bite (in the SF East Bay) many years ago.
When he was bitten he was inebriated (picked up a wiggling bag and the bat inside bit him), and the next morning he never saw any bite wound (because their teeth are so slender they don't necessarily leave a mark) -- so he wrote the whole thing off.
I'm haunted by his death. The painful lesson is that if one even thinks there was a possibility of a bat bite then one should seek treatment.
If covid-19 has taught me anything it's that I want absolutely nothing to do with bats or their habitats/waste stream. Previously I had zero appreciation for what an exceptional immune system the only flying mammals had evolved and how problematic that can be for other mammals.
In flight their heart rate is 1000 beats per minute and their body temperature approaches 105F (40C) - their high metabolism might explain a more tolerant immune response.
Enabling the high metabolic flux required to fly. As the only flying mammals, bats have the highest metabolism among mammals while also being more biologically compatible with us compared to e.g. birds.
A rather suboptimal evolutionary path - birds are way better adapted to flight at lower cost but then again they had a 100 million year head start (theropod dinosaurs) compared to bats.
Birds can extract more oxygen from each breath compared to bats - besides lungs they have additional air "storage" places called air sacs in their body.
Their lungs do not contract like mammals but the air sacs do - so when they exhale their lungs are still performing a gas exchange.
Being able to move your arms a bazillion times by second for hours and hours. It means finding how to pump an awful lot of sugar and oxygen to that muscles.
It's absolutely true that bats have an exceptional immune and metabolic system, unique among mammals and dangerous to other mammals. The flipside is that bat biology also provides an enormous amount to learn about immune system modulation, cellular repair, metabolic capacity, aging, and many other aspects of human biology.
A bit misleading to use the term "only" here, as there are over 1000 species of bats and they make up almost one quarter of all identified mammal species.
Not all species of bats are studied in the same detail. Again, there are over 1000 different species of bats, and when it comes to the internal immune system they can have large differences between species.
Focusing on internal temperature during flight[0], there can be swings between species as drastic as "this would be a life threatening fever in a human" to "this counts as hypothermia in a human".
Covid-19 taught me that I want absolutely nothing to do with reckless Gain of Function experimentation done secretly in government research laboratories, and to [fruitlessly] seek transparency and honesty regarding any such research done to date.
I worked with bats years ago. I remember when I went for my pre-exposure rabies shots, the nurse who gave me the shots was very concerned about the work I was going into. Apparently, her first ever patient was a man who ended up dying of rabies. A bat had flown into his tent while he was camping somewhere up north and landed on his head. He had a small bite but never went into the doctors or anything until the rabies symptoms started. By the time he went in to get checked out, it was too late, he ended up dying slowly over a month.
Even the pre-exposure rabies shots are only good for a year or two, at least when I got them. If I'd continued working with bats I would have needed yearly titer shots just to keep my immunity up enough to be safe around bats.
The problem with bats and rabies is, bats can be carriers without showing any symptoms until they're near death. The only way to know for sure if a bat that bites you has rabies or not is to take it in to be tested.
There's a critical (literally life and death) clarification to be made here. As far as I know, it's emphatically not true that you're doomed as soon as you are infected with rabies. My understanding is that a rabies infection is actually quite treatable if caught early. That's why, if you think there is any chance that you've bit bitten by a rabid animal, you should seek treatment immediately.
I think its when you begin exhibiting symptoms that you're basically a goner. If that's what you mean by "get it," then I don't disagree with your comment. But I'm not sure that's how people would interpret it.
Yes. Your statement is correct. It's "basically harmless" once it enters your body until it bumps into nerve cells. At which point you're almost certainly going to die unpleasantly.
My grandfather worked with rabies and I interviewed him for a school project. I remember being rather uncomfortable with his description of the disease. Perhaps a bit much to chew for a 4th grader. Anyway, the "once you show symptoms, you're dead" part really stuck with me.
About 50k die each year while the total number of people that survived after onset of symptoms can be counted on two hands. "Basically if you get it you die" is a quite good description. The vaccine is more a way to ensure you don't get it (the illness, not the virus), and it's useless once the illness actually sets in.
My statement wasn't an absolute, hance the basically allows for room for exceptions. Which 6-7 people really do count as a super tiny minority. So what was your point again?
What's the risk of contact with bats outdoors? I often go for twilight walks and see them flying from tree to tree. But I sometimes wonder if a rabid one could swoop by, scrape me with its teeth, and I'd never even know. Maybe that's too paranoid...
Your risk grows significantly if you enter their caves etc. Even bat guano is a good source of dangerous pathogens.
If you sleep with your window open, I recommend installation of a screen. Not just against bats, against insects, too. My wife got stung by a hornet when she stepped on it with a bare foot (it was right next to our bed on the floor) and it was a very painful experience. Our next residence is definitely going to include screens.
Rabies had never really been on my radar until I got bit by a dog in central Bangkok just over 2 years ago. After calling my travel insurance I rushed to a hospital for Rabies post-exposure treatment (although there were no clear signs that the dog was Rabid, I didn't want to take any chances).
I was given a booster shot of anti-tetanus. I was given a Human Rabies Immune Globulin injection straight into the wound on my hand between my finger joints (this was extremely painful). Then I received my first dose of Rabies post-exposure vaccinations (Day 0, Day 3, Day 7, Day 14, and Day 28). The following injections were in my arm. All of the costs were covered by my travel insurance and my home healthcare system.
The entire experience was traumatic. Even though I knew the circumstances were definitely in my favor (I knew the chance of the dog actually being rabid was probably quite low and I had received treatment within a couple of hours) I was still really freaked out for a couple of months.
To make matters worse, just a few days after my incident, there was a Norwegian girl that died from rabies after getting bit by a dog. That definitely didn't help calm my nerves.
Ever since then I am extremely cautious of any animals around me.
It means they shared the press release to media outlets in advance so they could write an article about it. But the outlets are not supposed to release their articles until the embargo expires.
This is a common practice for both government and private sector press releases.
My guess is every report by the CDC follows a standard embargo timeline unless it's time critical. You want to give journalists time to write a good article and not race each other to publish something first.
"None of the three individuals received post-exposure prophylaxis (PEP), shots that can prevent rabies from developing if received before symptoms start."
This isn't news. This is people being stupid and dying. In the Illinois case the patient specifically refused the shots.
The article linked said he knew it was a bat, they physically had the bat. They tested the bat for rabies and knew the bat had rabies. And still the person refused treatment.
Here, let me copy from the article so you can read it here:
"The Illinois Department of Public Health said in mid-August, a man in his 80s woke to find a bat on his neck. The bat was captured and tested positive for rabies. While health officials told the man he needed to start post-exposure rabies treatment, he declined."
Woke to find a bat on his neck.
Those "I didn't know" cases do exist. This is not one of them.
Because the cdc also employs veterinarians who are much less busy with covid
The cdc is huge…they do workplace safety to. A good portion of them have gotten sucked into covid but really it’s mostly been the people who do infectious disease, vaccination, or public health communications type stuff
That’s not to say the staff at cdc are not just completely burned out from it…
Just something to share about this as someone who had a recent almost-rabies encounter. TLDR is that rabies shots cost like 4K/ea. My wife and I woke up in the middle of the night with a bat flying around our room (thanks to our cat jumping on the bed). We caught the bat and released it and basically thought nothing of it.
A few days later my wife was talking to friend and she mentioned that we had a possible rabies encounter — bat bites are incredibly small and if you are sleeping its very possible you wouldn't have even felt the bite. Naturally we were shocked and searched our bodies and found nothing, but just to be certain we called our local department of health and found that, yes, this is a valid rabies exposure event and we were eligible for rabies care. (For future reference, you're supposed to basically catch and kill/freeze the animal and send it to animal control for rabies testing to see if you actually had an exposure. We were woken up at 4am so didn't really think to look up rabies protocol at the time)
Cue USA Healthcare insanity. So we first find out after calling the hospital that rabies vaccines are only administered in the ER, meaning we can't just go to any urgent care center and get a shot. Not only this, but the rabies vaccine is a series of 4 shots, each about a week apart. And "because USA", the system has no way of remembering that we're in for a planned series of shots, meaning we have to be re-ingested into the ER every time we enter (keeping in mind that a global pandemic is still going on). So now we're going to the ER for about ~3 hours every few weeks, of which on _literally every visit_ they ask us the exact same series of boilerplate questions about basic health info. 99% of our time is filling out paperwork, the shot itself takes seconds.
We started to wonder if it was really worth it, but its worth remembering rabies is basically 100% fatal. So it was basically risking sure death via rabies or being subjected to an ER wing during a global pandemic multiple times a month. We went with "get the shots".
But it gets worse. So after everything is done, we get a hospital bill. As it turns out, EACH RABIES SHOT IS $4,000! EACH SHOT! This means that between my wife and I, we accrued $32,000 in medical bills for simply trying to not subject ourselves to absolute death. I find this totally insane. On top of the rabies bills we were also charged for ER charges, which apparently are weird because the ER doctors bill separately from the ER itself, and those costs also ran into the thousands. Luckily we had health insurance, and our county covered some of the costs as well.
The whole structure of this is outrageous. Yes, for profit healthcare is bad, but this is on another level. Just imagining someone less fortunate than us that gets into this situation. You're staring down $32,000+ in medical bills, or death. Which do you choose? The whole experience left such a terrible taste in my mouth that I hate the USA even more for even requiring this calculus in the first place.
This is yet another example of the US healthcare funding model. While there are valid reasons for the cost to be relatively high, immunoglobulin treatments are expensive to prepare, it does not need to be that high. In single-payer systems (e.g. UK) the full cost of the same shot (generally not paid by the patient) is something like $800. It's not about subsidies, I'm talking about what the healthcare system pays to the multinational drug vendors for making the vial and also the relatively smaller cost of medical staff going the injection - that's what the treatment really costs, and the remaining $3200 is essentially the administrative/insurance/extra-profit overhead of the USA model of healthcare funding as every participant (drug manufacturers and hospitals) get all their necessary expenses and reasonable profit covered already with the $800 price.
The actual cost of a dose (Italy, in bulk) should be (just the vaccine, besides the doctor/nurse administering it) around 40 Euro [1] (which in most cases you do not pay, as it is covered by the SSN - corresponding to the MHS in UK).
Worse yet you are starting down 32k in medical bills vs a very small probability of certain death. Worse because this will make some people roll the dice and lose.
$4k is excessive but human immunoglobulin is famously expensive as it has to be extracted from human blood plasma, essentially a micro blood transfusion.
The rabies vaccine is different and costs much less, if you get vaccinated before exposure then you don't need the immunoglobulin if you later get exposed.
I've seen people freak out because they've seen a raccoon in the daytime and think (1) raccoons are nocturnal so this one is acting strange, and (2) raccoons are rabies carriers, and so it is probably acting strange because it is rabid.
In fact in this part of the country (western Washington) from 1988-2020 rabies has not been found in any wild terrestrial mammal. The only mammals found to have rabies over that time have been 530 bats, 2 cats, 1 horse, and 1 llama.
There's a nifty map here [1] showing what animal populations have rabies in which states.
So what does it mean when you see a raccoon in the daytime in western Washington? It almost always means they aren't finding enough food at night so have to put in overtime foraging.
This is quite common around breeding time. The pregnant females need more food than normal and often will have to go out during the day to get it.
BTW, I believe it is not known why rabies is not found in wild terrestrial mammals here.
For squirrels there are at least three theories. (1) Squirrels are safely asleep in their nests when bats are out, so don't get bitten by bats and if they get bitten by something else that something else is probably big enough that the encounter is fatal for the squirrel, (2) maybe squirrels have strong natural immunity so don't get it even if they do get bitten, or (3) maybe squirrels are particularly vulnerable to it so if they get bitten by a bat they quickly die before they can spread it and since we don't do autopsies on random dead squirrels we come across we never find out about the briefly rabid squirrels.
For raccoons, I don't think it is clear why they aren't picking it up from bats here.
[1] https://www.cdc.gov/rabies/location/usa/surveillance/wild_an...