Tag: rabies immune globulin

When Was the Last Time Someone Died from Being Bitten by a Rabid Dog in the United States?

Most people aren’t overly worried about rabies these days, at least not in the United States.

In the mid-1950s, rabies control programs began to get more and more dogs vaccinated against rabies.
In the mid-1950s, rabies control programs began to get more and more dogs vaccinated against rabies.

Is that because rabies isn’t around anymore?

Of course not. It is because a rabies vaccine has long been available both to prevent our pets from getting rabies from wild animals and to protect us if we are ever bitten by an animal that might have rabies.

Hopefully, especially after the recent rabies death of the 6-year-old in Florida, everyone understands that rabies is still around.

When Was the Last Time Someone Died from Being Bitten by a Rabid Dog in the United States?

Since 2008, at least 21 people have died of rabies in the United States, mostly after getting exposed to rabid bats.

There were more than a few exposures from dogs with rabies too. In fact, the last rabies death after a dog bite was not very long ago – it was in May 2017.

Exposure to rabid dogs typically happened while the person was out of the United States.
Exposure to rabid dogs typically happened while the person was out of the United States.

Does that mean that something isn’t working with our rabies prevention plans?

When you take a closer look at the statistics about rabies deaths after dog bites, it becomes clear where the problem is.

“In 1950, for example, 4,979 cases of rabies were reported among dogs, and 18 cases were reported among humans. Between 1980 and 1997, 95 to 247 cases were reported each year among dogs, and on average only two human cases were reported each year in which rabies was attributable to variants of the virus associated with indigenous dogs . Thus, the likelihood of human exposure to a rabid domestic animal in the United States has decreased greatly.”

Human Rabies Prevention – United States, 1999 Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Most rabies deaths in the United States from dogs occur in people who get bitten while they are traveling outside the country.

So when was the last human rabies death from a rabid domestic dog in the United States?

A 7-year-old girl died after she was bitten by a rabid dog in Texas in June 1979. Before that, in 1968, a 13-year-old boy died after getting bit by a rabid dog in Kansas.

That’s a long time ago.

Does that mean the rabies vaccine isn’t necessary anymore?

Rabies Vaccines Work

Of course not! That means the rabies vaccines works!

Two Indonesian boys proudly show off their puppy and her vaccination record.
Two Indonesian boys proudly show off their puppy and her vaccination record. Photo by the rabiesalliance.org.

There are two reasons that we don’t see human rabies deaths from dog bites in the United States anymore, unless the bites occur in another country:

  1. Most of us vaccinate our pets – fewer dogs and cats with rabies means that there are fewer chances for us to get bit and get rabies.
  2. Most folks get proper treatment if they are exposed to an animal that could possibly have rabies, whether it is an unvaccinated dog or cat, or a raccoon, skunk, fox, coyote, or bat. In fact, about 40,000 to 50,000 people in the United States get rabies post-exposure prophylaxis each year.

If you don’t believe this, just look back at what rabies was like in the pre-vaccine era, when dogs and cats would get rabies, and so would their owners. In the early 1960s and 1950s, rabies deaths from dog bites were more common, about 10 each year.

“The number of rabies-related human deaths in the United States has declined from more than 100 annually at the turn of the century to one or two per year in the 1990’s. Modern day prophylaxis has proven nearly 100% successful.”

CDC on Rabies in the U.S.

To understand just why rabies vaccines still so necessary,  you can also look at what is still happening around the world where rabies vaccines aren’t used as commonly as they are in more industrialized countries.

“Despite substantial gains in tackling this neglected disease, more than 20,000 people still die from rabies every year, mostly in Asia and Africa.”

Schneider et al on Substantial reductions in rabies, but still a lot to be done

In addition to the deaths from folks traveling outside the United States, there are many more rabies deaths in people, mostly children, who live in areas where rabies is still endemic.

Hopefully these deaths will end soon too, as experts from WHO, Food and Agriculture Organization (FAO), International Organisation for Animal Health (OIE) and the Global Alliance for Rabies Control (GARC) work together in the United Against Rabies collaboration to achieve “Zero human Rabies deaths by 2030.”

Because it has an animal reservoir, the rabies virus will likely always be around, and won’t be eradicated like smallpox, but hopefully we can one day control rabies by having fewer rabies exposures (vaccinate more of our pets) and we can eliminate dog-transmitted rabies deaths.

We won’t get there if folks continue to push myths and propaganda about rabies and the rabies vaccine.

What to Know About Controlling Rabies and Rabies Deaths

It has been a long time since someone in the United States died with rabies from a domestic dog bite, but that is simply a testament to the fact that vaccines work.

More on Controlling Rabies and Rabies Deaths

What to Do If Your Child Is Exposed to Rabies

Do kids still get rabies?

Tragically, most folks know that they do because of the story of the unvaccinated 6-year-old boy in Florida who died after being exposed to a rapid bat earlier this year.

Getting Exposed to Rabies

Rabies is a vaccine-preventable disease.

Unlike most other vaccine-preventable diseases though, unless you are at high risk for getting rabies, you don’t typically get the rabies vaccine unless you have already been exposed to rabies.

How does one get exposed to rabies?

Now that most people get their pets vaccinated against rabies, these exposures typically come from wild animals, including:

  • raccoons
  • skunks
  • foxes
  • coyotes
  • bats

While any mammal can be susceptible to rabies, small mammals, including squirrels, rats, mice, hamsters, guinea pigs, gerbils, chipmunks, rabbits, and hares, rarely get rabies and aren’t usually thought to be a risk for humans.

Your other pets, including dogs, cats, and ferrets, are though. They should be vaccinated against rabies. As should other domestic animals, including cows, goats, sheep, and horses.

To avoid rabies, teach your kids to avoid wild animals.
To avoid rabies, teach your kids to avoid wild animals. Photo by Emilie Chen (CC BY-ND 2.0)

It is also important to teach your kids to avoid wild animals. While most kids won’t go out of their way to pet a coyote, they might try to feed a racoon or skunk, and they might pick up a bat they find on the ground.

Kids should also avoid cats and dogs that they don’t know. Your kids should not just walk up and pet unfamiliar dogs and cats.

What to Do If Your Child Is Exposed to Rabies

Unfortunately, you won’t always know if an animal has rabies, although an animal acting strangely can be a tip off that they might have rabies.

Never touch a bat that you find on the ground during the day, as it might have rabies.
Never touch a bat that you find on the ground during the day, as it might have rabies. Photo by Radu Privantu (CC BY 2.0)

That bat your kids found on the ground could definitely have rabies, especially if they found it during the day. And the bat doesn’t even have to obviously bite your child. For example, if you find a sick or dead bat in your child’s room in the morning when he wakes up, you should consider that a possible exposure to rabies.

Many other exposures happen when kids are bitten by stray cats or dogs.

What do you do?

According to the CDC, if your child is bitten by any animal or has any possible exposure to rabies, you should:

  • immediately wash the wound well with soap and water, also using a povidone-iodine solution (Betadine Antiseptic Solution) to irrigate the wound if it is available
  • see a healthcare provider
  • call your local animal control for help in capturing the animal for observation or rabies testing

Animal control can also help in verifying a pet’s rabies vaccination status if your child was bitten by a neighborhood cat or dog.

“A healthy domestic dog, cat, or ferret that bites a person should be confined and observed for 10 days. Those that remain alive and healthy 10 days after a bite would not have been shedding rabies virus in their saliva and would not have been infectious at the time of the bite.”

CDC on Human Rabies Prevention — United States, 2008

In general, unless they already appear rabid, dogs, cats, and ferrets can be quarantined and observed for 10 days to see if they develop signs of rabies before your child begins post-exposure prophylaxis.

Other animals, including skunks, raccoons, foxes, coyotes, and bats should be considered rabid, with a quick start of post-exposure prophylaxis, unless the animal can be quickly tested (brain material) for rabies. And of course, you would be more considered about rabies if the animal was acting strangely, looked sick, or if it was an unprovoked attack.

What if you can’t find or capture the animal?

Depending on the circumstances, your pediatrician, with the help of your local or state health department, can determine if your child needs rabies post-exposure prophylaxis with rabies immune globulin and a 4 dose series of the rabies vaccine over 2 weeks.

“The number of rabies-related human deaths in the United States has declined from more than 100 annually at the turn of the century to one or two per year in the 1990’s. Modern day prophylaxis has proven nearly 100% successful.”

CDC on Rabies in the U.S.

About 40,000 to 50,000 people in the United States get rabies post-exposure prophylaxis each year. That works to keep the number of rabies cases and rabies deaths in people very low.

And it is not probably not at the top of your list of things to think about at a time like this, but animal bites can also be a risk for tetanus. Make sure your child doesn’t need a tetanus shot.

What to Know About Getting Exposed to Rabies

Keep your kids safe from rabies by vaccinating your pets and teaching them to avoid wild animals, but also know what to do if your child is exposed to rabies.

More on Getting Exposed to Rabies