Family Matters: Rabies 101
This virus may be more common than you think
Did you know that rabies is the leading fatal infectious disease in China? In 2007 alone, 3,380 people in China died from confirmed rabies exposure. Compare that to the 39 in the United States since 1990, and that is one scary statistic.
I know I recently shared my concerns on the safety and necessity of vaccinating our children, but when it comes to our pets, I'm all for it. In fact, I may vaccinate my son for rabies when he’s older. Why? Rabies is 100 percent fatal. Measles is not. ¡®Nuff said.
To learn more about the issue, I wrote to Mary Peng, manager of the International Center for Veterinary Services (ICVS), and here is some of what I learned: 1) Despite mandatory annual rabies vaccinations for all dogs in China, compliance is still low, with less than 10 percent of dogs and 5 percent of cats vaccinated. 2) A person is rabies exposed if they are bitten or have an open wound licked by an infected animal. In 2006, more than 140,000 people in Beijing sought medical treatment after being bitten by animals. 3) Many shops, breeders, kennels and clinics are not legally designated by the Agricultural Bureau to administer vaccinations. Instead, these facilities lure pet owners into a false sense of security by procuring vaccines from the black market which may be expired, improperly stored or even counterfeit.
So what can we do to protect ourselves? First off, Peng advises that we vaccinate our pets at an officially designated animal vaccination hospital. ICVS is one such hospital and frequently offers free rabies vaccinations to ensure the safety of the pets and people of our community. Next, be sure to obtain an official immunity certificate from the pet clinic as verification. Finally, make sure that all family members receive theseries of pre-exposure human rabies vaccination. These three shots taken over 28 days will save you future worry and the expense of post-exposure shots, which are also hard to come by. Besides, as the saying goes, it’s better to be safe than sorry and this is one virus we do not want to mess with.
Kristen Billings
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in considering human rabies vaccine and incidence, the China CDC site is tremendously useful to see the actual inumbers. And not only for rabies, but all infectious diseases, on Chinese soil.
http://www.chinacdc.net.cn/n272562/index.html Go to the bottom section "Notifiable Infectious Diseases", the incidence and death data is reported month by month.
Current Chinese population can be found here http://www.chinability.com/China%20population%20clock.htm
This population clock does not include all the travelers in and out of the country, nor the expats residing here, so this is an underestimate of the true incidence of disease, but these 2 sites alone will give all of you the basic tools to estimate the risks yourselves.
Be prepared to drop a zero here or there (my calculator doesn't take more than 9 places), and/or to work with extremely minute numerals in your calculations....China simply is not as disease ridden as we sometimes like to think.
In a country of 1.3 billion +, an incidence rate of 370 rabies cases in a month (as was the case in Dec.) is not very significant.
That's a rate of .00000028 or 28 out of ONE HUNDRED MILLION people for that month. Even adjusted for a yearly rate (using that one month's data...I have not checked to see how representative of the norm it is) it's only .00000337 or 337 cases per 100 million, if my calculations are accurate.
Now you all have the tools to see FOR YOURSELF how widespread a particular disease is here. I hope that some of you will think for yourselves, weigh your risks, and perhaps even say "no" when your doc presents vastly different sentiments which do not line up with reality (i.e. lies).
Seriously, ask for hard numbers and hear for yourself the misinformation-- lies, if you will--just to sell you their poison vaccine instead of it sitting and going bad on the shelves. Doctors are in essence the Point-of-Contact salesmen for a multi billion dollar pharmaceutical industry. We all distrust salesmen...it's obvious a salesman does not necessarily have your individual health in mind when pushing a medicine.
best, Liora
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I would like to clarify a couple of points in KBilling's blog.
First of all, if exposed to rabies it is not 100% fatal. Wound hygiene is of utmost importance and even if bitten by a rabies-carrying animal it can in many cases simply be washed away by the flowing blood and/or washing/flushing with soap/water/disinfecting solution and not cause any infection whatsoever. I am not saying it would be wise to rely on this in all situations, but, really now, if the animal is unlikely to be rabid (a house pet, for instance), I'd be inclined to wait and see, and observe its behavior rather than take the vaccine as a first step.
Once symptoms of rabies develop in the affected person/animal, rabies is nearly uniformly fatal (there are a handful of cases of surviving rabies infection).
But there is a window there--a few days at least--to observe and wait, and still get the vaccine series, IF NEEDED, as a rabid animal will always show symptoms before the bitten party.
Also, K Billings wrote,
"[The preexposure rabies series of] three shots taken over 28 days will save you...the expense of post-exposure shots, which are also hard to come by"
Post exposure: The WHO recommends a 2-shot rabies vaccine series and rIG (rabies Immunoglobulin) in all cases of broken skin with a suspected rabies infected animal.
Having gotten vaccinated Pre Expousure only lessens your post exposure series of shots by ONE shot--the Rabies (rIG which is a primarily a wound flush but also sometimes given as a shot at the same time. ) You still need the other two normal postexposure vaccines, which is the same standard treatment with or without pre-exposure vaccination.
The rIG, while best practice, is not an absolute requirement. The WHO details two regimens, for administering intradermally a series of "normal" vaccine.
Other considerations: check that your Rabies vaccine is NOT a brain or nerve tissue vaccine, as this vaccine is still being produced in Asian countries. Vaccines containing virus cultured in brain tissue/nerve tissue are much cheaper to produce than the alternative (culturing the rabies virus on either chick embryos, monkey kidneys, or human diploid cells--that is a "clean" way of saying aborted fetal cells.) Trace amounts of these large foreign proteins--including this dead baby's DNA--enter your body...a big problem for Catholics and others who do not want aborted fetal cells roaming around in their blood).
Brain tissue vaccines also have an unacceptably high rate of adverse reactions and are less effective than the other types of vaccines so if one decides they DO need a rabies vaccine it pays to research it a little, ask some questions and/or secure another care provider quickly who can offer you less harmful products.
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sorry I did not check that before sending out and it was unclear and incorrect as written.
Post Exposure:
Previously unvaxed people who need prophylaxis should take the full 5 course dose of Rabies vax, plus the rIG
Vaxed people already took 3 doses Pre-Bite, and take the other 2 doses Post Bite but do not need the rIG.
So in each case, if bitten, the number of normal vaccines is the same overall, it's the rIG that you would not need post bite.
I just read that the nerve tissue vaccines contain up to 5% actual nerve tissue from rabies infected animals. Scary.
Interesting chart here http://www.cdc.gov/rabies/exposure/types.html showing the various cases when it is recommended to start PEP Post Exposure Prophylaxis and when not.
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here is a Youtube Video by a veterinarian with an alternate viewpoint.
http://www.youtube.com/ watch?v=ZVVWbhpzRuM&