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ProMed: Rabies Vax Shortage, Human Exposure

mixin

Well-known member
An elderly man who fed stray cats in his Oak Hills neighborhood was
bitten by a kitten that has tested positive for rabies, health
officials said Wednesday [1 Oct 2008]. It was the 2nd rabid cat
identified in Bexar County this year [2008] - a highly unusual
occurrence. And it comes as a nationwide shortage of human
post-exposure rabies vaccine is worsening.

The man, identified only as being in his 80s, is undergoing
post-exposure rabies treatment, said Christine Patmon, a spokeswoman
for the Metropolitan Health District.

"He had been seeing a skunk around his neighborhood," Patmon said.
"The concern now is that obviously this is our 2nd domestic cat within
Bexar County, and this skunk has not been captured." [Evidently the
cats are thought to have contracted rabies from the skunk. - Mod.JW]

Animal Care Services staff will distribute fliers in the neighborhood
Friday [3 Oct 2008], alerting residents to the risk for rabies,
Patmon said. State health officials have been rationing access to
rabies vaccine since the 2 worldwide manufacturers have seen their
supplies dwindle.


Problems began last summer when one of the manufacturers, Sanofi
Pasteur, began renovating its plant in France to comply with Food and
Drug Administration regulations. The Centers for Disease Control and
Prevention (CDC) reports that the shortage is unlikely to be resolved
until mid- to late 2009.


Metro Health, which maintains one of several state depots for human
rabies vaccine in Texas, is down to only 7 doses. The Texas
Department of State Health Services, which normally maintains 2300
doses in Austin and throughout the state, currently has just over 200.


Each series of rabies shots typically consists of 5 doses of vaccine,
along with 1 dose of immune globulin. The series costs between USD
1200 and USD 2000. Under the current system, state health officials
judge each possible human exposure on a case-by-case basis to see if
it warrants treatment. If it does, the patient's doctor or hospital
is given a password to order vaccine directly from the manufacturer.

"We're not aware of anyone who needed the vaccine in Texas who has
not gotten it," said Doug McBride, a spokesman for the state health
department.

Matthew Whitson, who oversees the vaccine for Metro Health, said the
city released vaccine to just one person last month [September 2008]
-- a resident who was bitten by a raccoon that could not be found for
testing. Rabies in domestic animals -- dogs and cats -- is uncommon
in Bexar County, which has reported a single case every few years,
predominantly in cats. It is much more common in wild animals. This
year [2008], rabies has been confirmed in 17 animals locally - 8
bats, 7 skunks and now 2 cats. The 1st cat was infected by a skunk
strain of rabies. The type of virus that infected the most recent cat
has not yet been determined.

Health officials are stressing the basics of rabies prevention --
vaccinating pets (the rabies vaccine for animals is not in short
supply) and keeping pets and people away from wildlife. Texas has had
one of the most complex problems with rabies in wildlife, with
outbreaks in coyotes, foxes, skunks and bats in recent years. Since
1995, the state has maintained a program of dropping vaccine-laden
biscuits in South, Central and West Texas to snuff out rabies in
coyotes and foxes.

Only one unvaccinated person is known to have survived rabies
infection, a teenage girl treated in 2004 with a combination of
antiviral drugs and put in an induced coma. A total of 14 Texans have
died of rabies in the past 30 years.

[Byline: Don Finley - Express News]
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,74230
 
Rabid Bat Brought to School

Rabid Bat Brought to School

October 3, 2008 STEVENSVILLE (AP) ? A parent brought a dead bat to Stevensville Elementary School earlier this week, and school officials are encouraging any children who touched the bat to get a series of rabies shots.

Stevensville Superintendent Kent Kultgen said the woman brought the dead bat to school Monday morning and showed it to the kindergarten and fifth-grade classmates of her children. She talked about the bat and allowed students to touch the dead animal and gave them hand sanitizer to wash their hands.

When school officials were notified, they called county and state health officials, sent letters home with every student who may have been exposed and sent the bat to a laboratory for testing.

The bat had rabies.

While the risk of contracting the disease from the dead bat are low, Kultgen said the 80 students who touched the bat are ?strongly encouraged? to get the shots. Their parents must give permission.

?I believe that every parent is going to say yes,? Kultgen said.

Rabies is a potentially fatal neurological virus that can be spread through saliva, usually through a bite.

Kultgen says the school district?s insurance policy will cover the cost of the shots, which could be up to $800 per student.

Another 10 or so children may have touched the bat at a club soccer practice and were being urged to contact county health officials.

Becky Rose?s 11-year-old son was among the fifth-graders who may have handled the bat.

?I?m not happy about the incident on a couple of different levels,? Rose said. ?The bat should not have been allowed on school property. And it shouldn?t have been OK with the teachers.

?I?m obviously upset and scared about the whole thing,? she said.

Kultgen said students will start getting the series of vaccines early next week.

http://www.greatfallstribune.com/apps/pbcs.dll/article?AID=/20081003/NEWS01/81003024
-----------------------------------------------------------
part of ProMed comments

Communicated by:
ProMED-mail <promed@promedmail.org>

[The risk of contacting rabies from touching the dead bat is very low.
But the school is taking no chances, and likely the parents are not
taking chances either.

It is difficult to comprehend how someone could not think about
rabies when handling a bat. Although studying bats is quite
fascinating, one wonders where the dead bat came from and whether the
person bringing it into the school ever stopped to consider what
caused the death of the bat.

Readers are encouraged to read ProMED-mail post 20080826.2659
regarding a shortage of rabies post-exposure prophylaxis. The
indication for post-exposure vaccination with or without rabies immune
globulin depends on the type of contact with the rabid animal.
According the World Health Organization:
 
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