Rabies

Overview
Rabies is a viral infection transmitted in the saliva of infected mammals. The virus enters the central nervous system of the host, causing an encephalomyelitis that is almost always fatal.

Although all species of mammals are susceptible to rabies virus infection, only a few species are important as reservoirs for the disease in nature. In the United States, several distinct rabies virus variants have been identified in terrestrial mammals, including major terrestrial reservoirs in raccoons, skunks, foxes and coyotes. In addition to the terrestrial reservoirs for rabies, several species of insectivorous bats also serve as reservoirs for the disease.

Wildlife is the most important potential source of infection for both humans and domestic animals in the United States. Reducing the risk of rabies in domestic animals and limiting contact with wild animals are central to the prevention of human rabies.

Vaccination of all domestic dogs, cats, and ferrets coupled with the systematic removal of stray animals that are at risk of exposure to rabid wildlife, are basic elements of a rabies control program. Georgia law requires that all owned dogs, cats and ferrets be vaccinated against rabies by a licensed veterinarian using approved vaccines in accordance with the Compendium of Animal Rabies Prevention and Control (see pages 46-50).

In the United States, indigenously acquired rabies among humans has declined markedly in recent years. The decline is, in part, due to vaccination and animal control programs begun in the 1940s that have practically eliminated the domestic dog as a reservoir of rabies and also to the development of effective human rabies vaccine and immune globulin.

In the United States since 1990, there have been 32 reported human rabies deaths (including two in Georgia--in 1991 and 2000, respectively). Although 24 (74%) of the 32 cases since 1990 have been attributed to bat-associated variants of the virus, a history of a bite was established in only two cases. Contact with bats occurred in approximately half of the other cases. In many of these cases, the bat bite was presumably not recognized nor the risk of rabies appreciated in order to seek appropriate medical attention.

Human rabies is a completely preventable disease if the risk of acquisition is appreciated and appropriate rabies post-exposure prophylaxis (consisting of both active and passive immunization) is obtained.

Because rabies is a fatal disease, the goal of public health (in coordination with the medical community) is, first, to prevent human exposure to rabies by education and, second, to prevent the disease by administering rabies post-exposure prophylaxis (PEP) if exposure occurs. Tens of
thousands of people are successfully treated each year after being bitten by an animal that may have rabies.

Although the decision to provide post-exposure prophylaxis rests with the patient and his or her physician, valuable consultations can be provided by the Georgia Poison Center, local health departments, or the Epidemiology Branch, Georgia Division of Public Health.

Legal Authority
The primary responsibility for the control of rabies in Georgia rests with county
boards of health. Chapter 31-19-1 of the Official Code of Georgia Annotated
(O.C.G.A.) empowers and requires each county board of health to adopt and
promulgate rules and regulations for the prevention and control of rabies (see pages
43-45).

Source: Georgia Rabies Control Manual, Georgia Division of Public Health, DHR