The Virginia Department of Health (VDH) is investigating a confirmed case of human rabies. The Virginia resident was bitten by a dog while traveling in India.
While the only documented cases of human-to-human transmission of rabies have been via organ transplantation, acting out of an abundance of caution, VDH is assessing those who had direct contact with this patient to see if there is any concern that they may have been exposed to rabies.
VDH is working with the Centers for Disease Control and Prevention and healthcare centers where the patient sought care, to assess any healthcare worker who potentially may have been exposed to rabies virus due to contact with this patient. VDH is also working to identify any family members and close contacts who may have been exposed to rabies virus due to contact with this patient.
According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.
Rabies infected animals can appear very aggressive, attacking for no reason. Some may act very tame. They may look like they are foaming at the mouth or drooling because they cannot swallow their saliva. Sometimes the animal may stagger (this can also be seen in distemper). Not long after this point they will die. Most animals can transmit rabies days before showing symptoms.
Initially, like in many diseases, the symptoms of rabies are non-specific; fever, headache and malaise. This may last several days. At the site of the bite, there may be some pain and discomfort. Symptomsthen progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.
Human rabies cases in the United States are rare, with only 1 to 3 cases reported annually. Twenty-eight cases of human rabies have been diagnosed in the United States since 2006, of which 8 cases were infected outside the United States and its territories. The last time VDH reported a human rabies case was in 2009. This patient had also traveled to India and was bitten by a dog while there.
Worldwide, it is estimated that there are more than 69,000 deaths due to rabies annually.