First Human Case of Rabies in Illinois Since 1954(dph.illinois.gov)
dph.illinois.gov
First Human Case of Rabies in Illinois Since 1954
https://www.dph.illinois.gov/news/illinois-department-public-health-reporting-first-human-case-rabies-illinois-1954
185 comments
If it makes you feel any better, NH is about the same. We had a cat kill a bat overnight (except not all the way dead, as I found out). I wound up boxing the thing, leaving it in a cooler we never used any more and then driving it to the state hospital for testing because Fish and Game called me and walked me through an extensive flow chart style quiz about whether I needed to have it tested or not.
Easily 20 questions, Choose-Your-Own-Adventure-style. Except the last goddamn question was, "Was the animal you encountered a bat? If so, yes, get it tested".
Easily 20 questions, Choose-Your-Own-Adventure-style. Except the last goddamn question was, "Was the animal you encountered a bat? If so, yes, get it tested".
Maybe the need to think about rearranging the order of the questions. Seems like #20 => #1 would simplify a lot of things.
Kind of curious how that works, you just show up with a frozen bat in a box at USPS and they accept it?
[deleted]
Yes, if you comply with the relevant regulations.
https://pe.usps.com/text/pub52/pub52c5_008.htm#ep184109
526.7 Dead Animals or Parts of Animals
"GROUP A: Items that need to be refrigerated"
"GROUP B: Items that must be dried"
https://pe.usps.com/text/pub52/pub52c5_003.htm#ep183811
521 General Requirements
"protection of animal specimens against spoilage"
"Mailers are urged to work with postmasters"
https://pe.usps.com/text/pub52/pub52c3_027.htm#ep900096
349.23 Dry Ice
"containers that permit the release of carbon dioxide gas and conform to 49 CFR 173.217 and 175.10(a)(10)"
https://pe.usps.com/text/pub52/pub52apxc_029.htm#ep1000804
USPS Packaging Instruction 9A
"must be clearly marked “Carbon Dioxide Solid, UN1845” Or “Dry Ice, UN1845”"
https://pe.usps.com/text/pub52/pub52c5_008.htm#ep184109
526.7 Dead Animals or Parts of Animals
"GROUP A: Items that need to be refrigerated"
"GROUP B: Items that must be dried"
https://pe.usps.com/text/pub52/pub52c5_003.htm#ep183811
521 General Requirements
"protection of animal specimens against spoilage"
"Mailers are urged to work with postmasters"
https://pe.usps.com/text/pub52/pub52c3_027.htm#ep900096
349.23 Dry Ice
"containers that permit the release of carbon dioxide gas and conform to 49 CFR 173.217 and 175.10(a)(10)"
https://pe.usps.com/text/pub52/pub52apxc_029.htm#ep1000804
USPS Packaging Instruction 9A
"must be clearly marked “Carbon Dioxide Solid, UN1845” Or “Dry Ice, UN1845”"
Like a lot of things in life, it probably falls under "don't ask, don't tell", probably with some dry ice thrown in for good measure.
Mailing dry ice without following proper procedures as you describe can result in you being fined or arrested by the postal service, especially if your unlabeled dry ice injures a postal worker. Please don't put human beings at risk for the sake of laziness in mailing. There are good reasons for the rules, even if they're frustrating.
I knew there would be a comment like this. Excuse my while my eyes roll several loops in my skull.
Yes, mailing stuff that requires labeling without those labels can get you in deep shit (because the feds don't really do shallow shit).
That doesn't mean everyone doesn't do it left and right.
Go buy some refrigerated food or medication off eBay and see how it ships. Heck, a certain country will ship you all manner of truly dangerous things in nothing more than a bubble wrap envelope.
The amount of dry ice required to refrigerate a bat (or tub of caviar, or niche cheese, or whatever) is easy to package safely. Throw it in a rag in a strofoam temp cooler. Do a non-terrible job boxing it up and it won't get out in any form other than as a gas.
This is one of the many cases where the behavior of the average individual is not in accordance with the law and (as 20+yr of eCommerce have shown us) nothing bad happens except in cases of exceptional stupidity.
I know that "but the law" and assumptions of stupidity of the general public make for easy points around here but neither complaint is materially relevant in this situation.
Yes, mailing stuff that requires labeling without those labels can get you in deep shit (because the feds don't really do shallow shit).
That doesn't mean everyone doesn't do it left and right.
Go buy some refrigerated food or medication off eBay and see how it ships. Heck, a certain country will ship you all manner of truly dangerous things in nothing more than a bubble wrap envelope.
The amount of dry ice required to refrigerate a bat (or tub of caviar, or niche cheese, or whatever) is easy to package safely. Throw it in a rag in a strofoam temp cooler. Do a non-terrible job boxing it up and it won't get out in any form other than as a gas.
This is one of the many cases where the behavior of the average individual is not in accordance with the law and (as 20+yr of eCommerce have shown us) nothing bad happens except in cases of exceptional stupidity.
I know that "but the law" and assumptions of stupidity of the general public make for easy points around here but neither complaint is materially relevant in this situation.
"Do a non-terrible job boxing it up and it won't get out in any form other than as a gas."
It sounds like you're assuming dry ice is only dangerous in terms of cold burns.
The gas, carbon dioxide, is dangerous as well. People have died transporting dry ice in a vehicle. CO2 isn't the most dangerous gas, but in an enclosed space like a delivery vehicle it can cause problems. A delivery service needs to consider the cumulative effects of all packages. Your dry ice package may not be the only one in a vehicle.
Individuals without experience are generally not capable of doing a thorough risk assessment, which is why regulations are so important.
It sounds like you're assuming dry ice is only dangerous in terms of cold burns.
The gas, carbon dioxide, is dangerous as well. People have died transporting dry ice in a vehicle. CO2 isn't the most dangerous gas, but in an enclosed space like a delivery vehicle it can cause problems. A delivery service needs to consider the cumulative effects of all packages. Your dry ice package may not be the only one in a vehicle.
Individuals without experience are generally not capable of doing a thorough risk assessment, which is why regulations are so important.
Not disputing the dangers of CO2 in an enclosed space, but I'm going through my memory* of USPS/UPS delivery trucks, and not one of them have been enclosed. Sliding doors are always open. Semi-trucks are enclosed, yes, but humans are not in the enclosed areas.
*ymmv on your area
*ymmv on your area
I'm sure driving with the doors open in many delivery trucks helps as well, but I'm just as sure there are vehicle configurations where air is circulated between both areas and/or share an enclosed space.
Keep in mind, this is also an aviation concern as well as loading/unloading. Resting in the backs of trucks on break, etc.
Keep in mind, this is also an aviation concern as well as loading/unloading. Resting in the backs of trucks on break, etc.
My son flies cargo for FedEx in a smallish (Cessna Caravan) regional plane. It's pretty enclosed.
*ymmv applies here
As seen elsethread, there is one single model of plane in the entire air cargo freight industry that's able to protect the humans onboard from the atmospheric exposure risks of dry ice, so technically that's still YMMV, but realistically it's not, and thus the FAA warning last December.
https://www.freightwaves.com/news/dry-ice-the-russian-an-124...
https://www.freightwaves.com/news/dry-ice-the-russian-an-124...
There’s also air, sea, and rail transport to consider.
Again though, how many people are hanging out with the cargo in air/sea/rail transport?
Domestic air cargo flights typically have 2-3 crew members on board. They're inside the same pressure hull as the cargo; there's no barrier or filter. That's why dry ice must be declared and requires special handing for air transport.
https://www.freightwaves.com/news/faa-issues-dry-ice-alert-t...
https://www.freightwaves.com/news/faa-issues-dry-ice-alert-t...
Does someone crawl into the cargo compartment to unload it the moment its door is opened? If that person got caught in a CO2 pool they could plausibly fall unconscious & at least start suffocating before coworkers noticed they were absent for too long.
[deleted]
Yes, people knowingly set aside safety guidelines for their personal convenience all the time. Many NTSB investigations end up saying “pilot apparently skipped pre-flight checklist”. As with all such things, it’s fine until it’s not, and when something does eventually go wrong (and it will), the blame will rest on your shoulders for taking safety shortcuts. So I choose not to gamble the safety of others to avoid having to label a package as Dry Ice, even if others take the gamble instead.
[deleted]
Is it any different from Omaha Steaks shipping you some frozen steaks and burgers? As long as your box doesn't leak or smell, nobody at USPS is going to open it.
Yes. Omaha Steaks conform to USDA regulations and are regulated under 55 Meats, rather than 52 Animals:
https://pe.usps.com/text/pub52/pub52c5_011.htm
However, there is 349.23 Dry Ice, which applies to any package using it, whether meat or animal or other:
https://pe.usps.com/text/pub52/pub52c3_027.htm#ep900096
Note that USPS also requires you to declare if a package contains Perishable or Hazardous goods, and label it clearly if it's being mailed under 52 Animals:
https://pe.usps.com/text/pub52/pub52c5_004.htm
If you fail to do so, they can in theory fine you or have you arrested — especially for failing to declare dry ice, which falls under Hazard Class 9, the "miscellaneous" class:
https://pe.usps.com/text/pub52/pub52c3_004.htm
"Anyone who mails, or causes to be mailed, a nonmailable or improperly packaged hazardous material can be subject to legal penalties (i.e., fines and/or imprisonment)"
https://pe.usps.com/text/pub52/pub52c5_011.htm
However, there is 349.23 Dry Ice, which applies to any package using it, whether meat or animal or other:
https://pe.usps.com/text/pub52/pub52c3_027.htm#ep900096
Note that USPS also requires you to declare if a package contains Perishable or Hazardous goods, and label it clearly if it's being mailed under 52 Animals:
https://pe.usps.com/text/pub52/pub52c5_004.htm
If you fail to do so, they can in theory fine you or have you arrested — especially for failing to declare dry ice, which falls under Hazard Class 9, the "miscellaneous" class:
https://pe.usps.com/text/pub52/pub52c3_004.htm
"Anyone who mails, or causes to be mailed, a nonmailable or improperly packaged hazardous material can be subject to legal penalties (i.e., fines and/or imprisonment)"
and are regulated under 55 Meats, rather than 52 Animals
Talk about your "you must be fun at parties"; and this isn't necessarily directed at you, floatingatoll, but when I see comments like this I often wonder if it's a case of "memorizes USPS shipping rules for fun" or more likely "worked on a contract once where we had to codify USPS shipping rules into an application, so I don't have them memorized but sure as hell know where to look".
For example, I've written code for computers to consume for the vast majority of my career. But go ahead and ask me the finer points of cellophane manufacturing...please, I've been waiting years for it to come up in conversation.
Talk about your "you must be fun at parties"; and this isn't necessarily directed at you, floatingatoll, but when I see comments like this I often wonder if it's a case of "memorizes USPS shipping rules for fun" or more likely "worked on a contract once where we had to codify USPS shipping rules into an application, so I don't have them memorized but sure as hell know where to look".
For example, I've written code for computers to consume for the vast majority of my career. But go ahead and ask me the finer points of cellophane manufacturing...please, I've been waiting years for it to come up in conversation.
The latter is closer than the former, but I’ve put in a lot of time reading postal regs and studying library classification over the years, so I can navigate their index pretty quickly, is all.
I would like to sign up for cellophane facts.
I, too, would like to hear stories about cellophane manufacturing.
Mike, you should hook up with The Prepared email newsletter and ask to be a guest author some week. They would be super excited to have you participate. :)
Mike, you should hook up with The Prepared email newsletter and ask to be a guest author some week. They would be super excited to have you participate. :)
Man, tough crowd. One smart ass remark turns into writing a newsletter article. :-) In seriousness, I'll make an honest effort at seeing if I can come up enough interesting paragraphs, and then check The Prepared (a new one to me). Here's a preview of what I learned on my first day: cellophane is made from wood (which gets pulped, and broken down with nasty chemicals). I always assumed it was some kind of plastic. I was there to get them off that mainframe, but hung out with those on the floor when I could.
Depending on one's career path, though, I think we all collect little tidbits along the way that are way outside of the software craft. I was a partner in a consulting company back in the 90s, and we specialized in small-medium businesses. Anything from cellophane to auto body shops to mail-order jewelry (class rings and the like). It wasn't always interesting (see: mail-order jewelry), but my "TIL" moments were probably more frequent than any other time.
Depending on one's career path, though, I think we all collect little tidbits along the way that are way outside of the software craft. I was a partner in a consulting company back in the 90s, and we specialized in small-medium businesses. Anything from cellophane to auto body shops to mail-order jewelry (class rings and the like). It wasn't always interesting (see: mail-order jewelry), but my "TIL" moments were probably more frequent than any other time.
https://theprepared.org/newsletter-archive/2021-09-27
A post about cellophane would be perfect for this audience :)
A post about cellophane would be perfect for this audience :)
Agreed -- I already subscribe to the Prepared and can vouch for their readers' acute interests in manufacturing technology.
To be honest, just dealing with this once can make you remember it for eternity.
For example, I know that if I want to declare a computer peripheral to the customs, there is a good chance to get the correct TARIC code in the chapter that literally starts with "Nuclear reactors"...
For example, I know that if I want to declare a computer peripheral to the customs, there is a good chance to get the correct TARIC code in the chapter that literally starts with "Nuclear reactors"...
Not an answer, but there was an excellent thread about this topic this year: https://news.ycombinator.com/item?id=28210780
Yup. Had to pack bat in a freezer ziploc and stick it in the freezer. Then when shipping, pack it in another freezer ziploc with paper towels (for moisture) and a blue ice pack (no dry ice).
After that, put in a box with a UN 3373 category B label affixed to it. Add contents list to the box as required by the label and after that drop off with your mail company of choice (UPS in our case).
Seems to be a common thing, no one bat an eye :)
After that, put in a box with a UN 3373 category B label affixed to it. Add contents list to the box as required by the label and after that drop off with your mail company of choice (UPS in our case).
Seems to be a common thing, no one bat an eye :)
Ooo, fancy. "Biological Substance"! I missed that USPS would classify this as infectious matter, which is where they're hiding that UN requirement.
[deleted]
DEAD BAT DO NOT EAT
A similar incident happened to me about two years ago. Cats caught a bat around mid-late August, proudly brought it in and dropped it by me. Still kicking, the bat took off and flew into a ceiling fan.
I called animal control, they were out in about 30min to pick it up. Called the vet, cats were up to date on their vax, recommended boosters, explained that a 45 day quarantine was required. Animal control got back in touch about 48 hours later with the results - negative. I didn’t need to pay anything.
I’m also in the Mountain West, and although I’ve never encountered a rabid animal, apparently rabid skunks, bats, and raccoons aren’t uncommon around here. Animal control responds to these incidents pretty quickly.
I called animal control, they were out in about 30min to pick it up. Called the vet, cats were up to date on their vax, recommended boosters, explained that a 45 day quarantine was required. Animal control got back in touch about 48 hours later with the results - negative. I didn’t need to pay anything.
I’m also in the Mountain West, and although I’ve never encountered a rabid animal, apparently rabid skunks, bats, and raccoons aren’t uncommon around here. Animal control responds to these incidents pretty quickly.
I know skunks are one of the biggest carriers of rabies, and they are found even in big cities. A housecat that roams outside and has a scuffle with one could easily bring it home if the cat has not had its shots.
Similar story to friends of mine, only in their case the bat tested positive. They had to get the full series of shots.
Their cat who found the bat was already vaccinated but they had to take it to the vet for a booster. The cat does not travel well, so it got freaked out in the car and was sick, including foaming at the mouth. There was a new tech at the vet who I guess hadn’t been informed of the situation, so when my friends walked in and said “hi, our cat needs a rabies booster,” the tech was suitably freaked out for the 30 seconds it took them to explain.
Their cat who found the bat was already vaccinated but they had to take it to the vet for a booster. The cat does not travel well, so it got freaked out in the car and was sick, including foaming at the mouth. There was a new tech at the vet who I guess hadn’t been informed of the situation, so when my friends walked in and said “hi, our cat needs a rabies booster,” the tech was suitably freaked out for the 30 seconds it took them to explain.
There was a This American Life episode with a story about a woman attacked by a rabid raccoon. She called a few local health departments but since it was the weekend they were all closed so she left voicemails. She then went to the ER and was told that she had 10-14 days to get vaccinated.
Luckily one of the health departments called back and let her know she actually needed to get a rabies vaccination within 72 hours of the attack, which means she needed it today.
She was referred to her county's health department who informed her that they wanted to test the raccoon for rabies first and the closest lab was 2 hours away. After pleading with them they referred her to a hospital in another county, who refused to give it to her because she was from a different county. After pleading with them they finally gave her the shot, but in the wrong place.
She then had to fight with eight separate doctors to give her the 5 follow-up shots.
Luckily one of the health departments called back and let her know she actually needed to get a rabies vaccination within 72 hours of the attack, which means she needed it today.
She was referred to her county's health department who informed her that they wanted to test the raccoon for rabies first and the closest lab was 2 hours away. After pleading with them they referred her to a hospital in another county, who refused to give it to her because she was from a different county. After pleading with them they finally gave her the shot, but in the wrong place.
She then had to fight with eight separate doctors to give her the 5 follow-up shots.
Are you still doing PEP? I feel like betting your life on a $100 test of a frozen, shipped bat is really risky.
No, DOH + us decided against PEP because the bat didn't get near us. They asked us in umpteen different ways whether or not that was the case.
DOH seemed quite reluctant prescribing PEP mentioning too that it is quite an intensive treatment (who gives though, being dead being the other option).
DOH seemed quite reluctant prescribing PEP mentioning too that it is quite an intensive treatment (who gives though, being dead being the other option).
Well a buddy of mine found a bat in the backyard here in Portland. Went to dispose of it and the thing was still alive!
He called the Audubon Society – they wanted him to bring it in for rehab, which meant no rabies test. The animal can only be tested if dead.
The bad had an accident, died, and he sent it to Oregon State to be tested. It was positive!
Lesson, do not handle bats without extreme care, make sure your pets are vaccinated, and get the creature tested.
https://www.multco.us/multnomah-county/news/rabid-bat-found-...
He called the Audubon Society – they wanted him to bring it in for rehab, which meant no rabies test. The animal can only be tested if dead.
The bad had an accident, died, and he sent it to Oregon State to be tested. It was positive!
Lesson, do not handle bats without extreme care, make sure your pets are vaccinated, and get the creature tested.
https://www.multco.us/multnomah-county/news/rabid-bat-found-...
Ours was sent to Oregon State too, they got back to us with test results within 6 hours of delivery - 20 hours after I shipped it from the Seattle area. Was pretty impressive :-)
just today I was thinking about how more and more organisations show signs of systemtaic overload and cluelessness. even if you pay specifically for a service supposed to handle situations and shield you from further complications of specific incidences there is no guarantee they know what they are doing or - and that's one of the core reasons for this class of problems - know what their subcontractors are doing. often those don't even care because they themselves are shielded by other insurances and the responsibilites are passed on endlessly like a hot potato. a similar very recent problem would be the various supply chain issues we are experiencing. nobody seems to have close grip on things anymore. like playing the telephone game we can just hope the message is passed on uncurropted and the answer doesn't get stuck somewhere or also corrupted which might trigger just the next misunderstanding. it's totally nuts.
This story was interesting to me because growing up rabies was always something we kind of worried about as kids; it seemed like something that was common and to worry about. I distinctly remember people talking about how fatal it was if you weren't treated, and how horrible the treatment was. I remember people talking about needing multiple injections from large needles to your abdomen.
By the time I was a teen I learned that rabies was rare, but this story helped illustrate how rare it actually is, in my home state nonetheless!
By the time I was a teen I learned that rabies was rare, but this story helped illustrate how rare it actually is, in my home state nonetheless!
Same here. The bit about 21 needles in your stomach was especially horrifying. I knew a guy who had the treatment recently, and he said it was 6 shots in the arm.
I had the treatment- 5 or 6 shots in total in the arm, I think it was, over multiple sessions, staggered n days apart.
I had immunoglobulins injected directly into the dog bite wound and over 3 sessions along with shots in the arm.
My understanding is that the shots in the arm only work if you’ve also had the vaccine ahead of time. My knowledge may be out of date though.
Friends of mine had to get the series in 2019, and they were not previously vaccinated.
The vaccine is only recommended for people who are more likely to encounter rabid animals, like animal control workers or cavers. With prompt treatment, the PEP series is sufficient.
The virus moves through the body at up to around 7cm per day IIRC, so a bite on the neck is of more immediate concern than a bite on the hand, because it has less distance to travel to reach the brain. (Why anyone would wait at all is beyond me.)
The vaccine is only recommended for people who are more likely to encounter rabid animals, like animal control workers or cavers. With prompt treatment, the PEP series is sufficient.
The virus moves through the body at up to around 7cm per day IIRC, so a bite on the neck is of more immediate concern than a bite on the hand, because it has less distance to travel to reach the brain. (Why anyone would wait at all is beyond me.)
My brother was bit by a dog when he was 7 or 8 while we're at grandparents. I remember that there was uncertainty whether the the dog was rabid, and the doctors were seriously concerned. He had the full 20 needles into stomach treatment. It was not a happy time to be him.
When I was bitten by a dog around 7 or 8 my doctor just said it was no big deal.
Granted it was a domesticated dog (that I liked to pet on my way to school) but still they probably should have been a bit more careful!
Granted it was a domesticated dog (that I liked to pet on my way to school) but still they probably should have been a bit more careful!
Same. We were definitely told to stay away from raccoons and bats, especially during the day (both are normally nocturnal or close to it).
The only people I know who've required rabies treatment had encounters with bats. Usually a bat got into their home through an open window, but wasn't noticed for some time. From what I was told, small bat bites aren't particularly painful or large and can look like bug bites, so any bat in the house usually ends up with a rabies treatment for residents.
The only people I know who've required rabies treatment had encounters with bats. Usually a bat got into their home through an open window, but wasn't noticed for some time. From what I was told, small bat bites aren't particularly painful or large and can look like bug bites, so any bat in the house usually ends up with a rabies treatment for residents.
And what's worse, is when raccoons get distemper, they act massively aggressive, and really, really weird. SO there's nothing like the pants shitting terror of an aggressive raccoon, and then worrying that you might need rabies shots as well just to find out that it was just distemper.
I'm in in my mid 20s, and I distinctly remember the fear of rabies because of the injections (20 needles in the stomach).
Modern rabies shots (post 1970’s) are no longer painful. Had them after our dog died of rabies. It is a horrible death.
Yep, same here.
However, don't forget Old Yeller. Man, that movie certainly drove the fear home.
However, don't forget Old Yeller. Man, that movie certainly drove the fear home.
Two years ago a young woman died here in Norway from rabies - it was the first case in over 200 years. She had been on vacation in the Philippines, and while outside she and her friends had found a small puppy on the roadside. They took it with them back home, washed and cleaned. Apparently, the puppy had been nipping on them from time to time - like regular puppies do.
Later, back home, she started showing symptoms - and subsequently died 3 months after the vacation. None of the others that had played with the puppy tested positive.
In any case - if animals bite you, especially in high-risk countries, get started on a treatment.
Later, back home, she started showing symptoms - and subsequently died 3 months after the vacation. None of the others that had played with the puppy tested positive.
In any case - if animals bite you, especially in high-risk countries, get started on a treatment.
What a horrible way to die.
Fun Story:
Was out for a late night walk in the fall and heard the same "hoot hoot" from an owl I've heard forever. Except this night, as I'm walking on the sidewalk as I always do, I get slammed in the back of my head and lurch forward. I look up and I see an owl flying away. I literally got dive bombed by an owl.
I felt fine, outside of some cobwebs to shake off from getting my bell rung. I instinctively rub the back of my head where I got hit and find blood. So, I'm attacked by animal and drew blood, my first thought is rabies.
So like any self respecting nerd I google "owl rabies". The general answer here is I should be OK, but most of the data talks about BITES. I didn't get bitten. More information required.
Looking for more a more authoritative source information, and expecting I would need to contact my insurance company anyway if I did require treatment, I call our insurance company nurse line.
Their data isn't much better. I ask if I should go to the ER, they basically leave it up to me. I ask if it would be covered by the insurance, they have no idea. I decide I'm not messing with rabies, so to the ER I go.
The ER checks out my head and it is largely superficial damage that will heal on its own after being cleaned up, but definitely a legitimate blood drawing puncture wound. Their research notes that owls themselves are safe, but animals owls predate on can carries rabies and they obviously use their claws to do that. If the owl bit me I'd be free and clear, but since I got clawed we've entered the gray area where I had to make a choice.
In theory, I should be fine and can just go home. The owl would have to predate on an animal that had rabies, get its saliva or nervous system tissue on its claws, and then get that into me through the wound. Rabies odds are low, the specific circumstance required drives it lower, you know the drill.
But as most readers here know, theory isn't practice. Rabies has to essentially be treated immediately, so if if this is the one time in life that I hit the jackpot, that's all she wrote. The staff iterated that the treatment was going to be "unpleasant", but if I googled "rabies death" it would likely be much more palatable.
That first round was a bunch of shots at various locations around my body. To try to help they rounded up nurses, armed each one with a needle, and had everyone give it to me at the same time. I felt like a pincushion, but pain wise it did actually help. I remember a sense of bodily confusion, like my body was struggling to figure out and convey what was happening where. I've never felt anything like that before or since.
The boosters from there were single shots. Since we had no way to test the animal they took the worst case schedule, which I think added an additional shot. They were largely uneventful, other than needing to return to the ER because rabies vaccine is pretty much not available anywhere else (at least around here).
The series was EXPENSIVE. I'd have to dig up the bill to find the exact numbers, but it would have easily smashed my deductible on its own. Part of the issue were the follow-ups - each was the injection plus a minimum level ER visit.
I was fortunate because my wife was pregnant at the time and was due to give birth any day, so regardless of this incident we were going to be smashing through our out-of-pocket limit anyway. It did create some confusion when I had to go to the ER to get one of the boosters during her birthing stay. Not too often do people come to the ER for treatment from the hospital side with admittance bands on and whatnot :-)
Was out for a late night walk in the fall and heard the same "hoot hoot" from an owl I've heard forever. Except this night, as I'm walking on the sidewalk as I always do, I get slammed in the back of my head and lurch forward. I look up and I see an owl flying away. I literally got dive bombed by an owl.
I felt fine, outside of some cobwebs to shake off from getting my bell rung. I instinctively rub the back of my head where I got hit and find blood. So, I'm attacked by animal and drew blood, my first thought is rabies.
So like any self respecting nerd I google "owl rabies". The general answer here is I should be OK, but most of the data talks about BITES. I didn't get bitten. More information required.
Looking for more a more authoritative source information, and expecting I would need to contact my insurance company anyway if I did require treatment, I call our insurance company nurse line.
Their data isn't much better. I ask if I should go to the ER, they basically leave it up to me. I ask if it would be covered by the insurance, they have no idea. I decide I'm not messing with rabies, so to the ER I go.
The ER checks out my head and it is largely superficial damage that will heal on its own after being cleaned up, but definitely a legitimate blood drawing puncture wound. Their research notes that owls themselves are safe, but animals owls predate on can carries rabies and they obviously use their claws to do that. If the owl bit me I'd be free and clear, but since I got clawed we've entered the gray area where I had to make a choice.
In theory, I should be fine and can just go home. The owl would have to predate on an animal that had rabies, get its saliva or nervous system tissue on its claws, and then get that into me through the wound. Rabies odds are low, the specific circumstance required drives it lower, you know the drill.
But as most readers here know, theory isn't practice. Rabies has to essentially be treated immediately, so if if this is the one time in life that I hit the jackpot, that's all she wrote. The staff iterated that the treatment was going to be "unpleasant", but if I googled "rabies death" it would likely be much more palatable.
That first round was a bunch of shots at various locations around my body. To try to help they rounded up nurses, armed each one with a needle, and had everyone give it to me at the same time. I felt like a pincushion, but pain wise it did actually help. I remember a sense of bodily confusion, like my body was struggling to figure out and convey what was happening where. I've never felt anything like that before or since.
The boosters from there were single shots. Since we had no way to test the animal they took the worst case schedule, which I think added an additional shot. They were largely uneventful, other than needing to return to the ER because rabies vaccine is pretty much not available anywhere else (at least around here).
The series was EXPENSIVE. I'd have to dig up the bill to find the exact numbers, but it would have easily smashed my deductible on its own. Part of the issue were the follow-ups - each was the injection plus a minimum level ER visit.
I was fortunate because my wife was pregnant at the time and was due to give birth any day, so regardless of this incident we were going to be smashing through our out-of-pocket limit anyway. It did create some confusion when I had to go to the ER to get one of the boosters during her birthing stay. Not too often do people come to the ER for treatment from the hospital side with admittance bands on and whatnot :-)
Most probable explanation
Owlet falling from nest or ready to jump from it and falling at the soil
You were most probably walking too close to the hidden owlet.
Father did what owls do when feel their owlets threatened, dive bombing from behind and attack directly to the head and neck.
Rabies is a mammals disease, fortunately can't develop in other vertebrates or migratory bird season would be a nightmare, so this owl was not under the effect of this disease. Is a typical nest defense behavior.
Nurses were probably upset against you
Owlet falling from nest or ready to jump from it and falling at the soil
You were most probably walking too close to the hidden owlet.
Father did what owls do when feel their owlets threatened, dive bombing from behind and attack directly to the head and neck.
Rabies is a mammals disease, fortunately can't develop in other vertebrates or migratory bird season would be a nightmare, so this owl was not under the effect of this disease. Is a typical nest defense behavior.
Nurses were probably upset against you
This guy deserves a Darwin award to be named after him. He woke up with a bat gnawing on his neck and refused to get a rabies shot. He died of rabies.
He obviously was hoping to become our vampire overlord.
It's even worse than that. The news articles said that he had a bat colony living in his house.
I wonder if this was a case of "I don't want it" or "I can't afford it (but maybe could have some luck and don't get it)".
I am curious whether/to what extent cost played a role in his decision.
So just like our ancestors, he lived in a cage.
The patient was in their 80s. I can give a pass for "dont give a fuck" at that point
There are lots of ways to die in your 80s. Pretty sure "rabies" is not high on my list.
Are you 80? Clearly you don't have a very strong "dont give a fuck" sense
My grandfather starved himself to death in his 90s when gangrene started to take his feet. Pretty sure I know what "don't give a fuck" looks like, and rabies is NOT it.
Dying by rabies is very unpleasant.
There’s a couple videos on YouTube detailing the process.
It’s like advanced Alzheimer’s, delirium, and water starvation in one disease, mixed with unbelievable pain.
There’s a couple videos on YouTube detailing the process.
It’s like advanced Alzheimer’s, delirium, and water starvation in one disease, mixed with unbelievable pain.
Here is a video of the US Army Medical Service that shows dying of rabies.
https://youtu.be/OOu2JjQmS6Y
Even if you don't give a fuck, you wouldn't choose this way to die.
Even if you don't give a fuck, you wouldn't choose this way to die.
damn, 138k views with out one comment
Comments can be set to manually approve, then none approved.
An 80 year old male in the US has a life expectancy of 8.4 years[1]. That's a lot of time to bet, especially since "aggressive bat" is almost certainly rabid.
[1] https://www.ssa.gov/oact/population/longevity.html
[1] https://www.ssa.gov/oact/population/longevity.html
I thought bats are just rabies carriers and don’t exhibit any symptoms of the disease?
A rabid bat might not be showing any symptoms, so you have to assume all bats might have rabies. That's why health authorities tend to say "just looking at a bat, you can't tell if it has rabies."
That said, daytime flying, obvious sickness, and aggression/biting are all symptoms of likely rabies in bats.
That said, daytime flying, obvious sickness, and aggression/biting are all symptoms of likely rabies in bats.
On average, yes. That particular person might be a terminal cancer patient, though.
Rabies has to be one of the absolute worst ways to die.
Nowadays, they will put you into artificial coma and then you die.
Not nice, but not really worse than many other modes of death - at least superficially. We do not know what happens in the sedated brains of the patients in their last days.
Not nice, but not really worse than many other modes of death - at least superficially. We do not know what happens in the sedated brains of the patients in their last days.
Sure, but dying from rabies is not fun.
Presumably you won’t be aware of any of it. Any decent hospital will sedate a rabies patient with enough drugs won’t even know where you are.
See Milwaukee protocol. It did failed to improve outcomes after subsequent testing but they basically put you in a coma which I assume they still do out of compassionate reasons.
See Milwaukee protocol. It did failed to improve outcomes after subsequent testing but they basically put you in a coma which I assume they still do out of compassionate reasons.
Afaik it only worked once by pure luck.
[deleted]
Additionally:
Rabies treatment doesn't guarantee survival, it's really a crap shoot
Rabies treatment can cost $22k out-of-pocket [1]
[1] https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
In a very USA way, this guy might have been forced to choose between death-by-rabies and leaving something for his descendants.
Rabies treatment doesn't guarantee survival, it's really a crap shoot
Rabies treatment can cost $22k out-of-pocket [1]
[1] https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
In a very USA way, this guy might have been forced to choose between death-by-rabies and leaving something for his descendants.
I understand that rabies treatment promptly after the bite ( "post-exposure prophylaxis" ) has a very good track record. (1)
But if you leave it until symptoms start, it's pretty much a death sentence. A terrible, agonising death, too. (2)
There are also vaccines, that can be taken pre-exposure. What I did not know is that they date back to 1885 (3)
1:
> Existing vaccine regimens for rabies PEP are close to 100% effective and WHO-prequalified vaccines are highly effective. The expected number of rabies deaths in patients receiving PEP after a confirmed rabies exposure is fortunately extremely low.
https://www.sciencedirect.com/science/article/pii/S0264410X1...
2:
> As of 2016, only fourteen people had survived a rabies infection after showing symptoms. Rabies causes about 56,000 deaths worldwide per year
https://en.wikipedia.org/wiki/Rabies
3: https://en.wikipedia.org/wiki/Rabies_vaccine
But if you leave it until symptoms start, it's pretty much a death sentence. A terrible, agonising death, too. (2)
There are also vaccines, that can be taken pre-exposure. What I did not know is that they date back to 1885 (3)
1:
> Existing vaccine regimens for rabies PEP are close to 100% effective and WHO-prequalified vaccines are highly effective. The expected number of rabies deaths in patients receiving PEP after a confirmed rabies exposure is fortunately extremely low.
https://www.sciencedirect.com/science/article/pii/S0264410X1...
2:
> As of 2016, only fourteen people had survived a rabies infection after showing symptoms. Rabies causes about 56,000 deaths worldwide per year
https://en.wikipedia.org/wiki/Rabies
3: https://en.wikipedia.org/wiki/Rabies_vaccine
If you're 80 in the USA, you're on Medicare. In the article you link, a Medicare patient paid $186 for treatment.
That's why capturing the animal and prompt testing is important. If you get treated/shots right away, your prognosis is good. If you wait until the disease starts to affect you, your chances go way down.
> If you wait until the disease starts to affect you, your chances go way down.
This is an understatement: "Rabies causes about 56,000 deaths worldwide per year. As of 2016, only fourteen people had survived a rabies infection after showing symptoms."
This is an understatement: "Rabies causes about 56,000 deaths worldwide per year. As of 2016, only fourteen people had survived a rabies infection after showing symptoms."
Well at that age he would have passed on his genetic material already. The point of the Darwin “award” is to praise genetically unfit people who die before reproducing, thus improving the fitness of the species and pushing evolution forward. So no, he doesn’t get a Darwin Award.
From the Darwin Awards' official rules:
> The existence of offspring, though potentially deleterious to the gene pool, does not disqualify a nominee. . . [E]ach nominee is judged based on whether or not she has removed her own genes, without consideration to the number of offspring or, in the case of an elderly winner, the likelihood of producing more offspring.
https://darwinawards.com/rules/rules1.html
> The existence of offspring, though potentially deleterious to the gene pool, does not disqualify a nominee. . . [E]ach nominee is judged based on whether or not she has removed her own genes, without consideration to the number of offspring or, in the case of an elderly winner, the likelihood of producing more offspring.
https://darwinawards.com/rules/rules1.html
> While cases of human rabies in the United States are rare with only 1 to 3 cases reported each year
I'm rather amazed that case numbers are so low in such a large population as the US. I would have expected rabies deaths to be 1-3 per year, with cases being in the low hundreds. Clearly I've overestimated how often people come into physical contact with wild animals and or pets with rabies.
Back when I was a child parents always instructed children on avoiding animals in regards to rabies, what to watch out for as signs. Wildlife instructors would come into school for a fun day, and rabies would inevitably be one of the topics of safety. Given the warnings I fully expected to encounter rabid animals far more often than I have in my lifetime (which is zero times so far).
I'm rather amazed that case numbers are so low in such a large population as the US. I would have expected rabies deaths to be 1-3 per year, with cases being in the low hundreds. Clearly I've overestimated how often people come into physical contact with wild animals and or pets with rabies.
Back when I was a child parents always instructed children on avoiding animals in regards to rabies, what to watch out for as signs. Wildlife instructors would come into school for a fun day, and rabies would inevitably be one of the topics of safety. Given the warnings I fully expected to encounter rabid animals far more often than I have in my lifetime (which is zero times so far).
Plenty of people come into such contact in the US, but they get treated before they develop rabies [1]:
> Yet each year, hundreds of thousands of animals need to be placed under observation or be tested for rabies, and between 30,000 to 60,000 people need to receive rabies postexposure prophylaxis.
[1] https://www.cdc.gov/rabies/location/usa/surveillance/human_r...
> Yet each year, hundreds of thousands of animals need to be placed under observation or be tested for rabies, and between 30,000 to 60,000 people need to receive rabies postexposure prophylaxis.
[1] https://www.cdc.gov/rabies/location/usa/surveillance/human_r...
Any dog or cat bite where the animal is retained typically requires a 10 day rabies observation. I worked for a vet and was trained in the process. If the animal is alive after 10 days and not showing symptoms, no rabies. If the animal dies for any reason, remove head and ship to lab for testing.
When you don’t have the animal it is a problem. Had a friend but by a stray cat that subsequently ran away -— he had to get the treatment. Same friend was subsequently bit by a beaver and had the treatment a second time.
I’m sure this guy’s response at 80 was something like “ we all gotta die of something “
When you don’t have the animal it is a problem. Had a friend but by a stray cat that subsequently ran away -— he had to get the treatment. Same friend was subsequently bit by a beaver and had the treatment a second time.
I’m sure this guy’s response at 80 was something like “ we all gotta die of something “
I'm sure I got told to "stop, drop, and roll" dozens of times before I turned 10. I haven't caught on fire yet (mostly because of other fire safety techniques they taught).
Teaching before the knowledge is needed is important
Teaching before the knowledge is needed is important
I might be wrong, but I don't think they report cases prevented with post-exposure treatment as cases. This would mean that the 1-3 cases are equal to 1-3 deaths.
It used to be, treatment for rabies was subsidized by state governments in the US. Lately these programs have been discontinued because they were getting really expensive. Costs for rabies treatment has gone up 400% in the last 10 years or so. Someone posted this article recently.
https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
Ugh. 380% increase in the immunoglobulin cost in a decade. Large increases in the vaccine cost. 2-3x markup at the ER. Plus, the ER charges thousands for administering the shot. $20k for the first round alone in one case (most of which would have been hospital fees - the drugs don't come anywhere near that despite the massive markups).
Absolutely disgusting.
Absolutely disgusting.
Depends where you live I suppose. My daughter and two of her friends were in the woods with one of the moms a month or so ago, and one of the girls was bit by a presumably rabid raccoon. She went to the hospital, got treated, was released the next day and has been fine.
We don't live in a particularly dangerous area as far as rabies goes, and the county animal control guy was apparently surprised, but it just happens sometimes I guess. Fortunately it seems like the course of rabies treatment is not as difficult as it used to be assuming you get to the hospital in time.
We don't live in a particularly dangerous area as far as rabies goes, and the county animal control guy was apparently surprised, but it just happens sometimes I guess. Fortunately it seems like the course of rabies treatment is not as difficult as it used to be assuming you get to the hospital in time.
A case of rabies is, 99% of the time, a case of death.
There’s only one known survivor ever[1] and it’s a hell of a way to die.
[1] https://www.scientificamerican.com/article/jeanna-giese-rabi...
[1] https://www.scientificamerican.com/article/jeanna-giese-rabi...
That article is from a few years after the first successful attempt at treatment. While enormously involved and expensive, with a low probability of success and a near certainty of moderate to severe neurological damage, it appears that the general treatment approach used for Giese has since resulted in further survivors, such that there have now been around a dozen survivors out of a few dozen post-symptomatic treatment attempts.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
According to this study[1], there have been about 20 reported survivors worldwide. Because it's so rare in countries with the medical infrastructure to report these things, it's probably pretty hard to infer the actual survival rate.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
>Because it's so rare in countries with the medical infrastructure to report these things, it's probably pretty hard to infer the actual survival rate.
I'm reasonably certain that rabies without intensive treatment (Milwaukee or Recife or similar, the topics of that study) has had no recorded survivors after exhibiting symptoms, ever, in all the thousands of years it has been known. Given how technically intensive the treatment is, anyone performing it likely has the infrastructure to report on the treatment as well, and so I expect that study likely does include most treatment attempts.
With that said, cases slipping through pre-symptomatic discovery and treatment are so rare in countries with the infrastructure to even attempt post-symptomatic treatment that we likely don't have a good idea of what we could get the survival rate to be.
I'm reasonably certain that rabies without intensive treatment (Milwaukee or Recife or similar, the topics of that study) has had no recorded survivors after exhibiting symptoms, ever, in all the thousands of years it has been known. Given how technically intensive the treatment is, anyone performing it likely has the infrastructure to report on the treatment as well, and so I expect that study likely does include most treatment attempts.
With that said, cases slipping through pre-symptomatic discovery and treatment are so rare in countries with the infrastructure to even attempt post-symptomatic treatment that we likely don't have a good idea of what we could get the survival rate to be.
That virus is near 100% deadly and there's a vaccine. How comes that not everyone is vaccinated?
Because hospitals aren’t full of people with rabies.
But...neither are they full of people with varicella (nor were they ever).
So that's clearly not the only reason to vaccinate people.
I suppose rabies doesn't spread as easily between people, that might be a likely reason we don't vaccinate for it.
So that's clearly not the only reason to vaccinate people.
I suppose rabies doesn't spread as easily between people, that might be a likely reason we don't vaccinate for it.
Non-pharmaceutical interventions work extremely well for rabies - stay away from wildlife, bat-proof your house, that's about it. Can't do that with varicella.
The rabies vaccine is expensive, unpleasant, only confers protection for a limited time and is still effective after exposure but before the disease develops. There's no point in wasting the money to subjugate everyone to that when you can just vaccinate the people who have come in contact with rabies or are at risk of having done so.
It’s expensive because America wants it expensive. It’s not expensive in other countries (PReP isn’t. PEP is).
It’s also not unpleasant. PEP is because it’s a lot of shots, but PReP is just, like, 3.
It’s also not unpleasant. PEP is because it’s a lot of shots, but PReP is just, like, 3.
No it’s expensive because vaccinating 360M people when 1-2 died each year now isn’t cheap even when a PreP dose is cheap.
PReP would be cheaper, actually.
And, most people pay for their vaccines via insurance.
The flu shot isn’t free.
And, most people pay for their vaccines via insurance.
The flu shot isn’t free.
Insurance doesn't make money appear out of thin air. If they paid for a rabbies vaccine for everyone, they would charge everyone enough extra to cover for it.
And the mass production of it would greatly reduce its price. We don't pay much for our pets' rabies vaccine, for example.
The rabies vaccine is relatively expensive compared to others, even abroad.
When vaccinating in India, the rabies jabs were the most expensive by an order of magnitude.
When vaccinating in India, the rabies jabs were the most expensive by an order of magnitude.
I suspect you're being facetious, but I'll bite (ha): rabies pre-exposure vaccination requires (usually) 3 doses and is quite expensive (you could expect to pay over $1,000 for the series). Pre-exposure vaccination does not eliminate the need for post-exposure prophylaxis. If you have pre-exposure vaccination, you won't need human rabies immune globulin (HRIG) post-exposure, but that's a bigger benefit in isolated regions and the third world, where HRIG might not be easily accessed, than it is in the developed world.
Since most people in the developed world do not live in areas where rabies is endemic and/or where they are frequently in high-risk environments, and they can access the necessary prophylaxis in an emergency, the cost-benefit does not favor pre-exposure vaccination for most people.
Also note that rabies pre-exposure vaccination doesn't last for life. You usually need a booster every year that you remain at high risk.
Since most people in the developed world do not live in areas where rabies is endemic and/or where they are frequently in high-risk environments, and they can access the necessary prophylaxis in an emergency, the cost-benefit does not favor pre-exposure vaccination for most people.
Also note that rabies pre-exposure vaccination doesn't last for life. You usually need a booster every year that you remain at high risk.
Sounds like you know this, but Rabies PrEP can be had overseas far cheaper. IIRC, the WHO protocol is down to two doses from three.
Did my last round of travel jabs in India. Ended up being less than $200 for everything, including rabies prep, for two people.
Did my last round of travel jabs in India. Ended up being less than $200 for everything, including rabies prep, for two people.
It basically buys you more time to do the PEP protocol. It’s not completely protective. I had it done at a travel clinic when I was planning to go to Madagascar. That would buy me time to get to South Africa or Europe for the PEP. Even then, it was a three shot course over multiple weeks, and each one made my arm very, very sore—tetanus shot times 10, at least on the pain scale.
Humans don't spread rabies. Because the main aim of vaccination programs is to prevent spread in a population, not necessarily prevent disease in individuals, it's much more effective to vaccinate pets and other animals that can spread the disease through bites. In some places, they've even been able to vaccinate wild animals with vaccine-laced bait[1].
[1]https://thefactsource.com/switzerland-rabies-epidemic-air-dr...
[1]https://thefactsource.com/switzerland-rabies-epidemic-air-dr...
" In 2015 in the United States, a course of three doses could cost over $1,000, while in Europe a course costs around €100."
Wikipedia (https://en.wikipedia.org/wiki/Rabies_vaccine#Cost)
Wikipedia (https://en.wikipedia.org/wiki/Rabies_vaccine#Cost)
https://img.webmd.com/dtmcms/live/webmd/consumer_assets/site...
"The treatment regimen for rabies was first developed in the late 1800s, and it hasn’t changed much over the last 100 years.
"But the price of survival has gone up rather dramatically -- nearly 400% over the last decade for those shots.
"That rise is part of the reason why people who have insurance coverage may be stuck with hundreds of dollars in out-of-pocket costs, while the uninsured and underinsured often face thousands of dollars in medical bills.
"In 2007, for example, vaccine maker Sanofi Pasteur charged an average wholesale cost of $740 per 10 milliliters for its Imogam immunoglobulin, a purified blood product that is the most expensive part of the rabies treatment. Ten milliliters is the standard dose for an adult who weighs between 134 and 166 pounds.
"By 2017, the company charged $3,612 for the same dose, an increase of 388% over the last decade, according to First Databank, a company that tracks pharmaceutical costs.
"HyperRAB, the other brand of immunoglobulin on the market, has seen price increases of 370% over the last decade."
https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
"The treatment regimen for rabies was first developed in the late 1800s, and it hasn’t changed much over the last 100 years.
"But the price of survival has gone up rather dramatically -- nearly 400% over the last decade for those shots.
"That rise is part of the reason why people who have insurance coverage may be stuck with hundreds of dollars in out-of-pocket costs, while the uninsured and underinsured often face thousands of dollars in medical bills.
"In 2007, for example, vaccine maker Sanofi Pasteur charged an average wholesale cost of $740 per 10 milliliters for its Imogam immunoglobulin, a purified blood product that is the most expensive part of the rabies treatment. Ten milliliters is the standard dose for an adult who weighs between 134 and 166 pounds.
"By 2017, the company charged $3,612 for the same dose, an increase of 388% over the last decade, according to First Databank, a company that tracks pharmaceutical costs.
"HyperRAB, the other brand of immunoglobulin on the market, has seen price increases of 370% over the last decade."
https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
I had the post exposure protocol (3 vaccine and immune globulin shots) and in 2018 in the US it was about $5000. Also, you should not wait for the test results to come back after being exposed. By then it’s too late if you’re positive for it, so you kind of have to suck it up given that it’s near 100% fatal. I got a lab report back about a week later.
I was not exposed to a bat, but interestingly it is estimated 1 in 10 bats under the famous Congress Avenue bridge in Austin, Texas have rabies. Not sure what the spectator draw https://www.austinbats.org/ is, given that.
I was not exposed to a bat, but interestingly it is estimated 1 in 10 bats under the famous Congress Avenue bridge in Austin, Texas have rabies. Not sure what the spectator draw https://www.austinbats.org/ is, given that.
Because only 2-3 people die from the virus a year so the medical benefit does not outweigh the risks. Neither does the financial cost benefit. Even at $10/per shot, it would cost >$1 billion per life saved.
It's a three shot vaccine that only gives protection for two years. Considering how rare rabies infections are in humans, it seems like it makes more sense to treat people after they are bitten and only vaccinate those who may come in contact with infected animals.
This is not true.
After you get the first three doses you likely have life-long protection. In fact, when I got mine, I was informed they are not doing the follow-up anymore, because no case of rabies infections after the initial doses, ever.
"Duration of immunity
The relationship between the number of vaccine doses received for vaccination (PrEP or PEP) and the longevity of circulating VNA has been examined in several studies. In one study, 80% of vaccinees still had detect-able VNA titres 9 years after primary vaccination. No significant differences in VNA were observed in association with number of doses of vaccine received or the length of time after primary vaccination.16 Vaccine-induced memory B cells that appear to persist for life, and effective recall of the immune response to additional doses, such as for PEP, are documented for decades after priming."
https://apps.who.int/iris/bitstream/handle/10665/272372/WER9...
After you get the first three doses you likely have life-long protection. In fact, when I got mine, I was informed they are not doing the follow-up anymore, because no case of rabies infections after the initial doses, ever.
"Duration of immunity
The relationship between the number of vaccine doses received for vaccination (PrEP or PEP) and the longevity of circulating VNA has been examined in several studies. In one study, 80% of vaccinees still had detect-able VNA titres 9 years after primary vaccination. No significant differences in VNA were observed in association with number of doses of vaccine received or the length of time after primary vaccination.16 Vaccine-induced memory B cells that appear to persist for life, and effective recall of the immune response to additional doses, such as for PEP, are documented for decades after priming."
https://apps.who.int/iris/bitstream/handle/10665/272372/WER9...
Couldn't we all take the three shots every two years on a schedule?
I mean, we can't get people to take two shots for something that's killing thousands, and you think you'd be able to get people to get three shots every two years for something that kills...basically no one?
I believe that is standard practice...for animal control officers, serius spelunkers, and such.
For most folks, the risk/reward ratio just ain't there, to get regular rabies shots.
For most folks, the risk/reward ratio just ain't there, to get regular rabies shots.
That would be a massive healthcare spending and logistical challenge with negligible reward. The system works pretty well given that state of Illinois had its first case in 67 years and even that was only because individual refused treatment.
[deleted]
Covid killed 600k+ in the US, has effective and low side effect vaccines, and vaccines are still controversial. Rabies vaccines have more injections than covid and a much higher frequency of side effects. Rabies is not contagious person to person. Regular scheduled rabies vaccination for the general public would be a bad use of scarce healthcare resources. The US already has pretty close the optimal rabies policy already, as evidenced by the case numbers.
As others have noted, this person only had to take the shot. The bat tested positive for rabies and had bit him. It is inexplicable that the shot was declined - to the extent that they should have declared him incompetent and given them by force. Treating a dying rabies victim puts healthcare workers at risk (sharps/needles, etc). There isn't a healthcare policy solution that could have saved this person.
Now, vaccinating host animal populations is another story: https://en.wikipedia.org/wiki/Prevalence_of_rabies#Canada
As others have noted, this person only had to take the shot. The bat tested positive for rabies and had bit him. It is inexplicable that the shot was declined - to the extent that they should have declared him incompetent and given them by force. Treating a dying rabies victim puts healthcare workers at risk (sharps/needles, etc). There isn't a healthcare policy solution that could have saved this person.
Now, vaccinating host animal populations is another story: https://en.wikipedia.org/wiki/Prevalence_of_rabies#Canada
Also, remember the title of this post "First Human Case of Rabies in Illinois Since 1954" and ask yourself if giving 1 billion shots in the United states every 2 years is worth it. Not to mention the cost for the full series for each person is north of $10K, we're talking about $10 Trillion dollars every 2 years. Of course the price would probably come down.
You're confusing the cost of post-exposure treatment with the vaccine.
We’re about to. Just not for rabies.
[deleted]
Besides, what's the point? If after a year you are exposed would you trust a year old vaccine or get a fresh round anyway? Universal rabies vaccination might not even change best practices.
Low occurrence side effects would negate the health benefit. 2-3 people die a year from rabies, and we would be looking at vaccinating 350 million/year.
If everybody were vaccinated for every disease that poses a risk greater than or equal to rabies, we'd spent half our lives waiting in line at vaccination centers.
The history of rabies in Europe is particularly interesting. Rabies has been eradicated between 80's and 90's from France, Finland, Belgium, Switzerland, etc when the countries started to develop programs to vaccinate the main wild reservoir (and is not a bat, it was the red fox). The problem was reduced by an 80% or eradicated in many countries.
Currently things are starting to became more complex because we have a new actor coming from the east that is basically an European coyote, the golden jackal and because the 2008 crisis hit hard reintroducing the problem in Greece. Poland had problems with rabies also but vaccination of wild carnivores worked really well when culling failed loudly. Is the way to do it.
Currently things are starting to became more complex because we have a new actor coming from the east that is basically an European coyote, the golden jackal and because the 2008 crisis hit hard reintroducing the problem in Greece. Poland had problems with rabies also but vaccination of wild carnivores worked really well when culling failed loudly. Is the way to do it.
Because almost no one gets rabies and the vaccine is effective if it’s administered after exposure.
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I think “high risk” people like veterinarians are. I used to do a lot of traveling (in the before times) so I’m vaccinated and it’s definitely the toughest vaccine I’ve had. I felt genuinely ill after the first dose. Fortunately the second dose was much easier.
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Some vaccines can be used once. The risk increases in the next shoots, so you need to choose the time and do a risk vs benefit calculus.
Imagine declining treatment, Rabies is a terrifying and excruciatingly painful way to go, for yourself and everyone around you. It's physical and mental torture.
Indeed. The 1983 BBC mini-series "The Mad Death"†, about an outbreak hitting the UK, portrays it gruesomely.
† https://www.horrifiedmagazine.co.uk/television/the-mad-death...
† https://www.horrifiedmagazine.co.uk/television/the-mad-death...
Well, at least it's not the one 100% fatal disease known to man.
Oh, hang on, now they're saying it is.
Oh, hang on, now they're saying it is.
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This kind of thing makes me worried about my parents, who have been getting bats in their house for years. Never any known bites, but I've heard you can be bit in your sleep and not notice. Recently my dad hunted down a gap where they might have been getting into their master bathroom from the attic and sealed it, so hopefully they are less likely to have them in their bedroom from now on.
Maybe they should look into getting vaccinated? My insurance covers the vaccine as "medically necessary" because I sometimes go caving. I'd guess most doctors would consider having bats in the house as "high risk" enough, too. At the very least it doesn't hurt to ask.
My understanding though is that you still need to seek treatment if you know you've had a possible exposure but the post-exposure treatment is much less onerous. Another jab or two rather than several jabs and the (apparently very expensive) antibodies.
My understanding though is that you still need to seek treatment if you know you've had a possible exposure but the post-exposure treatment is much less onerous. Another jab or two rather than several jabs and the (apparently very expensive) antibodies.
I know everyone is making jokes and stuff, however I do wonder if there might be HUGE fucking liability on the county for this. Did they just call and say "the bat had rabies, do you want to be vaccinated?"
They better have a video of them saying repeatedly "If you don't do this, you have a 99.9999% chance of dying".
They better have a video of them saying repeatedly "If you don't do this, you have a 99.9999% chance of dying".
You should not wait for the lab testing to return before getting the post exposure protocol.
I'm not sure the person understood rabies and I feel like the county assumed he did.
Treatment costs $10K; he might have felt like he had to take the risk.
It doesn't cost anywhere near that for someone on medicare (under $200), which an 80 year old man would be. Quoting out-of-pocket costs for a medical procedure that's covered by insurance for the vast majority of people is kinda weird.
It's excruciating, certain death if you're wrong, though.
Agreed. At this point its possible he was so old and perhaps handicapped maybe he thought they were referring to the covid vaccine.
The fact that this comment section (d)evolved into a commentary on the state of US healthcare seems…telling
Every comment section outside the scope of what most people here can discuss authoritatively (i.e. tech and business stuff) always devolves into whatever related subject most easily makes the number in the top right corner go up. Welcome to the modern internet.
Bats have tremendously efficient immune systems. They also live rather long for mammals of such small size. There are 40 y.o. bats out there.
Unfortunately that means they will survive a lot of viruses that would be deadly to other creatures, and thus can become important vectors of infection.
Unfortunately that means they will survive a lot of viruses that would be deadly to other creatures, and thus can become important vectors of infection.
I thought they had just a more tolerant immune system than other mammals so they don't overreact to infections and is a carrier for all sorts of viruses ???.
If you can't fly - you can't eat - die.
If you can't fly - you can't eat - die.
I think this is still an area of active research. Bats don't seem to get cancer much, which might be another indication of overall efficiency of their immune systems. Where 'efficiency' means 'preventing negative outcomes to the animal'. In case of rabies, it might translate to not overreacting to the virus, or possibly having body temperature that inhibits the virus naturally.
Bats are strange creatures and we know much less about them than, say, about mice. They inhabit a very different world.
Bats are strange creatures and we know much less about them than, say, about mice. They inhabit a very different world.
Someone close to me works with this guy, who was a total hero last year. Obviously, he had to go through all the treatments. https://www.nbcboston.com/news/local/aggressive-coyote-stran...
i grew up on a dairy farm. we’d see rabid wild animals, usually raccoons or groundhogs, and I would always get excited as a child because that meant we got to get the guns out and it’s shootin time. luckily we were in an area with very little bat activity. we never had any of our animals (cows, goats, horses) come down with it, afaik.
how would you know that an animal was rabid?
those wild animals usually stay away from humans unless they had rabies. they act erratic and often have foam coming out their mouth.
but mainly I could always just tell something was off about their behavior and then we wouldn’t take any chances. groundhogs were pests as well, so it’s not like we needed any extra incentive to take them out.
The amount of misinformation and conflicting procedures we got from all the health professionals was staggering. Some said PEP right away, others told us no risk. Cats needed no boosters said the vet, but by law they did. Also had to quarantine the cats (120 days). Confusion all around and incredibly frustrating.
We had the bat tested, it was a $100 + $75 to ship a frozen bat to another state. If you can’t afford that, you are hosed. Thankfully it was negative.