We should expect 2014 to rank among the highest on record for rabies cases in Orange County.
If the incidence of rabies continues at the same pace, there could be upwards of 30 cases in 2014. That would rank with 2002 and 2006 as the only years in which the count has exceeded 25 since the onset of raccoon rabies in the 1990s.
The elevated number of confirmed rabies cases has caught our attention and we have every reason to believe that awareness and concern are growing among county residents as well.
From a scientific standpoint, it is too early to tell whether the incidence of rabies in wildlife in Orange County is truly increasing and also whether it is representative of any broader trends in the area or the state. Available data year-to-date for counties adjacent to Orange County and the state as a whole are consistent with the proposition that there is a localized cluster of rabies in Orange County. It may be that the topography of the county and/or mixture of rural, residential and other spaces creating so-called edge ecosystems are more favorable than elsewhere to a robust raccoon population.
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By the same token, it would be premature to rule out that we are experiencing an upswing in the cycle of rabies in raccoons, the reservoir species for the virus in our region. This is suggested by data for confirmed rabies cases for Orange County for the period 1996-2013, which are available from the N.C. Public Health Laboratory.
From the height of raccoon rabies in the latter 1990s, cresting in 1997 when there were 106 laboratory confirmed cases, rabies has ebbed and flowed roughly every three to five years in Orange County. There was a very sharp decrease after 1998, for instance, reaching a low of nine cases in 2000, followed by an upsurge of 28 confirmed cases in 2002. Similarly, there was a sharp dip in 2003 to only five confirmed cases, followed by a progressive increase over the following three years, reaching 27 in 2006.
The latest crest in the cycle lasted from 2005 until 2008, followed by the long trough that brings us to the present.
Our concern with rabies mirrors the very real risks of a disease that is fatal to people and pets alike. Exposure will most likely occur to our animals through their contact with wildlife, but humans are also attacked by foxes, beavers, raccoons, and skunks. Witness the recent experience of two Hillsborough residents who were attacked by a rabid fox.
Timely medical treatment after an exposure can prevent rabies in humans. However, there is no such treatment for our animal companions. If a dog, cat or ferret is already vaccinated against rabies when exposed to rabies, North Carolina general statute 130A-197 requires that the animal be boostered with a rabies vaccine within five days of exposure to remain currently vaccinated. According to the same statute, however, if they are not currently vaccinated the only choices are to euthanize them or to confine them for a period typically lasting six months to be sure they have not contracted rabies.
In our present context, owners of cats and dogs (and other animals) should recognize the very real risks of rabies exposure and we must be doubly sure to protect our own animals by conforming to the following guidelines.
Currently vaccinated! Our pets must be currently vaccinated not only because this is a requirement of state law (an owner of a cat, a dog or a ferret over four months of age shall have the animal vaccinated against rabies) but also because it protects the pet and the public. A number of animals are now under quarantine because their vaccinations had lapsed when they had an actual or suspected exposure to rabies. Notably, titer tests are unhelpful in these situations, not least because there is no way to tell whether a high titer is due to the exposure or the animals prior vaccinations.
Cats, too! According to a CDC document, cats are roughly three times more likely than dogs to be reported as rabid in our country, and North Carolina is no exception to this pattern. Indoor as well as outdoor cats are at risk of exposure to rabies. They may get outside unnoticed and come into contact with the same rabies carriers. Also, bats often enter the living space of dwellings through attics, uncapped fireplaces, open patio doors and windows without screens, and otherwise imperceptible cracks and crevices.
Reporting! Immediately reporting contact with wildlife is a fundamental responsibility. In the case of our pets, Animal Services will work with owners to be sure that appropriate measures are taken to protect the pet, family and community. A currently vaccinated cat, dog, or ferret that is exposed to an animal that is suspected of rabies or tests positive for rabies simply needs another rabies vaccination, but this booster must be received within five days (120 hours) of an exposure. Otherwise, the animal must either be euthanized or quarantined for a six month period.In addition, it is imperative that human risks be assessed by qualified public health professionals at the local health department or by a health care provider. Often this means that these professionals work with the pet owner to assess whether any humans have been exposed to rabies through bites, scratches, or through contact with the saliva or nervous tissue of the wildlife. A person that is exposed to rabies will have to go to the Emergency Room to receive PEP shots to prevent rabies.
Now is the time for us to prepare ourselves to protect the health of our animal and human companions. Recognizing that rabies is a dynamic as well as deadly zoonotic disease, we must reinforce and fulfill our responsibilities for what is increasingly called One Health, that is, the interdependent health of humans and all other animals. Unfortunately, human fatalities from rabies are not just part of our parents’ and grandparents’ memories. In fact, our last human fatality from rabies in North Carolina occurred in 2011, when a young man in Jones County acquired raccoon variant rabies after being bitten by a raccoon. This case from North Carolina was only the second case of Eastern Raccoon Variant (ERV) rabies ever reported in the United States. The first human case of ERV occurred in our neighbor state, Virginia, in 2003.
Thus it is more important than ever for us to be very informed and very responsible pet owners and community members. We should be sure to report any and all incidences in which we or other members of our households are bitten or have contact with a wild animal. We must also make a concerted and active effort to keep all of our dogs, cats, and ferrets currently vaccinated against rabies and prevent them from having contact with wildlife through close supervision. These precautions can go a long way towards limiting the number of animals that must be quarantined or euthanized and preventing incidences of human exposures to a rabid domestic animal.
Bob Marotto is the director of Orange County Animal Services. Previously, he managed the City of Minneapolis Animal Care and Control Program. He can be reached at firstname.lastname@example.org