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Alberta man bitten by
rabid bat ignored symptoms
Reprinted from: The Globe and Mail - March 5, 2007
Dawn Walton
CALGARY — Almost seven months
after he was bitten by a bat and failed to seek
medical treatment, an Alberta man is now gravely
ill in hospital and health officials are
searching for anyone he may have had close
contact with.
The man, who has not been
identified, was bitten on the shoulder last
August as he slept in his rural home east of
Edmonton, but shrugged off the incident until
January when symptoms of rabies, a deadly
neurological disease, first appeared.
Now, as the man is listed in
serious condition in hospital, there is little
health-care providers can do except attempt to
make him comfortable.
“Once an individual has
contracted rabies and has not received the
post-exposure treatment, rabies is almost
invariably fatal,” Shainoor Virani, Alberta's
associate provincial health officer, said
yesterday.
Human cases of rabies have been
rare in Canada, where 23 people have died since
record-keeping began in 1925. The most recent
victims include a 52-year-old British Columbia
man in 2003 and a nine-year-old Quebec boy in
2000.
Both succumbed to the virus from
bat bites. Alberta hasn't had a human case of
the virus since 1985.
The virus is transmitted through
the saliva of an infected animal, usually by a
bite or scratch, but also by a lick onto an
existing cut or mucous membrane.
It is theoretically possible to
pass the virus between people (it has only
happened a handful of times and most of those in
organ transplant patients) which is why
officials in Alberta are contacting those who
may have been in direct contact with the
patient's saliva or bodily fluids.
The Canadian Food Inspection
Agency reports hundreds of cases a year of
rabies in animals, most often in bats, skunks,
raccoons and foxes, but the virus has also been
found in dogs, cats and cattle.
Ontario, Manitoba and
Saskatchewan have been home to the majority of
cases in recent years, while the virus
infrequently surfaces in Atlantic Canada.
The viral infection, which is
carried by warm-blooded animals, attacks the
central nervous system and the brain of both
animals and people.
Infected animals can display
symptoms including aggression, depression,
paralysis (which can lead to drooling in
paralysis of the face) and unusual behaviour
such as wild animals losing their fear of humans
or pets hiding from their owners.
In people, symptoms can emerge
in as little as five days or take several years,
but they are usually felt within 20 days to two
months after exposure.
At first, those who are infected
usually complain of flu-like symptoms such as
headaches and tiredness, but the virus can
quickly progress to include anxiety, confusion,
insomnia, hallucinations, a fear of water,
difficulty swallowing and convulsions.
Complete paralysis and coma
follow. The disease is almost always fatal once
symptoms appear, but there have been a handful
of miraculous recoveries.
The Canadian Centre for
Occupational Health and Safety reports that a
handful of patients have survived once signs of
the disease began to show.
While rabies is uncommon in
humans in Canada, the World Health Organization
pegs the number of deaths worldwide at about
50,000 cases a year, the bulk in Indian,
Southeast Asia, Africa and Latin America.
Anyone exposed to a suspected
rabid animal should wash the wound with soap,
remove potentially contaminated clothing and
seek medical attention immediately, according to
public health officials.
In Canada, about 4,000 people a
year are vaccinated with post-exposure
prophylaxis.
The treatment regime includes an
injection of rabies immune globulin directly
into the wound as soon a possible.
At the same time, the human
diploid cell vaccine is injected into a muscle,
usually the shoulder area, or, in small
children, the thigh.
Patients then receive a series
of four more intramuscular injections within a
month.
“Post-exposure treatment is very
effective and safe,” Dr. Virani said, “It's most
effective if it's started right away, but it can
even be given months after a bite.”
But the best way to prevent
rabies is to stay away from wild animals, she
added.
Pre-exposure vaccines are also
available to those working in high-risk
professions such as veterinarians and to those
travelling to regions where the disease is
prevalent.
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