Rabies

Rabies vaccinations are available at the animal shelter Monday-Friday from 10:00a-4:00p. Vaccinations are $10.00 and include a rabies license. Cleveland County also hosts a free Rabies clinic twice per year usually in the Spring and Fall. Check back for dates and times.

Rabies is a viral zoonotic disease of mammals and is most often transmitted through the bite of a rabid animal. It can also be transmitted when the rabid animal’s infectious saliva comes into contact with another mammal’s mucous membranes or fresh open wound. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals such as raccoons, skunks, bats, and foxes. Rabies is rare in domestic pets and livestock because interactions with wild animals are not common unless the wild animal is sick, and domestic animals are often vaccinated against rabies.

The rabies virus infects the central nervous system, ultimately causing disease in the brain and
death. When the rabies virus is introduced into a muscle through a bite from a rabid animal or
through contact with a mucous membrane, the virus travels from that site to the brain by moving within nerves but does not yet cause symptoms. Once the virus reaches the spinal cord and brain and multiplies, it causes inflammation of the brain, and symptoms of illness may shortly begin to appear. The virus then progresses to the salivary glands and saliva, where it can be transmitted to people or other animals that come in contact with the saliva. The time between the introduction of the virus into the body and the appearance of symptoms, called the incubation period, may last for weeks or even months. Transmission of the virus does not occur until the very end of the incubation period when the virus has moved into the salivary glands and the saliva.

The early symptoms of rabies in people are similar to that of many other illnesses and include
fever, headache, and general weakness or discomfort. As the disease progresses, more specific symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation (increase in saliva), difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of these symptoms.

In animals, the first symptoms of rabies may be nonspecific and include lethargy, fever, vomiting, and anorexia. Signs progress within days to cerebral dysfunction, cranial nerve
dysfunction, ataxia, weakness, paralysis, seizures, difficulty breathing, difficulty swallowing,
excessive salivation, abnormal behavior, aggression and/or self-mutilation, and ultimately death.

When a person is exposed to the rabies virus, disease prevention includes thorough washing of the wound site for 15 minutes and administration of both passive antibodies (through an injection of human rabies immune globulin) and a series of injections with rabies vaccine.

Once a person begins to exhibit signs of the disease, survival is rare. According to the CDC, fewer than 10 documented cases of human survival from clinical rabies have been reported to date, and only two of those cases did not have a history of pre- or post-exposure prophylaxis.

According to NCGS 130A-196 , “… All dogs and cats that bite a person shall be immediately confined for 10 days in a place designated by the local health director. …”

When a person is bitten by a dog, cat or ferret, or another animal that is a potential carrier of rabies, the following events should occur:

REPORT the bite to Animal Services.

Persons required to report are:

The person bitten, or the parent/guardian of a bitten minor (report immediately); and
The owner or person in possession of the animal (report immediately); and
The physician or health care provider who attends to the bitten person is required to report the bite and the person’s name, age, and sex to the Animal Services Director within 24 hours of the incident.

Animal Services will attempt to capture or secure the animal for a mandatory 10-day confinement or testing. Normal and healthy domestic dogs, cats and ferrets, regardless of vaccination status, should immediately be placed in a 10-day confinement. The animal services director determines the location and conditions of the confinement.

Law enforcement dogs may be released from confinement by the local health director to perform official duties if the dog has proof of a current rabies certificate.

Owned dogs and cats: The local health director may allow the animal to be confined on the owner’s property only after a careful review of the circumstances of the case. A 10-day confinement period cannot be implemented for a wolf hybrid, cat hybrid, or a wild animal that bites a person because the shedding period for rabies virus is not known for hybrids or wild animals. Therefore, if a hybrid or wild animal bites a person, the animal should be humanely euthanized and the head submitted for rabies diagnostic testing at the State Laboratory of Public Health.

Owners who do not comply with 130A-196 are guilty of a Class 2 misdemeanor, and the local health director may order the seizure of the animal and confinement at the owner’s expense.

ASSESS the status of the animal during the 10-day confinement to determine if the person bitten needs post-exposure prophylaxis (PEP). In all cases, if an animal is tested and found positive for rabies, rabies PEP should begin without delay. According to the 2011 Rabies Compendium, rabies is communicable during the period of salivary shedding of rabies virus.

Experimental and historic evidence document that dogs, cats, and ferrets shed viruses for a few days prior to the clinical onset of disease and during illness. According to the 2008 ACIP Guidelines, “Those that remain alive and healthy 10 days after a bite would not have been shedding rabies virus in their saliva and would not have been infectious at the time of the bite.”

Any animal that dies for any reason during the 10-day confinement and observation period — whether from illness, accidental, intentional, or mysterious circumstance — must be tested for rabies. The head must be sent without delay to the State Laboratory Public Health for testing. There are no exceptions. Begin PEP immediately if the lab test is positive for rabies. If it is negative, no PEP.

Any animal that develops unusual behavior or clinical signs consistent with rabies as diagnosed by a licensed veterinarian during the 10-day confinement period must be humanely euthanized and immediately submitted to the State Laboratory Public Health for rabies testing. Clinical signs of rabies vary but may include abnormal behavior, lack of appetite, difficulty swallowing, cranial nerve deficits, ataxia, paralysis, altered vocalization and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs. Begin PEP immediately if the lab test is positive for rabies. If it is negative, no PEP.

The legal authority for euthanasia and for SLPH testing follows:

§ 130A-199. Rabid animals to be destroyed; heads to be sent to State Laboratory of Public Health. An animal diagnosed as having rabies by a licensed veterinarian shall be destroyed and its head sent to the State Laboratory of Public Health. The heads of all animals that die during a confinement period required by this Part shall be immediately sent to the State Laboratory of Public Health for rabies diagnosis. (1935, c. 122, s. 16; 1953, c. 876, s. 12; 1973, c. 476, s. 128; 1983, c. 891, s. 2; 2009-327, s. 14.)

Administration of rabies vaccine to the dog, cat or ferret is not recommended during the confinement period to avoid confusing signs of rabies with possible side effects of vaccine administration. Euthanasia of dogs, cats and ferrets that bite a person is not permissible unless signs or symptoms compatible with rabies develop during the 10-day confinement period or there are extenuating circumstances confirmed by Veterinary Public Health that support euthanasia or early submission for laboratory testing.

Some examples follow:

a. A severely injured animal bites that a person (e.g., after being hit by car). A veterinarian determines that euthanasia is necessary to relieve the animal’s suffering.

b. A licensed veterinarian determines that it would be cruel and unusual to keep the animal alive throughout the 10-day confinement (e.g., a cat is brought into a vet clinic to be euthanized for a terminal cancer and bites someone before it is put to sleep).

c. An animal is considered a public safety threat to the staff assigned to care for it during the 10-day quarantine period (e.g., a dog viciously attacked someone and continues to be dangerous to staff).

N.C. Rabies Control Manual – February 2013