DOVER – State health officials urged residents from inner-city Wilmington to rural Sussex County to report animal scratches and bites in the wake of a Felton area woman’s countryside death from rabies exposure last week.
“Everyone needs to be aware of the constant risk of rabies,” Delaware Division of Public Health Director Dr. Karyl Rattay said Tuesday during a 50-minute teleconference with reporters.
“ … Rabies is endemic, it is out there.”
While humans contracting rabies is rare – the recent case was just Delaware’s second documented incident in nearly 80 years – it is likely deadly when present. Two deaths have been reported nationally this year, the other case a 6-year-old boy who perished from the disease in Florida in January.
The day after alerting the public about the fatal rabies case, officials provided more information about the adult woman believed to have contracted the disease before the first week of July. That timeline couldn’t be confirmed conclusively, though, and officials said incubation can range from three weeks to many months.
Citing Health Insurance Portability and Accountability Act considerations, state officials did not disclose the late woman’s name, age or address.
Senator questions timing
State Sen. Dave Lawson, R-Marydel, described the state’s response to now go public with information as “a day late and a dollar short. It’s been possibly a month since something happened and the public hasn’t been notified.”
A constituent contacted the senator on Monday, he said, expressing concerns about rumors of a rabies incident and possible death nearby “and she said it would bear some looking into.
“She said ‘All we’ve heard are rumors and no facts.’ and (there is some worry about what might have happened).”
The senator said he went to an area west of Viola to gather information with residents and then spoke with Dr. Rattay later in the day to express “my concern why the public had not been notified.”
Acknowledging that DPH has been dealing with a Whooping Cough outbreak as well in the area, Sen. Lawson said the DPH could have at least released general information on rabies control and safety procedures to assist the public at some point.
The senator was concerned for other animals that might have been affected in the time that elapsed, along with residents unaware that a rabid animal might have been in the area.
The woman lived alone in her home with a cat that was not believed to be the source of rabies. Other feral cats roamed the area, officials said, along with wildlife typical to the surroundings.
The feral cats were trapped and are being held for observation for possible symptoms and signs of rabies “out of an abundance of caution,” officials said.
An unusual case
Officials said the case was unusual because typically persons know when they were bitten or scratched and by what animal.
The infected animal was presumed dead due to a short incubation period, officials said. A search for the remains by Animal Control Officers did not extend past the late woman’s property lines and animal bones located nearby were not linked to the incident, according to the Delaware Department of Agriculture.
The sequence began when the woman arrived at an undisclosed Delaware hospital reporting gastrointestinal issues punctuated by vomiting and diarrhea. When her condition quickly deteriorated, officials said she was transported to an unnamed Pennsylvania hospital for further treatment.
State health officials had no information on what the woman may have communicated with hospital staff, saying “we can’t speak to the hospital’s experience.”
The DPH is assessing who was in contact with the woman two weeks before and after the suspected infection. Officials said rabies can’t be spread from human to human unless through an organ transplant. Risk assessments were also conducted to staff who may have been in close proximity with the late woman.
Delaware officials learned on Aug. 15 that preliminary tests were inconclusive, but could indicate the presence of rabies or possibly other diseases. A rabies confirmation was received in Delaware Thursday.
Several state agencies then met to determine a response, which included public notification plans that were executed in a news release late Monday afternoon. While nearby residents to the recent incident were told with everyone else, officials said Monday they would reach out to the local community and answer any questions or provide any assistance needed.
According to the DPH Monday, the last known case of rabies occurred in 1941 and involved a “young boy from Newport” who died after being bitten by a stray dog.
The state’s Agriculture Department and DPH continue investigating the incident along with Pennsylvania health officials and the Centers for Disease Control and Prevention.
Dr. Rattay described rabies as “a largely preventable disease.” DPH advised pet owners to vaccinate their animals – listing cats, dogs and ferrets mandated by law once six months old.
Also, officials recommended “consulting with your private veterinarian regarding vaccination of livestock and horses; avoiding touching unfamiliar animals, even if they appear friendly; and being on the lookout for potentially rabid animals (foxes, cats, dogs, bats, raccoons, etc.).”
DPH said that since Jan. 1 of this year, it has performed rabies tests on 83 animals, nine of which were confirmed to be rabid, including three foxes, three raccoons, one cat, one dog and one horse. Rabies tests performed on two animals (one sheep and one dog) were indeterminate.
According to DPH it “only announces those rabies cases for which it is possible the animal had unknown contacts with humans and there is a risk of exposure to the community.”
What to do
DPH said it is imperative to report animal bites and scratches immediately to state health officials so that preventive treatment can be initiated. If the animal is unavailable to be quarantined or tested, DPH recommends that people receive post-exposure prophylaxis, a series of four vaccinations, as a precautionary measure.
DPH said anyone who has been bitten, scratched by, or come in close contact with, a stray, wild or unfamiliar animal, should immediately contact their health care provider or call the DPH Rabies Program at 744-4995 (during business hours) or 1-888-295-5156 (outside of business hours). An epidemiologist is available 24/7.
If your animals have been bitten or scratched by another animal, or have come into contact with their saliva or remains in the last two months, DPH said to contact the Department of Agriculture at 698-4630 or firstname.lastname@example.org.
Recommended steps to stay clear of exposure include:
• All dogs, cats, and ferrets 6 months of age and older are required by Delaware law to be vaccinated against rabies by a licensed veterinarian. Consider vaccinating livestock and horses as well. It is recommended to consult with your private veterinarian if you have any questions regarding whether your animal(s) should be vaccinated against rabies.
• Reduce the possibility of your pets being exposed to rabies by not letting them roam free.
• Spaying or neutering your pet may reduce the tendency to roam or fight and, thus, reduce the chance they will be exposed to rabies.
• Do not keep your pet’s food or water outdoors; bowls can attract wild and stray animals.
• Keep your garbage securely covered.
• Do not touch or otherwise handle wild or unfamiliar animals, including cats and dogs, even if they appear friendly.
• Wild animals, particularly raccoons and bats, are the highest risk of exposure to rabies. Do not handle or go near wild animals even if they appear approachable.
For more information on the DPH rabies program, go online to www.dhss.delaware.gov/dhss/dph/dpc/rabies.html or call 1-866-972-9705 or 744-4995. For more information on rabies, visit the Centers for Disease Control and Prevention at www.cdc.gov/rabies/.