What you need to know about rabies and how to protect against infection

An Ontario resident, who health officials have not identified, remains in hospital after testing positive for rabies.

In a release shared last week, the Brant County Health Unit said they believe the person was exposed to the illness while in the Gowganda area of the Timiskaming region.

Rabies is a viral infection that causes brain and spinal cord inflammation. It usually spreads to humans through the saliva or mucous of an infected animal, such as a bat, skunk, fox or raccoon. According to the World Health Organization (WHO): “Once the virus infects the central nervous system and clinical symptoms appear, rabies is fatal in 100 per cent of cases.”

Until now, there has never been a confirmed case of rabies in a Brant County resident.

It is also the province’s first confirmed case of domestic human rabies in nearly 60 years, according to Public Health Ontario.

“Our heartfelt thoughts are with this individual and their loved ones during this incredibly difficult time,” Dr. Rebecca Comley, the county’s medical officer of health, said in a Sept. 6 media release. “Rabies, though rare, is a serious virus in humans. If you have direct contact with any animal known to carry rabies, you should seek immediate medical attention.”

The WHO says the incubation period for rabies is typically two to three months, but can vary based on the viral load. Initial symptoms can include fever, pain, unusual or unexplained tingling, pricking or burning sensations at the wound site. Once the virus begins to move to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.

How is rabies transmitted?

Health officials are urging the public to take certain precautions to reduce their risk of getting rabies, including avoiding contact with wildlife when possible.

“Rabies is very typically spread through the saliva of an infected animal,” explained Rebecca Comley, the medical officer of health for the Brant County Health Unit. “Any contact with that saliva, on an open wound, for example, in the eyes, nose and mouth… those are all ways, or theoretical ways, where rabies can be transmitted.”

She added that rabies does not spread through the air.

“If you don't have direct contact with an animal, you're not going to get rabies,” Comley said. “You're not going to get it through touching feces or urine or blood. It's really transmitted through infected saliva.”

Worried about your risk?

If you are bitten or scratched by an animal, especially a wild animal, wash the wound thoroughly with soap and water and seek immediate medical care.

“One wouldn't expect symptoms. You're really doing this preventatively. So if you've been exposed, you're protected by that treatment before you would have any symptoms at all,” Comley explained.

According to the Public Health Agency of Canada (PHAC) early symptoms may include headache, malaise, fever and fatigue

How can a doctor help?

Both pre-exposure immunization and post-exposure prophylaxis are used to fight the infection by neutralizing antibodies and preventing the virus from entering the peripheral nervous system, according to PHAC.

Pre-exposure immunization is usually given to people who have had close contact with rabid animals, travellers with occupational exposure to animals and lab workers handling the rabies virus, as well as hunters and trappers in areas with confirmed rabies and spelunkers.

Medical professionals determine an individual’s need for post-exposure prophylaxis by conducting a risk assessment related to their exposure to the potentially rabid animal.

“There's two parts to rabies prophylaxis,” Comley explained. “The first part includes a series of vaccinations, and that provides protection against rabies in that short term at the beginning, before the rabies vaccination is effective. You're also given something called immunoglobulin, which is an immune product that protects you until the vaccine is effective. It's a two tiered, process.”

Why are cases so rare in Canada?

Comley said one reason why the number of rabies cases is so low in Canada is because of the high vaccination rates for domestic pets.

“In a lot of other countries, where rabies is much more prevalent, the main source of rabies is in stray dogs,” she said.

Between 1924 and 2009, public health said 24 people in six provinces died of rabies. The three most recent human cases in Canada were bat-related and occurred in Quebec in 2000, British Columbia in 2003 and Alberta in 2007.

For more information on rabies prevention and what to do if you suspect exposure, residents are encouraged to visit the provincial or federal public health websites or contact their local health unit.