Medical letter: Rabies!

There has been an unexpected development in our town -- and outbreak of rabies among livestock.  Apparently there have been rabid dogs here before, but this is the first time that cows and horses have been affected.  It is a type of "paralytic" rabies, as opposed to the kind of rabies that we usually think of, where animals become aggressive and run around biting people and other animals.  Several families have had cows and horses die recently of the same kind of illness -- their legs become uncoordinated and they look "drunk," then over the course of a few days they fall to the ground and can't get up.  As the disease progresses upward in their bodies. they get spasms in their throat muscles and become unable to swallow, which is what causes the "foaming at the mouth" and water phobia that we normally think of in rabies cases.  Then the animals die.

The problem is in what comes next.  Because cows and horses are so big and heavy, if they lie down and die in a field, people often just leave them there and don't bury them.  Vultures and street dogs come and eat the meat, and people sometimes eat the meat as well, not knowing that it is a rabid animal.  People here are trying to make ends meet, and a farm animal represents a big financial investment -- so it is financially a very big deal for a family lose a cow, and many people feel like with that kind of a loss, they might as well feed their family with the meat.  If people butcher the animals, they come into contact with all kinds of infected body fluids.  I am also told that if the owner of the cow pays a couple of guys to butcher a cow, they often pay the guys with the cow's head (which people will eat).  Since rabies concentrates in the brain, handling or eating the brain of a rabid animal is the worst thing you can do.

There are also vampire bats here, which are probably the reservoir of the rabies virus.  Bats tend to be natural carriers of rabies, but they are somehow unaffected by it and don't die from it.  The bats come and bite the farm animals at night, which is very likely how the animals got rabies -- and they can bite people as well, though less often.  Apparently their bite is barely detectable, like getting pricked with a needle.

It has been interesting -- and heartening -- to watch the community and government response to this situation.  Once the local vet started to suspect rabies, the heads of two of the affected animals were sent to a lab (apparently all the way to Quito) to confirm the rabies cases.  Meanwhile, still waiting for the results, the local public health center got on top of contacting the affected families to start rabies prophylaxis treatment for the highest risk family members.  Once the cases were confirmed, the Ministry of Agriculture sent representatives out to hold a town meeting to educate the local livestock owners about rabies, what to look for, and what to do.  They sent out a mobile veterinary unit to start vaccinating all the animals in the area, and I suspect they were also investigating new cases.

With regard to dogs, the government has apparently been good about coming out and offering people free (but voluntary) rabies vaccines for their dogs once or twice a year (though not livestock, until now).  So most of the dogs that people actually own as pets are vaccinated.  However, there has been this big cadre of skinny street dogs in town that clearly are not owned by anybody.  Amazingly, they are just about gone, overnight.  The government workers must have come to round them up, or to feed them strychnine (we hear this is what they have done in the past).  Just like that, the streets are less crowded and noisy, and there are about 80% fewer dogs on the street that there used to be.  I feel bad for those pups, but in this situation, they really are a public health hazard.  To me, the human lives are more important.

So what do you do about bats?  We hear that one night the Ministry of Agriculture folks took a bunch of cows and put them in a circle in a field, and covered them with netting.  The bats came to bite the cows at night and got stuck in the nets.  They then captured the bats, painted some kind of poison on their backs, and let them fly back to their lair.  Apparently the bats lick each other, and so the other bats lick the poison off the previously captured bats -- each one can eradicate about 12-15 other bats. To they are reducing (though not eliminating) the bat population as well, in an attempt to control this rabies outbreak.

How does all of this affect us?  So far, not that much.  We are not eating any beef or red meat at the moment, and we are not touching the animals (including beloved Aspen the horse, who seems perfectly fine, but you never know).  We have not had any physical contact with sick animals, so we don't need rabies prophylaxis vaccines -- and hopefully it will stay that way!  We are just doing our best to stay out of harm's way.