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Mass. health officials confirm human rabies case

By Bob Salsberg
Associated Press / December 30, 2011
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BOSTON—A man from Cape Cod is the first person on record to contract rabies in Massachusetts in more than 75 years, state public health officials said Friday.

The man, who is in his 60s, was in critical condition at an undisclosed hospital and his prognosis was poor, officials said. His name and hometown were not released.

It is not clear how the man was infected, but there was evidence that he may have been exposed to a rabid bat, said Dr. Al DeMaria, medical director of the state's Bureau of Infectious Disease.

"Over the last few days he wound up being hospitalized with enough clinical symptoms to suggest the potential for rabies," DeMaria said.

Tests performed at the Centers for Disease Control and Prevention confirmed the diagnosis on Thursday, he said.

"Unfortunately there have been very few survivors of rabies," DeMaria said.

Rabies is a deadly virus that spreads to humans from the saliva of infected animals. The disease affects the central nervous system and brain.

The last confirmed case of human rabies contracted in Massachusetts was in 1935. DeMaria said he believed that victim was a teenager from Saugus.

In 1983, a 30-year-old Waltham man died after being exposed to rabies, apparently from a dog bite in Africa. The man developed symptoms, including high temperature, difficulty breathing, sore throat and excessive salivation, about three months after returning to the U.S., and was admitted to Waltham Hospital, according to CDC records. He died a few weeks later.

There have been other instances over the years in which individuals infected elsewhere have received treatment in Massachusetts because of the state's highly-regarded hospital system, he said.

The CDC said rabies-related human deaths have fallen dramatically in the U.S. from 100 or more annually at the turn of the century to no more than 2 or 3 per year, most but not all involving bats.

The CDC reported two other fatal human rabies cases this year, one in New York and one in New Jersey, with both victims believed to have acquired the disease from dog bites outside the U.S., Haiti in one case and Afghanistan the other.

Two fatal human rabies cases were reported to the CDC in 2010, one in Louisiana and one in Wisconsin. The Louisiana case involved a migrant farm worker who was believed to have been bitten by a vampire bat in Mexico.

There were 6,154 rabid animals confirmed in the U.S. and Puerto Rico in 2010, about 8 percent of which were domestic animals. More than $300 million per year is spent on rabies prevention programs, including vaccinations of pets and other domestic animals, and wild animal control programs, the CDC said.

While U.S. cases are rare, worldwide an estimated 55,000 people die from rabies each year.

Experts say preventative treatment for humans feared to have been exposed to rabid animals has proven nearly 100 percent effective in staving off the disease, as long as the treatment is given before the onset of symptoms.

"If someone presents after they have developed the symptoms and signs of rabies, it's the reverse," said Dr. Laurence Madoff, director of the Division of Epidemiology and Immunization at the Massachusetts DPH. "Almost no one survives at that point."

DeMaria said the state hopes to confirm shortly from the CDC if the victim contracted rabies from a bat.

He said authorities were still determining whether family members or other people who had contact with the infected man will be given preventative treatment, but he added that there has never been a medically documented case of person-to-person transmission of rabies.

He said while it was highly unusual for bat rabies to spread to people or even to other animals, people can protect themselves by making sure their home is as bat-proof as possible. This includes keeping chimneys capped and repairing holes in attics, cellars and porches to keep bats and other wild animals out.

"Avoid exposure to potential rabid animals and make sure children do not go near any animal that they don't know," DeMaria said.

Anyone bitten by a bat or any other wild animal should seek medical attention immediately.

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