Rabies cases surge in city

2 raccoon attacks occur in Dickeyville

serum supply tight


Feather Davis heard about the rabid raccoon in her Dickeyville neighborhood soon after the animal attacked and bit her friend, Ken Mayers, on Dec. 2.

Even so, she was surprised when, a few hours later, a raccoon appeared out of nowhere as she walked her mixed spaniel, Midget. The crazed animal charged her and clamped its jaws on the leg of her corduroy pants.

Davis, 61, didn't realize she was at the epicenter of a surge in animal rabies cases that would spur Baltimore's health commissioner to issue a citywide public health alert yesterday. Nor could she know how frustrating it would be to get all of her rabies shots with a key serum in short supply.

FOR THE RECORD - An article about rabies in yesterday's Sun incorrectly described the case of a 15-year-old Wisconsin girl as the only one known in which a rabies victim survived after the appearance of symptoms. Six people have survived after symptoms appeared. The girl was the only survivor who did not receive rabies shots before or after exposure. Also, the girl's case occurred in 2004, not 2003.
The Sun regrets the error.

She only knew at the time that there was an angry raccoon attached to her slacks. "I tried kicking at it, screaming and waving my arm," she recalled.

"My dear dog ignored the whole thing."

Unfortunately, her kicks threw her off balance and she wound up on her knees, face to face with her attacker.

"I've got the tail in my right hand, and the front left leg in my left hand, and the back of my left fist under its jaw. And I have it pinned on the ground," she said.

Neighbors heard her shouts and called 911. One of them, Jim Griffin, came to her aid. "He walks up and asks if there is anything he could do for me," Davis said.

She replied, "Either hog-tie it or bash its brains in, please!"

He chose the second option, clobbering the raccoon's head with a handy rock.

The animal tested positive for rabies, the 10th raccoon and 18th animal found with rabies in the city this year. In 2004, there were only two, according to the city Health Department.

Animal bites, too, are up sharply in the city, according to health officials. Most involve dogs and cats, which are supposed to be vaccinated against rabies. But bites by raccoons and bats - both well-known carriers of rabies - are also up, from 68 last year to 100 in 2005.

Some of the increase might be the result of "increased vigilance," said City Health Commissioner Dr. Joshua M. Sharfstein. But the figures "likely also indicate a growing problem."

In the health alert issued yesterday, he said, "Rabies is a fatal disease, and city residents need to be aware of this risk. Stay away from suspect animals, and seek treatment quickly if possibly exposed."

State health authorities said they've seen no major changes in the overall incidence of animal rabies.

"Whether something is changing in the city, I don't know," said John P. Krick, director of Maryland's office of epidemiology and disease control. "We are not staffed to the point where we can analyze in depth the rise in numbers."

The increase in animal rabies and bite cases in Baltimore has raised the demand for human rabies shots. They consist of rabies vaccine, plus a scarce and costly antibody serum, human rabies immune globulin (HRIG).

This year, 68 patients have sought and received rabies shots in the city, up from 43 last year.

The rising demand and tight supplies can sometimes delay treatment, which Davis discovered when she went to the city health department last week for her shots. Officials there told her they had run out of HRIG, and her antibody treatment was delayed nearly to the point where it would have been ineffective. More on that later.

The current eastern U.S. epizootic of raccoon rabies (the animal equivalent of a human epidemic) is "one of the biggest wildlife rabies outbreaks on record, ever," said Dr. Cathleen A. Hanlon, veterinary medical officer in the Rabies Section at the U.S. Centers for Disease Control and Prevention in Atlanta.

It began in Florida in the 1950s and spread north, aided by suburban sprawl, access to garbage and a human tolerance for animals. It reached the Middle Atlantic states in the 1970s and has spread explosively from there.

Raccoons are now the most common source of rabies from Ohio and the Appalachian ridge to the Atlantic, and from Ontario to the Gulf of Mexico. Their knack for survival in the city and suburbs puts them in direct contact with dense human populations and their pets.

Laboratory tests have confirmed 300 to 400 cases of animal rabies in Maryland annually in recent years. About two-thirds were raccoons, followed distantly by bats, foxes, cats and skunks.

The numbers rise and fall in cycles. But the statewide trend in recent years has actually been down, from 396 in 2002 to 334 last year. The total through Oct. 15 of this year was 319.

An exception is Baltimore City. Although its counts are small compared with suburban counties, they're up sharply in 2005, prompting yesterday's health alert.

Rabies is a viral illness that attacks the brain. It is transmitted from wild animals to unvaccinated pets and people through the saliva of the infected animal.

Symptoms, which can appear days or years after exposure, include pain at the bite site, fever, chills, muscle aches and irritability, leading to confusion, agitation, seizures, coma and death.

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