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From: omo@mcnc.UUCP (Julie Omohundro)
Newsgroups: net.med
Subject: Re: Viruses (esp. rabies)
Message-ID: <715@mcnc.mcnc.UUCP>
Date: Wed, 14-Aug-85 22:43:55 EDT
Article-I.D.: mcnc.715
Posted: Wed Aug 14 22:43:55 1985
Date-Received: Sat, 17-Aug-85 16:33:37 EDT
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Several years ago, I was bitten by a potential rabid animal which disappeared,
so I was trying to decide whether or not to take the shots.  I was living
in Fayetteville, Arkansas, at the time (where there was and is a rabies
epidemic).  I did as much studying up on the subject as I could in the
7-10 days alloted for my decision.  While I cannot verify much of the below
as Absolute Truth, I can assure you it was collected with a lot more care
and attention than most of the info posted on the net!!!

I had no access to medical books, but I did check out 5-6 encyclopedias,
all of which were published in the 1970s.  In each of them the entry always
began something like this, "Rabies is an invariably fatal disease..."

The course of the disease is something like this:  No verified symptoms for 
about 2 weeks, although some patients reported a slight tingling at the 
sight of the wound (upon reading this I immediately felt a tingle, which
lasted until I made my decision).  Symptoms usually appear two weeks after
contact, but sometimes it is as long as 4.  Then the patient goes into
the "rabid state", which does not include foaming at the mouth, but sounds
like you are dramatically overdosed on speed or something--the whole system
is running on high--sounds very awful.  This lasts 3-5 days, or until the
patient dies, which is what usually happens (98%?).  If, however, you gut
it out through this delightful experience, you then lapse into a coma and
die, period.

An Aside:  On the duration of the initial symptomless period, there is one
report of a dog who died after a year in quarantine (in England, I think,
which is an island with no rabies and therefore has very strict quarantine
rules).  However, since in every other recorded case, the symptoms have
always shown in less than 6 weeks, it seems to me infinitely more likely
that the quarantine was violated than that this demonstrates a potential
one-year gestation.

I talked to the local Health authorities, my vet and my doctor.  My doctor
seemed by far the most knowledgeable.  (This probably being partially
due to the fact that he practiced in a rabies-epidemic area.)   He said,
as did several of the encyclopedias, that, if you are bitten by an animal
that actually HAS rabies, the chances that you will contract the disease
are only about 1 in 10.  I think this will come as surprise to most people.
So rabies is really not wildly contagious--it only gets its rep from being
so wildly fatal.  Much of our discussion centered around the old versus
wildly fatal.

Much of our discussion centered around the old versus new shots, which
were just becoming available at that time (Catch 22 for me was that the
new shots weren't due in Arkansas for another week or two!)  He said their
was really little statistical evidence to show that the original shots
were effective AT ALL.  The serum was invented/discovered by Pavlov.
He didn't know if it was worth sh*t, but the King's son got bitten by
a supposedly rabid dog and the king said shoot up my kid or off with
your head (my doctor may have colored this story for me a little), so
Pavlov said what the heck.  The kid didn't get rabies, so presto, we
had a rabies vaccine.  The problem is, since you only have a 1/10
chance of getting the disease even if the animal has rabies, and most
of the shots in the civilized (and medically recorded world) are taken
in cases where the animal escapes or is butchered by some idiot, so
you usually don't know if the animal had rabies, and statistically
it probably didn't anyway, the evidence just isn't there.  Most people
who take the shots simply wouldn't contract the disease anyway.

He was much more optimistic about the new vaccine, since they had been
able to verify the titers.  (I don't know exactly what these are, but
I also take allergy shots and titers are involved there, too.  It seems
the more titers you have, the more resistance.)  However, he had just
been recently involved in a case in Oklahoma where a guy had been bitten
by an animal that was verified to have rabies.  They followed all the
rules--washed the wound immediately and gave him the new vaccine.  The
guy died 4 days into the rabid phase.

I got from another source, which I have always known to be reliable,
that the first recorded case of a rabies survivor was a 14-year-old
boy in the USA.  This was late 70s, so my encyclopedias wouldn't have
known about it.  I don't remember if my doctor confirmed this, but a
virology student I talked to recently said that he thought he had also
heard this.  I asked him if perhaps the new vaccine had been made from
this kid's blood, with all the titers he developed in licking the
disease (I don't know much about this, but I know that you can make
some kind of serum with the blood of the survivors of some kinds of
diseases).  He said no, but then I'm not sure what he did say.  I think
he said that the old serum was from a live virus and the new from
a killed one, but I'm not sure why that would make it more effective
(as measured by titers).  Does anyone know the difference between
the two vaccines?  (I'm very interested in rabies now, when your
life may depend on a subject, it does wonders for your attention span!)

I did NOT take the shots, although I might have, had the new vaccine
(which requires only 3-5 shots rather than 10-20 and is much less
painful) been available in time.  The tingling at the sight of the 
wound disappeared instantly upon making the decision.  So what happened?
I died, of course |-).

IMPORTANT NOTES:  If you are ever bitten by a suspected rabies carrier,
do NOT kill the animal!!!  Cage it.  Yes, you CAN kill it and cut off
its head and send it to the State Vet for tests, as many poor fools do.
Then they find out that, if the test comes out positive, you know the
animal has rabies.  However, if the test comes out negative, you DON'T
know that it doesn't.  The only way to be SURE you haven't been bitten
by a rabid animal is to keep it in quarantine for 2 weeks (actually,
there are no guarantees, but, if it's still alive after 2 weeks, you
are VERY unlikely to have been exposed to rabies.

Also, if you are ever traveling in Arkansas, consider all strays as
suspect:  The state has a virtually continual rabies epidemic.  Almost
95% of the cases are in skunks, and ANY skunk seen wandering around in
the daylight sould be assumed to have rabies.  (They are nocturnal.)
In fact, any skunk wandering around in the daylight anywhere is 
potential death.  I was bitten by a stray kitten.  Cats are very
poor carriers of rabies (although no one could tell me if that is
due to their habits or their immune system, anyone know?), so you 
don't normally think rabies when bitten by a cat, unless you are in 
an epidemic area.