Felton woman did not say how she contracted rabies

Delaware health officials have not been able to confirm the source of a rabies infection that resulted in last week’s death of a Kent County resident.

The animal that infected the Felton-area woman would be dead by the time the illness was confirmed as rabies, said Dr. Karyl Rattay, director of the Delaware Division of Public Health, during a Tuesday morning press conference.

Citing privacy concerns, Rattay refused to give any information that could reveal the woman’s identity.

The woman, who lived alone, did not tell doctors how she became infected, Rattay said. Although circumstances of each incident usually can point to the cause of an infection, that is not the case this time, she said.

Based on the evidence, it appears the woman probably was exposed to the rabies virus in late June, but only started showing gastrointestinal problems by the end of July. She then was admitted to a Delaware hospital and later transferred to Pennsylvania for more testing. She died there at the end of the week of Aug. 19.

No suspect animals have been identified, said state veterinarian Dr. Karen Lopez.

“The premises at which the patient lived was assessed by the Department of Public Health and animal control officers from the Office of Animal Welfare and there were no remains of animals,” she said.

While tests show the possibility of rabies infection by Aug. 15, it only was confirmed Aug. 23, Rattay said. Anyone who came in contact with the woman is being assessed for exposure, she said.

This is only the second fatal case of human rabies in the country this year, according to Dr. Ryan Wallace of the Centers for Disease Control and Prevention. Nationally, there are one to three fatal cases of human rabies each year, Wallace said, usually related to rabid bats.

In the other case, a 6-year-old boy died Jan. 14 after being bitten by a rabid bat. Like the Felton woman, it took several weeks for the boy’s symptoms to develop.

Once symptoms develop there is no treatment.

Delaware’s only other rabies fatality, 77 years ago, was in October 1941. A 4-year-old Newport Pike boy was bitten by a stray dog. He appeared to be recovering, but after several weeks became ill and feverish, needed hospitalization and died in December.

Rabies can occur anywhere in Delaware

Animal rabies cases this year were not confined to any one area, Rattay said, since rabies can occur anywhere in the state. This year, there have been nine confirmed rabid animals, but none infected humans, Rattay said. Although humans can transmit rabies, such instances are extremely rare and usually only occur through an organ transplant.

Rattay declined to give any details about the Kent County woman, including her age or where she lived. She did have one house cat, which is being kept under observation, but because rabid animals die more quickly than humans, it would have died already, Rattay said.

“If that cat had rabies and had infected her, that cat would no longer be alive,” she said. Some feral cats in the area have been trapped and are being observed for symptoms of rabies. However, because of how rabies develops, Rattay added, the animal who passed the disease to the woman in June or July would be dead by now.

Health officials held off on until Aug. 27 to make a public announcement about the case because initial test results for the rabies virus were conflicting and inconclusive, Rattay said. Additional tests to rule out other possibilities were needed and even the CDC was not confident of a rabies diagnosis until Aug. 23.

“It would be irresponsible for DPH to notify residents and announce a case of possible rabies without confirmation of the virus, especially since tests were being conducted to rule out several conditions,” Rattay said in a follow-up email.

“We do not want to panic people unnecessarily. Neighbors who did not have extremely close contact with the individual are not at risk of exposure.”

ORIGINAL STORY: The Delaware Division of Public Health and Department of Agriculture are asking residents to increase efforts to prevent exposure to rabies after the death of a Kent County woman from the disease.

The woman, who lived west of Felton, is the second Delawarean to contract and die from the disease. The first was a young boy from Newport, who passed away in 1941 after being bitten by a stray dog.

Rabies is an infectious disease affecting the nervous system of humans and other mammals. Infection can occur through the bite or scratch of an infected animal, or if saliva from such an animal gets into the eyes, nose, mouth or an opening in the skin. It is transmitted from animals to humans or from animals to other animals. There have been no reported cases of human-to-human transmission other than through organ transplantation.

“Our hearts go out to this woman’s family during this very difficult time,” said DPH Director Dr. Karyl Rattay. “Because rabies is a fatal disease once symptoms develop, we urge all Delawareans to ensure they are taking steps to avoid exposure. This is a largely preventable disease.”

Important preventive measures include vaccinating your pets (dogs, cats and ferrets over the age of 6 months as required by state law); consulting with your private veterinarian regarding vaccination of livestock and horses; avoiding touching unfamiliar animals, even if they appear friendly; and being on the lookout for potentially rabid animals (foxes, cats, dogs, bats, raccoons, etc.).

DPH and DDA are working closely with Pennsylvania health officials and the Centers for Disease Control and Prevention on the investigation. The woman was admitted to a Delaware hospital in late July after becoming ill. Her condition quickly deteriorated, and she was transferred to a Pennsylvania hospital for further treatment and testing. She passed away last week. Test results did not confirm the presence of rabies until recently. The source of the disease has not been identified.

Though the risk of human-to-human transmission is extremely low, the health care facilities that provided care to the patient are conducting risk assessments with staff to identify anyone who may have had direct exposure to infectious materials and coordinating with state health officials. DPH is also conducting assessments with anyone else who may have had direct contact with the patient up to two weeks before she became ill.

It is imperative to report animal bites and scratches immediately to state health officials so that preventive treatment can be initiated. If the animal is unavailable to be quarantined or tested, DPH recommends that people receive post-exposure prophylaxis, a series of four vaccinations, as a precautionary measure.

Anyone who has been bitten, scratched by, or come in close contact with, a stray, wild or unfamiliar animal, should immediately contact their health care provider or call the DPH Rabies Program at 302-744-4995 (during business hours) or 1-888-295-5156 (outside of business hours). An epidemiologist is available 24/7.

If your animals have been bitten or scratched by another animal, or have come into contact with their saliva or remains in the last two months, please contact the Department of Agriculture at 302-698-4630 or rabies.hotline@state.de.us.

Rabies is almost completely preventable. DPH recommends that members of the public take the following important steps to stay clear of exposure:

· All dogs, cats, and ferrets 6 months of age and older are required by Delaware law to be vaccinated against rabies by a licensed veterinarian. Consider vaccinating livestock and horses as well. It is recommended to consult with your private veterinarian if you have any questions regarding whether your animal(s) should be vaccinated against rabies.

· Reduce the possibility of your pets being exposed to rabies by not letting them roam free.

· Spaying or neutering your pet may reduce the tendency to roam or fight and, thus, reduce the chance they will be exposed to rabies.

· Do not keep your pet’s food or water outdoors; bowls can attract wild and stray animals.

· Keep your garbage securely covered.

· Do not touch or otherwise handle wild or unfamiliar animals, including cats and dogs, even if they appear friendly.

· Wild animals, particularly raccoons and bats, are the highest risk of exposure to rabies. Do not handle or go near wild animals even if they appear approachable.

Since Jan. 1, 2018, the Division of Public Health has performed rabies tests on 83 animals, nine of which were confirmed to be rabid, including three foxes, three raccoons, one cat, one dog and one horse. Rabies tests performed on two animals (one sheep and one dog) were indeterminate. DPH only announces those rabies cases for which it is possible the animal had unknown contacts with humans and there is a risk of exposure to the community.

For more information on the DPH rabies program, visit http://www.dhss.delaware.gov/dhss/dph/dpc/rabies.html or call 1-866-972-9705 or 302-744-4995. For more information on rabies, visit the Centers for Disease Control and Prevention at http://www.cdc.gov/rabies/.