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1995 Rabies Annual Summary

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Introduction

Three rabies-related trends characterized the disease in New York during 1995: (i) the occurrence of the second human rabies death in a New York hospital in three years associated with an inapparent exposure to a relatively rare bat-related rabies variant; (ii) the continued spread of the raccoon rabies outbreak into previously unaffected areas of the state, including another "jump" of more than 60 miles; and, (iii) the emergence of a "second wave" of rabid raccoons in those counties first affected by this major rabies epizootic.

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Human Rabies Death

A 13 year-old resident of a nearby Connecticut community died of rabies in October in a Westchester County hospital. The variant of rabies virus implicated in the case is that which is associated with the silver-haired bat, a solitary, arboreal animal that is not frequently encountered by man. There was in this case, as in a similar 1993 New York case and several other recent cases elsewhere, no history of known bite, scratch, or other direct contact with a rabies suspect animal. However, as in several of the other cases, there was a history of a bat flying around in the home one month before the illness, while the child slept in a room with an open door. This recurrent pattern in human rabies mortality in the U.S. has resulted in more aggressive recommendations regarding the need for rabies examination of bats found in close proximity to sleeping persons or unattended young children, even in the absence of evidence of a bite, scratch, or other direct contact.

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Animals Tested/Positives Reported

There were 8,865 animals examined for rabies in the State in 1995: 8,027 at the Wadsworth Center Rabies Laboratory and 838 at the New York City Health Department Laboratory. Characteristically, cats were the most commonly examined animal, accounting for 27% (2,421) of all submissions to the laboratories. Raccoons were next, comprising 25% (2,201) of all rabies examinations. Domestic animals comprised 43% (3,776) of submissions. Among all animals examined at the Wadsworth Center, 62% (4937) had reportedly bitten or otherwise potentially exposed a human to rabies, and 44% (3,535) had a history of contact with a domestic animal. There were 17% (1,344) strictly surveillance specimens with no reported human or animal contacts. Among domestic animals examined, 90% (3,193) had potentially exposed a human to rabies.

Rabies infection was confirmed in 1,162 animals statewide, with infected wild species accounting for 96% (1,120) of all cases. Rabid wildlife included: 846 raccoons (73%); 182 skunks; 49 bats; 22 gray fox; 10 red fox; 7 woodchucks; 2 whitetail deer; 1 beaver; 1 bobcat. Domestic animal rabies occurred in: 27 cats; 8 cattle; 3 dogs; 3 horses; 1 ferret. For the fifth straight year, rabies in cats was by far the most prevalent domestic animal rabies. The rabid ferret was the first recorded in New York, and the nineteenth confirmed in the U.S. It was one of forty ferrets examined in the State in 1995. Three weeks before onset of rabies the ferret had been at-large for several days near its home in Oneida County, and was unvaccinated at the time of its potential exposure. The rabies virus implicated in the case was identified as the raccoon rabies variant.

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The Raccoon Epidemic

The raccoon rabies outbreak continued its steady advance across the State, affecting 60 new towns and 3 new counties during 1995, bringing to 889 and 57, respectively, the total of affected towns and counties since the outbreak entered New York State in 1990. This leaves only Kings County in metropolitan New York, Nassau and Suffolk Counties on Long Island, and Franklin and St. Lawrence Counties in northernmost New York yet unaffected. The advance in 1995 resulted from a spread of the disease of about 20 miles from the 1994 epizootic front, into Jefferson, Lewis, Warren, Washington and Essex Counties. Early in the year, there also was an unexplained northward "jump" of the disease, approximately 60 miles from the existing front into a remote area at the boundary of Clinton and Essex Counties.

A "second wave" of epizootic activity is emerging in the first tier of counties in New York affected by the raccoon rabies outbreak. Analysis of the number of rabid raccoons confirmed in the 11 counties that were fully involved with the outbreak by the end of 1991 discloses that each of these counties experienced a greater than 200% increase in cases from 1994 to 1995, and that the combined number of rabid raccoons in those counties increased by 345%, from 40 in 1994 to 138 in 1995. Another interesting attribute of the raccoon rabies outbreak is that during the three-year period 1993-1995, of 513 spillover cases in skunks, 60% (306) occurred in the fall months (September - November).

Among 1,840 raccoons received at the Wadsworth Center, 1,763 were testable, and 48% (842) of those were determined to be rabid. Fourteen New York counties had active surveillance related to oral rabies vaccine field trials or were participating in a laboratory- initiated enhanced surveillance trial during 1995: of 781 testable raccoons from those counties, 41% (307) were rabid. Among 903 raccoons that had a history of contact with a domestic animal, 66% (598) were rabid. Among the 842 rabid raccoons, 3% had reported contact with livestock, 7% had contact with a cat, 32% human contact and 64% contact with one or more dogs.

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Bat Rabies

Rabies in bats was once again geographically widespread in the State in 1995, with the 49 cases occurring in 43 towns in 24 counties. Since 1981, 369 towns in 60 counties have had at least one confirmed rabid bat. Among bats submitted to the Wadsworth Center, big brown bats accounted for 63% (710) of the 1,125 bats tested, and 81% (39 of 48) of rabid bats. The little brown bat accounted for 23% (257) of the bats examined, but only 6% (3) of the rabid bats. Rabies also was confirmed in 2 hoary bats, 1 Keen's bat and one red bat during 1995. Overall, rabies was confirmed in 4.3% of bats tested, 5.5% of big brown bats tested, and 1.2% of little brown bats tested. These figures are, characteristically, very similar to the cumulative rabies prevalence figures compiled since 1981: 4.2% for all bat species combined (781 of 18,491), 6.0% (656 of 10,999) for big brown bats and 1.0 % (58 of 5,756) for little brown bats. Among all bats submitted for rabies examination during 1995, 33% reportedly had contact with a human, 45% with a cat, and 8% with a dog. Among rabid bats in 1995, 37% reportedly had contact with a human, 38% with a cat, and 18% with a dog.

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(New York City data provided by Dr. Igbal Poshni, Director, Virus Laboratory, New York City Department of Health)