Brunswick has been a hotbed of activity for rabies in Maine this summer.
Foxes have attacked a half-dozen people in the area. The most recent attacks occurred last week, when three adults and a child were scratched or bitten by a rabid fox. The state of Maine doesn't track the number of people treated for rabies exposure each year, but nationwide, the U.S. Centers for Disease Control (CDC) estimates it's about 30,000 to 60,000. Both the disease and treatment for rabies has changed over the years.
First the good news about treatment for rabies exposure: "Thus far, it's been 100 percent effective.”
That’s according to Dr. Justin Bennett, the assistant director of the Mid Coast Hospital emergency department in Brunswick, where patients have been showing up with rabies exposures this year. The treatment for rabies entails a number of shots. First, with an antibody that can sometimes take several injections, depending on a patient's size. Next, it's a series of vaccinations.
"Four shots, unfortunately,” says Bennett. “So a patient gets their first shot on their initial visit and then needs to return for a shot at three days, seven days and 14 days from the initial exposure."
After that, says Bennett, patients are free and clear. The key is to get treatment before symptoms appear, which Bennett says usually takes about 10 days. Symptoms include fever and aches that progress to insomnia, anxiety and confusion. By that point, the virus is in the brain and it is fatal.
But cases of humans rabies are rare. According to the U.S. CDC, an average of two to three people per year die from the disease, and that's because they didn't realize they were exposed.
In Maine, the incidence is even more rare.
"The last case of human rabies in Maine was in 1937,” says state epidemiologist Dr. Siiri Bennett.
Bennett says the state CDC doesn't track how many people are treated for rabies exposure, but last year the agency received more than one thousand calls about rabies, and 991 animals were tested.
"Of those, 67 were positive,” she says.
Any animal can carry rabies, but it's most commonly found in wild carnivores, like foxes, skunks, raccoons and bats. Bennett says that's a shift from a little more than a half-century ago when rabies was mostly found in domesticated animals.
"The pattern has gradually changed, certainly in the US, with the advent of vaccination, because dogs and cats — domestic dogs and cats — you're required to vaccinate against rabies,” she says.
Her advice to avoid rabies includes making sure that pets are vaccinated and don't approach wild animals.
Dr. Justin Bennett says also to keep in mind that some cases of exposure may not be obvious.
"Cases where it's not so obvious would be, say, commonly, someone wakes up and there's a bat in the room,” he says.
And bat bites, he says, can be difficult to detect. So when in doubt call the doctor.