[Health] The Infectious Diseases Thread

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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

So, Smoove, how many shots does this man need?

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Re: [Health] The Infectious Diseases Thread

Post by $iljanus »

Isgrimnur wrote:So, Smoove, how many shots does this man need?

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Re: [Health] The Infectious Diseases Thread

Post by Paingod »

Just nopenopenope. I don't even let my boxer lick my hands.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Isgrimnur wrote: Tue Oct 24, 2017 5:04 pm So, Smoove, how many shots does this man need?
Ugh. Too many to name. Would not recommend. I'd be amazed if he doesn't get some type of parasitic worm. You can love your dogs, but do not make out with them.
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

Smoove_B wrote:
Isgrimnur wrote: Tue Oct 24, 2017 5:04 pm So, Smoove, how many shots does this man need?
Ugh. Too many to name. Would not recommend. I'd be amazed if he doesn't get some type of parasitic worm. You can love your dogs, but do not make out with them.

Per the place I stole it from, that’s a wolf.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Could be. Still wouldn't make out with one. Whatever diseases your dog can pass along, so can the wolf. :D
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Re: [Health] The Infectious Diseases Thread

Post by Punisher »

Smoove_B wrote: Thu Oct 26, 2017 11:54 am
Isgrimnur wrote: Tue Oct 24, 2017 5:04 pm So, Smoove, how many shots does this man need?
Ugh. Too many to name. Would not recommend. I'd be amazed if he doesn't get some type of parasitic worm. You can love your dogs, but do not make out with them.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

I tried to convince someone to do a research project on Dog Kissing booths that have seemingly become popular in parts of the US. They declined and my chances of appearing in the Morbidity and Mortality Weekly Report with it. :(
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

Vet sez
What are the most common zoonotic diseases of dogs?

Ringworm
Salmonellosis
Leptospirosis
Lyme disease
Campylobacter infection
Giardia infection
Cryptosporidium infection
Roundworms
Hookworms
Scabies
Harvest mites
Rabies
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

And remember, always cook your bear meat to the proper temperature.
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Re: [Health] The Infectious Diseases Thread

Post by stessier »

I was wondering where to ask this and thought this was the best place. We got a fried turkey for Thanksgiving. We picked it up on Wednesday and it was fully cooked. Took it home and put it in the fridge. The reheating directions told us to be sure to get it to an internal temp of 165F. Was this necessary? It seems like after being fully cooked, we only had to get it to whatever temp we desired and could have even eaten it cold.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Reheating it to 165 degrees dramatically reduces the chances that any pathogens that were re-introduced after it was first cooked, then cooled, then transported, handled, etc... would be killed.

Could you re-heat it to whatever temperature you liked? Sure. But as a business, they're obligated to tell you what they're required to do by law - so you don't sue them when your insides liquefy and you're praying for death on the toilet. :wink:
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Re: [Health] The Infectious Diseases Thread

Post by stessier »

Smoove_B wrote: Mon Nov 27, 2017 5:04 pm Reheating it to 165 degrees dramatically reduces the chances that any pathogens that were re-introduced after it was first cooked, then cooled, then transported, handled, etc... would be killed.

Could you re-heat it to whatever temperature you liked? Sure. But as a business, they're obligated to tell you what they're required to do by law - so you don't sue them when your insides liquefy and you're praying for death on the toilet. :wink:
Ah, fair enough.

It was cooked and taken out hot and taken right home and into the fridge - 15 minutes from fryer to my fridge. Well, 20 really as there were 5 minutes of putting it in a pan and covering in tin foil. Very tasty - too (in case anyone is still a fried turkey virgin like me before this weekend). :)
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

That actually makes me more nervous. Home refrigerators aren't designed to cool foods - they're designed to keep cold foods cold. Not sure what your state laws are (doesn't matter, really), but here in NJ when a restaurant is doing advanced food preparation there are requirements for how long it can take for food to get from just cooked temperature to down below 45 degrees. I remember one restaurant that was cooking whole chickens before they'd close for the night and then cramming them into glass-door display refrigerators to cool down overnight - the kind most places use to display soda bottles or milk to customers. When I came in to inspect at 10am the next morning (~12 hours after they'd been cooked), their internal temperature was somewhere around 70 degrees. Into the trash they went! They were also sealed in foil, insulating them from the cold air and sealing that heat in.

Food that is just cooked and needs to be cooled rapidly should go into a blast chiller, a walk in refrigerator and/or portioned into shallow containers.

Anyway, putting just cooked turkey into a refrigerator probably raised the temperature of all the surrounding foods. Don't be surprised if your milk goes south much faster.

Also, you can probably understand why I'm no fun at holiday gatherings. :wink:
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Re: [Health] The Infectious Diseases Thread

Post by Blackhawk »

Isgrimnur wrote: Mon Nov 27, 2017 4:44 pm And remember, always cook your bear meat to the proper temperature.
I've never had bear, which is kind of surprising. I do have an offer for some mountain lion, though.
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Re: [Health] The Infectious Diseases Thread

Post by stessier »

Smoove_B wrote: Mon Nov 27, 2017 5:14 pm That actually makes me more nervous. Home refrigerators aren't designed to cool foods - they're designed to keep cold foods cold. Not sure what your state laws are (doesn't matter, really), but here in NJ when a restaurant is doing advanced food preparation there are requirements for how long it can take for food to get from just cooked temperature to down below 45 degrees. I remember one restaurant that was cooking whole chickens before they'd close for the night and then cramming them into glass-door display refrigerators to cool down overnight - the kind most places use to display soda bottles or milk to customers. When I came in to inspect at 10am the next morning (~12 hours after they'd been cooked), their internal temperature was somewhere around 70 degrees. Into the trash they went! They were also sealed in foil, insulating them from the cold air and sealing that heat in.

Food that is just cooked and needs to be cooled rapidly should go into a blast chiller, a walk in refrigerator and/or portioned into shallow containers.

Anyway, putting just cooked turkey into a refrigerator probably raised the temperature of all the surrounding foods. Don't be surprised if your milk goes south much faster.

Also, you can probably understand why I'm no fun at holiday gatherings. :wink:
Yes, I'm sure you're a blast. :P

There is no food left from that day. We had a ton, but had my brother's family over. Never seen such ravenous beasts. So far no one has had issues, so looks like we dodged another bullet.
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

Smoove_B wrote: Mon Nov 27, 2017 5:14 pm Not sure what your state laws are (doesn't matter, really), but here in NJ when a restaurant is doing advanced food preparation there are requirements for how long it can take for food to get from just cooked temperature to down below 45 degrees.
CDC (PDF)
Specifically, the Food Code states that cooked potentially hazardous food (foods that require time-temperature control to keep them safe for consumption) should be cooled ‘‘rapidly,’’ i.e., from 135 to 70F (57.2 to 21.1C) in 2 h or less, and from 70 to 41F (21.1 to 5C) in 4 additional h or less. Thus, according to the FDA, proper cooling is cooling that minimizes the amount of time that food is in the temperature ‘‘danger zone’’ of 41to 135F (5 to 57.2C), the temperature range in which
foodborne illness pathogens grow quickly.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

stessier wrote: Mon Nov 27, 2017 5:24 pmSo far no one has had issues, so looks like we dodged another bullet.
Well... (you knew there would be a well...)

Depending on the agent, some can take up to 90 days before someone gets sick. But the good news is that they probably would think your hot turkey did it. I mean, it'll be February! :D

The ones I'd be most concerned with would likely hit anywhere between 30 minutes to 48 hours, so yeah, you're likely in the clear!
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Isgrimnur wrote: Mon Nov 27, 2017 5:29 pm
Specifically, the Food Code states that cooked potentially hazardous food (foods that require time-temperature control to keep them safe for consumption) should be cooled ‘‘rapidly,’’ i.e., from 135 to 70F (57.2 to 21.1C) in 2 h or less, and from 70 to 41F (21.1 to 5C) in 4 additional h or less. Thus, according to the FDA, proper cooling is cooling that minimizes the amount of time that food is in the temperature ‘‘danger zone’’ of 41to 135F (5 to 57.2C), the temperature range in which
foodborne illness pathogens grow quickly.
I was going to quote the CDC but didn't want to get Isgrimnur'd during my reply. :D But I do make lots of Danger Zone! Archer jokes in class that I'm sure no one but me finds amusing.
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

:D
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Re: [Health] The Infectious Diseases Thread

Post by Jeff V »

Smoove_B wrote: Mon Nov 27, 2017 5:14 pm That actually makes me more nervous. Home refrigerators aren't designed to cool foods - they're designed to keep cold foods cold. Not sure what your state laws are (doesn't matter, really), but here in NJ when a restaurant is doing advanced food preparation there are requirements for how long it can take for food to get from just cooked temperature to down below 45 degrees. I remember one restaurant that was cooking whole chickens before they'd close for the night and then cramming them into glass-door display refrigerators to cool down overnight - the kind most places use to display soda bottles or milk to customers. When I came in to inspect at 10am the next morning (~12 hours after they'd been cooked), their internal temperature was somewhere around 70 degrees. Into the trash they went! They were also sealed in foil, insulating them from the cold air and sealing that heat in.

Food that is just cooked and needs to be cooled rapidly should go into a blast chiller, a walk in refrigerator and/or portioned into shallow containers.

Anyway, putting just cooked turkey into a refrigerator probably raised the temperature of all the surrounding foods. Don't be surprised if your milk goes south much faster.

Also, you can probably understand why I'm no fun at holiday gatherings. :wink:
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

San Diego, homelessness, and Hep A
Like other major cities all along the West Coast, San Diego is struggling with a homeless crisis. In a place that bills itself as "America's Finest City," spiraling real estate values have contributed to spiraling homelessness, leaving more than 3,200 people living on the streets or in their cars.

Most alarmingly, the deplorable sanitary conditions help spread a liver-damaging virus that lives in feces, contributing to the deadliest U.S. hepatitis A epidemic in 20 years.
...
Meanwhile, San Diego County has spent $4 million to contain the hepatitis outbreak that has killed 20 people and sickened more than 560 in the past year.
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Re: [Health] The Infectious Diseases Thread

Post by gilraen »

Nasty flu season incoming
Medical experts in the United States are worried that this year's flu season could be a nasty one that may be lethal. That's because this year's main flu strain, the influenza A virus, known as H3N2, is worse than the swine flu in 2009.
[...]
To make matters worse, the flu vaccine is not proving to be very effective against this year's main strain, because of a virus mutation. In Australia it has been effective in only 10 percent of cases, reports The New England Journal of Medicine. The vaccine now being administered to Americans uses the same formulation.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

In case you're not feeling freaked out enough over that news, here's an opinion piece in the NYT from yesterday, co-authored by Dr. Osterholm:
The eradication of smallpox in the 1960s and ’70s was arguably the greatest achievement in the annals of public health. We have the tools to potentially accomplish this with influenza, and with the stakes as high as they are, isn’t it worth a Manhattan Project-scale effort to defend ourselves?

The next few weeks will highlight how ill prepared we are for even “ordinary” flu. A worldwide influenza pandemic is literally the worst-case scenario in public health — yet far from an unthinkable occurrence. Unless we make changes, the question is not if but when it will come.
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

It's been 100 years since the 1918 pandemic.
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Re: [Health] The Infectious Diseases Thread

Post by Stefan Stirzaker »

But only 9 years since H1N1 with 151-500K estimated deaths due to it https://www.cdc.gov/flu/pandemic-resour ... emics.html. Having had "Australian" flu this season in Australia, it was nasty and killed a few people who were otherwise healthy but not too bad. Yes I agree another one is around the corner, but I don't think there is a Manhatten project style solution to eradicate influenza out there, unless you can account for every variation in every species that might jump to Humans. Maybe one day but not in my lifetime.

*edit for linky *edit to work out it's 9 years not 19 since 2009
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Stefan Stirzaker wrote: Tue Jan 09, 2018 5:50 pm Maybe one day but not in my lifetime.
We might be closer than you think. It would absolutely be another major public health achievement.
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Re: [Health] The Infectious Diseases Thread

Post by Stefan Stirzaker »

Smoove_B wrote: Tue Jan 09, 2018 6:31 pm
Stefan Stirzaker wrote: Tue Jan 09, 2018 5:50 pm Maybe one day but not in my lifetime.
We might be closer than you think. It would absolutely be another major public health achievement.
Hmm yes, I did read this the other day, but only just read the whole study now. I think it has promise, whether it will provide life long full spectrum flu immunity is still up for grabs, virus reassortment and drift and vacuum filling is a hard thing to counter. From their paper themselves, they note this would be a critical thing. I think it's great and a new method and probably very promising, but it won't "eradicate" influenza...ever. Smallpox died as there is no reservoir after we were vaccinated. I look forward to this one shot, broad coverage though.

As a side note, vacuum filling (it's got a proper name but can't remember it at moment) for Meningococcal is happening in Aus now, after extensive Mening C vaccination campaigns in the top end, Mening W has taken over.
Influenza viruses are continuously evolving through genetic drift. This is a major obstacle in creating a universal vaccine. Including the consensus antigens in the annual vaccine formulation would likely induce a selective pressure to evolve and thus escape the immunity induced by the consensus antigens. Therefore, virus surveillance and monitoring would still be critical to controlling outbreaks. In addition, as more viruses are sequenced and the databases are updated, new consensus antigens could be derived in order to account for the new virus variants. This unique vaccine strategy provides a foundation for anti-influenza immunity that may provide broader cross-protective immunity against heterologous challenges and future antigens would require continuous monitoring and modification.
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Re: [Health] The Infectious Diseases Thread

Post by Blackhawk »

*cough*

*cough*

*gaspsnort*
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

Rabies
A 6-year-old in Florida named Ryker Roque has died from rabies despite the use of an experimental protocol to treat the condition.

The boy's father, Henry Roque, confirmed Ryker's death on Sunday to the Today show. According to Roque, Ryker was scratched by a sick bat that Roque had found and then placed in a bucket under the family's porch. The family's pit bull and a cat may also have been infected, the local sheriff's office told the Orlando Sentinel.

Immediately after Ryker was scratched, his father had him wash his hands. That should have decreased the chances of an infection, according to the Centers for Disease Control and Prevention's website. However, Ryker was afraid of shots, so his parents didn't get additional treatment. A vaccine against rabies given after someone believes they might be exposed to the virus can be life-saving. However, that vaccine will only work if it's given shortly after a bite or scratch.

By the time he arrived at the emergency room about a week later, Ryker was already "having hallucinations and convulsions," according to the family's GoFundMe page. According to the CDC, "once a person begins to exhibit signs of the disease, survival is rare." Only 10 people have survived rabies after showing symptoms; most of them had received the vaccine at some point before or after they were diagnosed.
...
If it's too late to give an infected person the vaccine, some doctors have tried an experimental treatment called the Milwaukee Protocol. Invented in 2004, the treatment requires a person receive drugs while they are in a medically-induced coma; a 15-year-old girl from Wisconsin was the first to survive after receiving the treatment, according to New Scientist.

However, one paper criticizing the technique published in 2016 notes the drugs used have changed over time. According to that paper, the treatment has failed more than 30 times. Two of the people in the United States whose survival has been attributed to the protocol in the last 10 years did not have antibodies for the rabies virus in their blood, which may mean they weren't infected with the virus in the first place.

However, it's not like doctors have anything better to try. "We do not have an alternative protocol to put forward for therapy of patients with rabies," the authors wrote.

Only one or two people die of rabies in the United States each year. Before Ryker, the last person to die of rabies in the United States was a 65-year-old Virginia woman who was bitten by a dog.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Yeah, the story is making the rounds. A true tragedy as it was likely preventable. I don't know who was giving the parents advice after the exposure but they didn't clearly communicate risk here. I've had dozens of similar conversations with people and while I could never force someone to receive post-exposure treatment, making sure they're clear on the possible outcomes for their decision was important. My own daughter is terrified of needles, but if she was scratched by a bat, it wouldn't even be a discussion. Terribly sad.
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

Flu
A 6-year-old girl in North Carolina has died from the flu just days after showing symptoms
...
The family took her to urgent care on Thursday and they called an ambulance a day later when the girl was having trouble breathing. An emergency medical technician on Friday morning said Emily had the flu and that she would "get even worse," the post said. The family was told to keep her hydrated and that she'd be OK in a week or so.
...
Hours later, her breathing difficulties worsened. At one point, she got up and sunk back down.

"I went, 'Emily, Emily.' And I noticed she wasn't breathing," her mother told the station.

The girl was rushed to a WakeMed hospital in Raleigh. By then it was too late. She died that day, the crowdfunding post said.
...
This flu season has been one of the worst in recent history. A particularly aggressive flu strain remains widespread in every state except Hawaii, the federal Centers for Disease Control and Prevention said last week. With this year's higher-than-average mortality rate, the CDC says the disease has crossed into epidemic levels.

At least 30 children have died, a third of them during the week ending Jan. 13, the last date covered in the CDC's latest surveillance report.
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

Indian Chickens
A study by the Bureau of Investigative Journalism has found that hundreds of tonnes of colistin, described as an antibiotic of last resort, have been shipped to India for the routine treatment of animals, chiefly chickens, on farms.

The finding is concerning because the use of such powerful drugs can lead to an increasing resistance among farm animals around the world. Colistin is regarded as one of the last lines of defence against serious diseases, including pneumonia, which cannot be treated by other medicines. Without these drugs, diseases that were commonly treatable in the last century will become deadly once again.

There is nothing to prevent Indian farmers, which include some of the world’s biggest food producers, from exporting their chickens and other related products overseas. There are currently no regulations that would prevent such export to the UK on hygiene terms, except for those agreed under the EU. Any regulations to be negotiated after Brexit might not take account of these regulations.
Wiki
Colistin is a decades-old drug that fell out of favor in human medicine due to its kidney toxicity.
...
As multi-drug resistant bacteria became more prevalent in the 1990s, colistin started to get a second look as an emergency solution, in spite of toxic effects.
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Re: [Health] The Infectious Diseases Thread

Post by LawBeefaroni »

Good news!

More than 70 people are dead in North Texas after one of the worst bouts of flu in recent years.

But Tarrant County televangelist Gloria Copeland, one of President Donald Trump's faith advisers, wants you to know there is no such thing as flu season.

"We got a duck season, a deer season, but we don't have a flu season," she said in a Facebook video posted last week that's making headlines. "And don't receive it when somebody threatens you with, 'Everyone's getting the flu!'"

She went on: "Jesus himself gave us the flu shot. He redeemed us from the curse of flu."

Gloria Copeland's prescription for avoiding the flu is to tell yourself that you won't get sick.

"If you say, 'Well, I don't have any symptoms of the flu,' well, great, that's the way it's supposed to be," she says in the video. "Just keeping saying that. 'I'll never have the flu. I'll never have the flu.' Put words. Inoculate yourself with the word of God."
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

That's what went wrong in 1918-19. That was the Year without Jesus.
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Re: [Health] The Infectious Diseases Thread

Post by noxiousdog »

Smoove_B wrote: Tue Jan 16, 2018 1:20 pm Yeah, the story is making the rounds. A true tragedy as it was likely preventable. I don't know who was giving the parents advice after the exposure but they didn't clearly communicate risk here. I've had dozens of similar conversations with people and while I could never force someone to receive post-exposure treatment, making sure they're clear on the possible outcomes for their decision was important. My own daughter is terrified of needles, but if she was scratched by a bat, it wouldn't even be a discussion. Terribly sad.
Just bats or any non-vaccinated mammal?
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Isgrimnur
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Re: [Health] The Infectious Diseases Thread

Post by Isgrimnur »

CDC
Any mammal can get rabies. The most common wild reservoirs of rabies are raccoons, skunks, bats, foxes, and coyotes. Domestic mammals can also get rabies. Cats, cattle, and dogs are the most frequently reported rabid domestic animals in the United States.

You should seek medical evaluation for any animal bite. One important factor in deciding if you should have postexposure prophylaxis will be if the animal can be found and held for observation.
It's almost as if people are the problem.
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Re: [Health] The Infectious Diseases Thread

Post by Smoove_B »

Any mammal could carry it, but here in NJ bat exposures are considered higher risk as anywhere between 2-5% of the tested bats (bats that are captured after an exposure and then tested, not testing of wild animals) are rabid. In theory rabies could come from squirrels or chipmunks but I'm not aware of a single documented case. In any event, if there was any type of (mammal) animal exposure (bite, scratch) and that animal wasn't available for observation, I'd get post-exposure treatment -- which is consistent with the official recommendations. Where it becomes more difficult is when you wake up in a room with a bat, let the bat go and are now left wondering if it bit or scratched you while sleeping and you just have no idea. Without that bat to test, I'd always lean towards treatment. For the other animals that can carry it - like raccoons or foxes - exposure isn't a grey area. People tend to know when they've had contact so the recommendations are easier. Bats are an interesting edge case simply because of how we can be exposed.
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Re: [Health] The Infectious Diseases Thread

Post by noxiousdog »

Smoove_B wrote: Mon Feb 12, 2018 11:22 am Any mammal could carry it, but here in NJ bat exposures are considered higher risk as anywhere between 2-5% of the tested bats (bats that are captured after an exposure and then tested, not testing of wild animals) are rabid. In theory rabies could come from squirrels or chipmunks but I'm not aware of a single documented case. In any event, if there was any type of (mammal) animal exposure (bite, scratch) and that animal wasn't available for observation, I'd get post-exposure treatment -- which is consistent with the official recommendations. Where it becomes more difficult is when you wake up in a room with a bat, let the bat go and are now left wondering if it bit or scratched you while sleeping and you just have no idea. Without that bat to test, I'd always lean towards treatment. For the other animals that can carry it - like raccoons or foxes - exposure isn't a grey area. People tend to know when they've had contact so the recommendations are easier. Bats are an interesting edge case simply because of how we can be exposed.
I ask because my daughter was bitten by a stray house cat. We had no way of knowing whether it had be vaccinated. This was years ago, but it would be good to have the informatoin going forward.
Black Lives Matter

"To wield Grond, the mighty hammer of the Federal Government, is to be intoxicated with power beyond what you and I can reckon (though I figure we can ball park it pretty good with computers and maths). Need to tunnel through a mountain? Grond. Kill a mighty ogre? Grond. Hangnail? Grond. Spider? Grond (actually, that's a legit use, moreso than the rest)." - Peacedog
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