Thursday, October 27, the Pasteur Institute confirmed a case of rabies in a Husky cross-type dog detained in a shelter in Évry-Courcouronnes in Essonne. The animal bit several people.
[Mise à jour le 28 octobre 2022 à 08h19] Thursday, October 27, the Pasteur Institute confirmed a case of rabies in a Husky cross-type dog kept in a shelter in Évry-Courcouronnes in Essonne (91). The animal has bit several people who were taken care of by the rabies center of the Institut Pasteur, which administered post-exposure prophylactic treatment. The other people identified as having been exposed to the animal have been contacted by the ARS Ile-de-France and are also directed, if their exposure requires it, to a consultation in a rabies center. The rabies is not transmitted between humans, says the press release from the Ministry of Agriculture. The first investigations, still in progress, indicate that this dog could have been illegally imported from Morocco, a country where rabies circulates endemic. The animal developed the first signs on October 19 and is died October 25. During the whole period of contagiousness (up to 15 days before the first signs), the dog stayed in the shelter, alone in its box or in a relaxation courtyard. No other animal in the shelter showed symptoms or signs suggestive of rabies. Given the incubation period, the dog had necessarily contracted rabies before arriving at the shelter. In the world, rabies kills one person every ten minutesrecalls the Ministry of Agriculture in a press release dated June 30, 2022. Once symptoms appear, rabies is always fatal. The France is regularly confronted with cases of rabies linked to illegal imports of pets from countries where the disease remains endemic. To prevent the introduction of the disease and its spread, means exist and good actions are to be adopted. Practical advice.
Definition: what is rabies?
Rabies is a viral disease, caused by viruses of the lyssavirus family. It is a zoonosis, so it is a disease transmitted to humans by animals. Rabies is responsible for encephalitis, infection and severe inflammation of the brain. “Rabies is almost always fatal once the first symptoms have appeared”adds Dr. Perrine Parize, Deputy Head of the National Reference Center for Rabies at the Institut Pasteur.
Is rabies present in France?
France is free of rabies. “Ldog rabies has been eradicated at the beginning of the last century” inform him Dr. Perrine Parize, Deputy Head of the National Rabies Reference Center at the Institut Pasteur. Rabies cases in France all come from animals infected abroad. France is thus regularly confronted with rabies cases linked to illegal imports pets from countries where the disease remains endemic, informs the Ministry of Agriculture. In October 2022, the Institut Pasteur confirmed a case of rabies in a Husky cross-type dog kept in a shelter in Évry-Courcouronnes in Essonne (91). The animal has bit several people who were taken care of by the rabies center of the Institut Pasteur, which administered post-exposure prophylactic treatment. The dog would could have been illegally imported from Morocco, a country where rabies circulates endemic. In February 2020, a case of rabies had been detected in a puppy brought back from Morocco via Spain. “Every year, several bats are sent to our laboratory or that of the Nancy Wildlife and Rabies Laboratory (ANSES) and are diagnosed positive for these lyssavirus“, she adds. The situations at risk of transmission of rabies on French territory are therefore exhibitions (bites, scratches, licking of wounds or mucous membranes) by a bat or an illegally imported animal (without adequate rabies vaccination) from another country. The situation most at risk for French nationals is a exposure to an animal in a country where terrestrial mammal rabies still occurs (everywhere in the world except Western Europe, Japan, Australia…) during a trip.
What are the symptoms of rabies?
After contamination by a rabid animal, the first signs of the disease occur on average after a period of 1 to 2 months which corresponds to the incubation period. This period is however variable and can last only a few days after the bite or several months. Rabies is responsible for a encephalitis, an infection of the nervous system central. The main symptoms are:
- Of the abnormalities of consciousness with behavioral change, anxiety, agitation progressing to coma.
- Of the spasms : hydrophobia and/or aerophobia may be observed (spasm of the neck muscles at the sight of water or following exposure to air). These spasms are uncontrollable and characteristic of the disease. By the way, in some countries, rabies is called hydrophobia.
- A dysregulation of the autonomic nervous system : it controls breathing, digestion, sweating, heart rate, blood pressure… Patients then present blood pressure abnormalities, heart rate changes, pupil abnormalities, hyper-salivation in particular. This sign is also very characteristic in dog rabies.
“After the appearance of the first symptoms, the evolution is rapid and death generally occurs within a few days”, says Perrine Parize.
WHO estimates that 99% of human rabies deaths are linked to a dog bite. “The disease is transmitted to humans by direct contact with a rabid animal (via its saliva)either by biting, or by scratching, or by licking a wound or a mucous membrane. Most of the deaths occur in countries where dogs and certain wild mammals can be rabid, and where access to preventive treatments for the disease are not accessible to the most vulnerable populations. Africa and Asia bear the bulk of human rabies mortality“advances the specialist. “There is no risk of transmission of rabies from man to man apart from extremely rare cases of contamination following organ or tissue transplants”, says the scientist. Rabies is not transmitted by caressing the animal.
What are the diagnostic tests for rabies?
The diagnosis can be carried out in the animal if the veterinarian suspects this disease (in an animal illegally imported from a country where rabies still circulates in dogs, for example). In humans, there is no no diagnostic test for the disease before the onset of symptoms of encephalitis. In France, rabies diagnoses are often suspected by resuscitators or infectious disease specialists in hospitals. “The disease is suspected because the clinical symptoms and the patient’s history are suggestive. Has he been exposed to animals by bite or scratch abroad or exposed to a bat or an animal illegally imported in France? When all these elements are combined, the only laboratory in France authorized for human diagnosis is the CNR for rabies at the Institut Pasteur. Diagnosis is made by PCR on saliva and skin biopsy samples”, explains Dr. Parize.
What are the treatments for rabies?
There is no no effective cure for rabies. We only have preventive treatments called post-exposure prophylaxis (vaccination and rabies immunoglobulin). “The only preventive treatment for rabies is ppost-exposure rophylaxis who should be started as soon as possible after being bitten by an animal suspected of having rabies. The vaccine is 100% effective in preventing infection. In France, there are rabies centers in almost every department, where we treat patients bitten or scratched by an animal suspected of rabies. Only these centers are authorized to deliver post-exposure prophylaxis. The treatment consists of a series of 4 or 5 injections of vaccine and sometimes the injection of anti-rabies immunoglobulins or antibodies, directed directly against rabies”, lists the specialist. These treatments must be administered in the days following the bite or scratch, during the incubation period and before the onset of symptoms.
Who should get vaccinated against rabies?
The vaccine against rabies Rabies vaccine Pasteur® it’s not mandatory in France but it is recommended:
- after exposure to a suspicious animal
- during a stay in a country at risk “especially in children“explains Perrine Parize.
- when there is an occupational risk of exposure to rabies (veterinarians, laboratory personnel who carry out the diagnosis of rabies or produce vaccines or chiropterologists who are in contact with bats)
The specialist advises discussing it with your doctor – all doctors can vaccinate against rabies as a preventive measure – or to go to an international vaccination center where doctors specialized in traveler’s illnesses inform the public.
The situation most at risk for French nationals is a exposure to an animal in a country where terrestrial mammal rabies still occurs (everywhere in the world except Western Europe, Japan, Australia…) on the occasion of a travel. To protect yourself, during a stay abroad in a country at risk, do not touch an unknown animal and not bring it back with you. The animal can be infected with rabies and transmit the disease to people or other animals.
To travel with your pet, prior procedures are mandatory (failure to comply with them is liable to criminal penalties):
- contact your veterinarian early enough before departure (from 1 to 4 months depending on the destination);
- your animal must be identified and accompanied by its up-to-date passport;
- your pet’s vaccinations must be up to date, especially the one against rabies;
- a blood test to carry out the serum titration of anti-rabies antibodies is necessary before traveling to certain countries at risk of rabies.
In the event of exposure by biting, scratching or licking in France with a bat or an illegally imported animal or in the event of exposure with an animal abroad, it is advisable to immediately contact a rabies center. “And when you travel, I advise you to find out about the risks before leaving with your doctor or to go to an International Vaccination Center”adds Perrine Parize.
Which countries are at risk of rabies?
The list of countries at risk of rabies was updated in March 2022 by the The Minister of Agriculture. Among them :
- Afghanistan
- South Africa
- Algeria
- Angola
- Saudi Arabia
- Argentina
- Armenia
- Azerbaijan
- Bangladeshi
- Belize
- Benign
- Bhutan
- Belarus
- Bolivia
- Botswana
- Brazil
- Burkina Faso
- Burundi
- Cambodia
- Cameroon
- Canada
- Chile
- China (People’s Republic of)
- Colombia
- Costa Rica
- Cuba
- Egypt
- United States of America
- Hungary
- India
- Madagascar
- Morocco
- Mexico
- Norway
- Poland
- Russia
- Thailand
- Tunisia
- Ukraine
- Venezuela
- Vietnam
Thanks to Dr. Perrine Parize, deputy head of the National Reference Center (CNR) for rabies at the Institut Pasteur. Interviewed in March 2021.
Source: “Beware of rabies”: launch of the annual information and prevention campaign. Press release. June 30, 2022