Zoonosis News from Public Health Region 1

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					                                        Zoonosis News from Public Health Region 1
Pub. #50-10970, Vol. 44-02                                                                                                                March, 2004

                                                                                                                       Inside this issue:

From Doc’s Desk
By James Alexander, DVM, MPVM                                                                                          Doc’s Desk                 2
Our region had an interesting year     fatality. Last year, we had a spe-      affected. The WN infections re-
in 2003. While our rabies cases        cies reversal. While only 61 horses     sulted in 167 (61.4%) WN fever
were relatively few, West Nile virus   were confirmed with infection, with     cases, with a mean age of 43.5          Bait Drop Success-         2
(WNV) and hantavirus infections        a slightly higher CFR (34%), hu-        years (range 6-89). The 105 peo-        fully Completed
took up the slack. In a few short      man cases increased dramatically!       ple with the more severe encepha-
months we will once again see an       We have nearly concluded the            litis or meningitis forms of the dis-
increasing risk for both of these      investigations of all reported test     ease had a mean age of 52.9             Website Additions          2
diseases.                              results. Approximately 385 test         years (range 11-87). All deaths
                                       results were received in our of-        that were recorded as being due to
In 2003, the state documented the
                                       fices. After weeding out duplicate      WNV occurred in people with the         Training Opportuni-        3
most cases of hantavirus infections
                                       names, test results that were inde-     more severe form of the disease.
in Texas in a single year (7), in-
                                       terminate, out-of-state residents       However, while investigating the
cluding our first case which did not
                                       (26) and folks who could not be         cases, we realized very quickly
develop into the hantavirus pulmo-
                                       located, we have obtained informa-      that the majority of the people that    Smile!                     4
nary syndrome (HPS). Of the
                                       tion on 304 people, with a few          reported having the “less severe”
seven individuals, two died, result-
                                       more still being worked.                form experienced a debilitating
ing in a 29% case fatality rate
                                                                               disease. The recovery time from
(CFR) for the year. This was a vast    The majority of the people were                                                 Free Pet Supplies          4
                                                                               the fever form was in excess of
improvement over the situation in      infected with the WNV (272,
                                                                               four weeks in many instances. In
2002, when all four confirmed          89.4%). Another disease that had
                                                                               some people, the encephalitic form
cases died. Five of the seven          not been identified in quite a while,
                                                                               resulted in recurring headaches,
cases were in Public Health Re-        St. Louis encephalitis (SLE), af-                                               Rabies Update              4
                                                                               fatigue, and, on occasion, lasting
gion 1, including one of two fatali-   fected 14 people (4.6%). We sus-
                                                                               neuralgic damage.
ties. When the weather warms up,       pect that SLE, a “cousin” of WNV,
the usual “spring cleaning” will       has been active in the past, but        We were able to obtain information
ensue. Please remind your clients,     was probably diagnosed as aseptic       about the use of DEET-based             Dr. Mahlow Resigns 4
family and friends that certain pre-   meningitis in most cases. The final     repellents from 166 (55%) of the
cautions need to be taken before       group of 18 people (5.9%) was           304 cases investigated. Only 12,
embarking on cleaning out the          classified as “flavivirus” cases.       two-thirds of whom were females,
stuffy storerooms, garden sheds,       These were people with symptoms         reported using DEET 100% of the
etc.                                   compatible with SLE and WNV, but        time. The average use of DEET
                                       whose titers were not clearly in-       was 19.3% of the time, with 62% of
In 2002, our region experienced an
                                       dicative of which infection was         the people who responded report-
extremely high incidence of West
                                       active.                                 ing no use at all!
Nile virus infections in horses (387
confirmed) with a CFR of about         For the 272 WNV infections, the         This brings me to the final mes-          PHR 1 ZOONOSIS STAFF
24%. That year we only docu-           mean age was 47 (range 6-89),           sage: this is a disease that can be
mented 11 human cases, with one        with 135 males and 137 females                       (Continued on page 2)       James Alexander, DVM, MPVM
                                                                                                                            Regional Veterinarian
Pet Guinea Pig in New York Tests Positive for                                                                            Suzan Norwood, Admin Asst.
Rabies                                                                                                                        300 Victory Drive
Adapted from an article by Millicent Eidson, MA, DVM, DACVPM, New York State Health Dept.                                    WTAMU Box 60968
                                                                                                                           Canyon, TX 79016-0968
Never say never.                       been a pet with one family its          burrowed under the edge of a                     806-655-7151
The New York State (NYS)               entire life.                            dog house. For the next few                   806-655-1354 (Fax)
Department of Health has iden-         On September 27, 2003, the              days, the animal favored a hind
                                                                               limb, though the owner did not                 Karen McDonald
tified a pet guinea pig infected       owner took the animal outdoors                                                       Zoonosis Technician
with raccoon variant rabies.           for fresh air, and allowed it to        report a visible wound.
This is the first rabid guinea pig     roam free. Hearing the guinea           On October 23, the owner was                  1109 Kemper Street
and the first rabid pet rodent         pig squeal, the owner saw a             bitten by the guinea pig. She                 Lubbock, TX 79403
identified in the state. The ani-      raccoon running off to climb a                                                          806-767-0427
                                                                                            (Continued on page 3)            806-741-1366 (Fax)
mal was six years old, and had         tree. The guinea pig was found
                          Page 2                            Zoonosis News from Public Health Region 1

                                    From Doc’s Desk (cont.)
                                    (Continued from page 1)                how to prevent mosquito breeding      the dangers that dogs can pose.
                                    prevented fairly easily. The 4Ds       in water troughs, playa lakes, etc.   As always, please continue to
                                    still apply: avoid being out at dusk   We hope this year will be a much      promote rabies vaccinations,
                                    and dawn, if possible; if out at       less active year for all three pri-   based on the schedule established
                                    those times, use a DEET-based          mary species: birds, horses, and      in your community.
                                    repellent; dress in proper clothing    humans.
                                                                                                                 Thank you for your assistance in
                                    when out during the peak of mos-
                                                                           We have also had a number of dog      protecting the health of our re-
                                    quito activity; and drain standing
                                                                           attacks recently. Several children    gion’s citizens.
                                                                           have been injured; we are thankful
                                    Please help us spread the word         there have not been any deaths. In
                                    about how to prevent WNV infec-        one incident, the child had played
                                    tions. It’s relatively easy, a whole   with the dogs before, but was
                                    lot less expensive than the treat-     placed in the yard unsupervised
                                    ment for the disease, and much         and was viciously attacked. In
                                    less painful, too. Horse owners        another instance, a child walked
Mosquitoes kept health care         need to be reminded of the vac-        into the yard of a neighbor and
professionals, veterinarians, and   cines that are available for pre-      was attacked. Please work within
TDH employees busy through-         venting the disease in their horses,   your communities to help educate
out the last half of 2003.          as well as being advised about         children and their parents about

                                    ORVP Successfully Completed for 2004
                                    Adapted from ZCD Website
                                    Two rabies epizootics (epidemics in    Texas. The two epizootics ex-         was completed January 12, with
                                    animals) began in Texas in 1988,       panded to involve a total of 69       approximately 730,400 baits
                                    one involving coyotes and dogs in      Texas counties by 1996.               dropped and 30,959 miles flown.
                                    South Texas and the other in gray                                            The West-Central bait drop was
                                                                           In February 1995, the Texas De-
                                    foxes in West-Central Texas. The                                             completed January 30, with ap-
                                                                           partment of Health (TDH) initiated
                                    South Texas epizootic has resulted                                           proximately 1,986,020 baits
                                                                           the Oral Rabies Vaccination Pro-
                                    in two human deaths and has                                                  dropped and 59,314 miles flown.
                                                                           gram (ORVP) as a multiyear pro-
                                    caused over 3,000 people to re-
                                                                           gram, with a goal of creating zones   For additional information, please
   The bait drop has been a         ceive post-exposure rabies treat-
   yearly event in Texas since                                             of vaccinated coyotes and gray        contact Dr. Tom Sidwa or Guy
                                    ment. In 1994, the public heath
   1995.                                                                   foxes along the leading edges of      Moore with the TDH Zoonosis Con-
                                    threat created by these two ex-
                                                                           the epizootics, thereby halting the   trol Division at (512) 458-7255, or
                                    panding epizootics prompted then-
                                                                           spread of the disease.                go to the website at http://www.tdh.
                                    Governor Ann Richards to declare
                                    rabies a public health emergency in    This year’s South Texas bait drop

                                    New Publications Added to Website
                                    By Pam Wilson, RVT, M.Ed., CHES, and Eric Fonken, DVM, M.P.Aff.

                                    The updated version (2004) of          the treatment of probable expo-       sion of a pamphlet about Bay-
                                    the Rabies Prevention in Texas         sures. Instructions to veterinari-    lisacaris procyonis, the raccoon
                                    booklet is now available on the        ans and animal control officers       roundworm, to the ZCD website.
                                    Texas Department of Health             submitting animal specimens for       You may access it at http://www.
                                    Zoonosis Control Division’s            rabies evaluation are included,       tdh.state.tx.us/zoonosis/
                                    (ZCD) website at: http://www.tdh.      as well as recommendations for        diseases/baylisascaris/
Be sure to check our website for    state.tx.us/zoonosis/diseases/         management of biting animals          raccoonlatrine.pdf directly, or if
new publications.                   RABIES/rabiesprevention.asp.           and management of domestic            you are browsing from the main
                                                                           animals exposed to rabid ani-         page the link is at http://www.
                                    This guide assists in the evalua-
                                                                           mals.                                 state.tx.us/zoonosis/Safety/
                                    tion of possible exposures of
                                                                                                                 Outdoorsafety.asp under our
                                    humans to rabies virus, and in         Also, we have added a PDF ver-
                                                                                                                 “Outdoor Safety” page.
                          Pub. #50-10970, Vol. 44-01                                             Page 3

Pet Guinea Pig in NY Tests Positive for Rabies (cont.)
(Continued from page 1)             with slightly crusty eyes from       the guinea pig may never have          This case has many similari-
promptly washed the area            an ocular discharge, but noth-       been tested and the patient            ties to some of the incidents of
twice with soap and water, and      ing seemed out of the ordinary       may never have received post-          rabid pet rabbits in NYS.
assumed she was bitten be-          for an older guinea pig. In hind-    exposure prophylaxis. Guinea           These incidents serve as a
cause she was squeezing the         sight, the owner reported the        pigs frequently give small bites       warning about the risks of let-
animal too hard. After thinking     guinea pig had become copro-         to their owners, and guinea            ting unvaccinated pets, espe-
about the bite incident for sev-    phagic in the week prior to          pigs usually die at home with          cially small rodents and rab-
eral days, the owner contacted      euthanasia. The animal was           nonspecific signs such as the          bits, outside without the pro-
local health authorities and was    not seen by a veterinarian. The      pet in this case, without the          tection of double cages. It also
advised to submit the animal        brain tested strongly positive       owners contacting local health         emphasizes the importance of
for rabies testing. The animal      for rabies infection by im-          departments for rabies testing.        reporting all potential contacts
was euthanized on October 30.       munofluorescence microscopy;         If the owner had subsequently          of those animals with wildlife to
The veterinary technician who       this finding was confirmed by        developed rabies, the guinea           health departments for appro-
euthanized the animal noted         virus isolation in cell culture.     pig bite and the raccoon inci-         priate follow-up.
that the guinea pig had a poor      If the owner had not happened        dent may never have been               And it teaches us to “never say
hair coat and was a bit thin,       to witness the raccoon attack,       included in the patient’s history.     never.”

   Some people believe this may be worth a try: for mosquito control at home, put some water in a white dinner plate and add a couple of
   drops of Lemon Fresh Joy dish detergent. Set the dish on your porch, patio, or other outdoor area. Whether it’s the lemon smell, the
   white plate color, or something else that attracts them, mosquitoes supposedly flock to it — and drop dead shortly after drinking the
   mixture, usually within about 10 feet of the plate!

Training Opportunities are Available Statewide
If you missed the deadline to       The 14th Annual Texas Fed-           The annual Southwest Con-
sign up for the April 20-21 Ba-     eration of Humane Societies          ference on Diseases in Na-
sic Animal Control Officer          (TFHS) Conference will be in         ture Transmissible to Man,
Training Course in Lubbock,         Austin at the Omni Austin Hotel      sponsored by the Zoonosis
you still have ample time to        Southpark, April 25-27. Regis-       Control Division of the Texas
register for the one in Amarillo    tration is from 11:00 a.m. to        Department of Health and the
scheduled for October 26-27. If     6:00 p.m. on Sunday, April 25.       Texas Health Foundation, will
training is needed sooner, and      Sessions begin at 2:00 p.m.          be held June 2-4 at the Austin
your agency is willing to send      that same day.                       Marriott at the Capital. The
you out of the region, there are    In addition to the presentation      conference is attended by
several other courses sched-        of a number of topics by vari-       health professionals worldwide,      Don’t miss a chance for train-
uled. View those dates and          ous speakers, there will also be     and is the oldest continuous         ing!
register online at www.tdh.         exhibits set up in the ballroom,     meeting of its kind in the U.S. It
state.tx.us/zoonosis.               and a silent auction that opens      provides continuing education
The new euthanasia techni-          Monday at 9:00 a.m. and              credits for physicians, veteri-
cian training requirement be-       closes Tuesday at 10:45 a.m.         narians, animal control officers,
comes effective January 1,                                               and veterinary technicians.
                                    Further information can be ob-
2005. Various agencies are          tained by contacting TFHS.           For further information, go to
currently seeking approval of       Scholarships are available;          the Zoonosis website at www.
their course curricula. Course      Pam Burney (pamb@aspca.              tdh.state.tx.us/zoonosis.
dates will be announced in the      org) can provide details.
coming weeks.
                                                                        A woman brought in a very limp duck into a veterinary clinic. As she
                                                                 placed her pet on the table, the vet pulled out his stethoscope and listened
                                                                 to the bird’s chest. After a moment or two, the vet shook his head sadly
                                                                 and said, “I’m so sorry, Cuddles has passed away.”
                                                                        The distressed owner wailed, “Are you sure?”
             300 Victory Drive                                          “Yes, I’m sure. The duck is dead,” he replied.
            WTAMU Box 60968                                  “How can you be so sure?” she protested. “I mean, you haven’t done any test-
          Canyon, TX 79016-0968                       ing on him or anything. He might just be in a coma or something.”
                                                             The vet rolled his eyes, turned around, and left the room. He returned a few
           Phone: 806-655-7151
            Fax: 806-655-1354                         moments later with a black Labrador Retriever. As the duck’s owner looked on in
 E-mail: james.alexander@tdh.state.tx.us              amazement, the dog stood on his hind legs, put his front paws on the examination
                                                      table, and sniffed the duck from top to bottom. He then looked at the vet with sad
                                                      eyes and shook his head.
                                                             The vet patted the dog and took it out, and returned a few moments later with a
                                                      beautiful cat. The cat jumped on the table and also sniffed delicately at the bird. The
                                                      cat sat back on its haunches, shook its head, meowed softly, and strolled out of the
                                                             The vet looked at the woman and said, “I’m sorry, but as I said, this is most defi-
                                                      nitely, 100% certifiably, a dead duck.” Then the vet turned to his computer terminal,
                                                      hit a few keys, and produced a bill, which he handed to the woman.
                                                             The duck’s owner, still in shock, took the bill. “$150!” she cried. “$150 just to tell
                                                      me my duck is dead?”
                                                             The vet shrugged. “I’m sorry. If you had taken my word for it, the bill would have
                                                      been $20, but what with the Lab Report and the Cat Scan…”

                                                       The Texas Federation of Humane Societies (TFHS) has received a donation of pet
                                                       supplies for distribution to animal shelters in Texas. If you’re interested, particularly
                                                       if you work with a shelter that has a small budget, check the details at their web-
                                                       site: www.txfederation.org.

                                                                                                                Dr. Mahlow
Rabies Update
By Karen McDonald, Public Health Technician IV, Lubbock                                                         Resigns
Unlike Public Health Regions      homes in the Lazbuddie town-           exposure prophylaxis as a pre-         Jane Mahlow, DVM, MS, Direc-
2/3 and 7 (Abilene/Arlington      ship. It was killed and submit-        caution. Remember, for rabies          tor of the TDH Zoonosis Control
and Temple), we have started      ted without any exposures.             testing, the laboratory requires       Division, resigned her position
off 2004 rather quietly. There    There was one investigation of         samples from three areas of            effective last month.
has only been one case of ra-     a “destroyed” specimen. It was         the brain. Citizens should be          Dr. Mahlow stated in her letter
bies reported so far in Public    a stray dog a family had been          discouraged from shooting an           of resignation, “There’s an ad-
Health Region 1. It was in Par-   feeding that became aggres-            animal in the head, thus de-           age that the reward for doing
mer County. A skunk was           sive and bit. It resulted in an        stroying the brain, if rabies is a     something is not what you get
found wandering around some       individual receiving rabies post-      consideration in an incident.          from it, but rather what you be-
                                                                                                                come from it. That certainly ap-
                                                                                                                plies to me. I have enjoyed a
                                                                                                                phenomenal amount of per-
                                                                                                                sonal and professional growth
                                                                                                                while employed with this
                        By the way, is your dog or cat                                                          agency, and I shall be forever in
                                                                                                                debt to those of you who con-
                        current on its rabies vaccination?                                                      tributed to that growth.”
                                                                                                                Dr. Tom Sidwa is the Acting
                                                                                                                Division Director.