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Utah man dies from rabies, the first in the state since 1944
- kleopullin 8y agoThis is a badly written article, journalists should have a little science background. "... the bats .... were carriers of a rabid and highly contagious virus." Yes, it is a rabid virus... "A person usually has some time before it is necessary to get the post-exposure prophylaxis vaccination." A friend had to handle a bat in her cabin, and she was not told she had "some time" before the shots. If you've been exposed get your butt to the ER. "An estimated 40,000 people in the US who might not be up-to-date on vaccinations get preventive treatment for rabies after a bite or scratch from a dog or cat." Statistically 100% of peeps aren't up to date on rabies vaccines. Vets, bat researchers, and bat house zookeepers may be up-to-date, but no one else is. Rabies shots costs thousands of dollars, btw. Tricare, for military dependents, doesn't charge a copay for rabies post-exposure injections. My friend's insurance had something like $4000 copayment.
- madeuptempacct 8y ago"Rabies shots costs thousands of dollars" I assume you mean in the US. Really? I had no clue. They are like $5 in Eastern Europe. Edit: I am referring to the post-exposure shots. Edit 2: All of this reads like a bad joke - if our numbers are representative, rabies treatment is 20-2000x the cost of other countries in the US. Would be interesting to see someone play devil's advocate on this.
- billfruit 8y agoIn India they are free in State owned hospitals.
- lostgame 8y agoFree in Canada, as well.
- pvaldes 8y agoFree in Spain, if I'm not wrong
- nhauz 8y agoCompletely free and everybody is vaccinated because they vaccinate kids in schools, I assume it's the same in every country of the first world.
- pvaldes 8y agoHum, not. Is obligatory for dogs (it was like 50€ or so), but children aren't vaccinated from rabies normally in Spain at the school. Rabies is endemic in Ceuta and Melilla in any case. I don't know if people in those places are systematically vaccinated but would be a surprise to me.
- nhauz 8y agoWow, I stand corrected! I thought rabies was in the programme. My mistake. About Ceuta and Melilla, there have been efforts to have pets vaccinated for free: https://elfarodeceuta.es/sanidad-vacunacion-gratuita-rabia/ https://elfarodeceuta.es/sanidad-vacunacion-gratuita-rabia/
- dgacmu 8y agoI got them in the us about 10 years ago (international travel with likely animal exposure). About $600.
- twunde 8y agoParent is talking about post-exposure rabies shots, not the rabies vaccine. If you read https://www.vox.com/policy-and-politics/2018/2/7/16851134/rabies-treament-expensive-emergency-room https://www.vox.com/policy-and-politics/2018/2/7/16851134/ra... it's actually still very expensive in the UK as well.
- bhousel 8y agoOh! I got rabies shots in 2014 after being bitten by a dog. The course of treatment is injections 0day, 3day, 7day, and 14day. I went to the emergency room to get these injections, at the recommendation of my primary doctor. Unfortunately I don't have the bills anymore, but the total cost was a bit over $20,000, which insurance adjusted down to about $500/visit. Basically, it would have bankrupted me if I didn't have insurance. Yes, the US healthcare system is really this broken.
- tom_b 8y agoYep, my family had to do the same ER visit for our treatments. Immune globulin is a blood product and I was told it is atypical for any medical center outside of a hospital to have it available. Having to go the ER added a not insignificant amount to our total bill, but we did only have to pay for a single visit to the ER - our followups, we just walked in and a nurse would give us the shot. On the somewhat funny side, it's weird walking into an ER and being greeted by first name and a wave . . .
- bhousel 8y agoHah yeah, it was kind of funny that by the 4th shot, the ER docs and police there knew me as "the rabies guy". I also was told that the immune globulin is a bit complicated because it needs to be prepared specifically for the person's weight. So unlike off the shelf vaccines, it requires an on duty pharmacist to actually do something before they can give it to you, which I'm sure adds to the cost.
- foldr 8y agoI can also confirm this. Similar situation and similar pre-insurance costs.
- jartelt 8y agoI got the post-exposure series with rabies vaccine and immune globulin shots earlier this year. The total insurance charge was around $20,000 for me as well. $15,000 for the immune globulin and $5,000 for ER/Vaccine/etc. My out of pocket cost was below a few thousand after insurance, but it was expensive nonetheless.
- rerx 8y agoPre-exposure rabies vaccination is generally not included with statuatory health insurance in Germany. Still, the insurance carrier often covers it if the vaccination is indicated for a country you travel to. The three shots cost about 200-300 Euros combined, IIRC.
- tom_b 8y agoYes, post-exposure costs in the US for human rabies immune globulin (antibodies isolated from the blood of a vaccinated person) in the United States is roughly a $10,000 to $15,000 expense per person (dosage is based on body weight). The vaccine cost is much less, well under $1,000 total per person. I know these costs from direct experience. I also know that insurance coverage for this cost varies widely as well. My entire family had a nighttime (meaning the family members were in bed asleep) exposure to an untested bat. Following the U.S. Center for Disease Control and local health department guidelines, plus the advice of infectious disease MD specialists, we had to receive both the immune globulin and rabies vaccine. These costs were not covered expenses under my (otherwise pretty solid) medical insurance plan - we wound up having to pay approximately 30% of the total cost. In the end, I felt fortunate that at least our insurance kicked in to cover 70% of the costs and that we were in a financial position that allowed us to pay the low five-figure out-of-pocket expense for our treatment without undue hardship. I'm actually debating keeping our vaccinations up-to-date going forward - I think the booster vaccine, while still uncovered by my medical insurance plan, is relatively low cost and incidences of rabid animal encounters seems to be steadily rising in my home state.
- planteen 8y ago> I'm actually debating keeping our vaccinations up-to-date going forward - I think the booster vaccine, while still uncovered by my medical insurance plan, is relatively low cost and incidences of rabid animal encounters seems to be steadily rising in my home state. You can get a rabies titer to see if you need the vaccine booster. https://www.cdc.gov/rabies/specific_groups/doctors/serology.html https://www.cdc.gov/rabies/specific_groups/doctors/serology....
- justjash 8y agoI took my wife/daughter/myself to the ER to figure out if we should get it since it is the only place that carries the vaccine near us. We ended up not getting it and still walked out with a $3000 bill.
- Dannymetconan 8y agoOr in Vietnam it was about 10 euro a shot and probably would have been free if I had been a local.
- PhasmaFelis 8y ago> A friend had to handle a bat in her cabin, and she was not told she had "some time" before the shots. If you've been exposed get your butt to the ER. The article doesn't claim otherwise. Rabies can usually be treated successfully days or weeks after the initial bite. Obviously you should get the shots ASAP regardless; it's more likely to take hold with every day that passes. > Statistically 100% of peeps aren't up to date on rabies vaccines. Vets, bat researchers, and bat house zookeepers may be up-to-date, but no one else is. Again, the article doesn't say otherwise. It doesn't say "40,000 people aren't vaccinated," it says "40,000 people (who aren't vaccinated) get rabies shots after a dog/cat bite."
- kleopullin 8y agoThe article does specifically say "a person usually has some time," which is why I put it in quotes. There's no value to the article downgrading an urgent medical situation, and the author lists herself only as a journalist. The standard of care is urgent, ERs are equipped to give the shots. This is USA. "An estimated 40,000 people in the United States who might not be up-to-date on vaccinations," again, I used quotes specifically because that is how it is worded, "people who might not be up-to-date on vaccinations," as it is less usual for someone to be up to date on rabies vaccinations. The science was badly worded, as if it was copied without understanding the context, and this is a legitimate concern when the press misstates medical advice. The number is probably from the CDC information page, "Every year, about 40,000 people receive a rabies prevention treatment called post-exposure prophylaxis (PEP) because they had contact with potentially rabid animal." CDC also doesn't say dog/cat bite or scratch, just potentially rabid animal, mostly dogs or cats. I read the article, notices her carelessness, checked sources. There are more errors. It's badly done.
- madeuptempacct 8y agoRabies is one of the scariest diseases to me, because most aren't vaccinated, it's virtually 100% lethal, and most of the time, doctors will tell you that you don't need to be vaccinated "just in case", because the incidence is so rare. If you can, bring in the animal that bit you; you don't want to go through the shots unless they are necessary, but you also don't want to die.
- Alex3917 8y ago> If you can, bring in the animal that bit you Don’t they still need to kill the animal and send it’s head to the lab? At least when I was a kid you still needed the shots because it took a week to get the animal’s results back.
- madeuptempacct 8y agoI was told you could avoid shots by bringing the animal in, but I am not in the field, so I don't know if that's generally true.
- pvaldes 8y agoYes, and if is alive is easier to look for symptoms. People bitten by any species of microbat receive three shots. There is a lot of difference between risk depending on the bat species, so it helps a lot if can be classified by a specialist.
- seandougall 8y ago> if is alive is easier to look for symptoms As I understand it, removing and examining the brain can yield a definitive diagnosis in cases where time is of the essence. In cases where it's not immediately obvious that the animal is rabid, it can take a week or two of observation to look for more overt symptoms. That's how my parents ended up adopting a stray dog, who later became just about their favorite pet ever. By the time they'd watched him for a couple weeks, he wasn't going anywhere. :)
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- dahart 8y ago> They never hurt us I guess as I understand it, it doesn’t matter if animals are normally friendly because rabies causes them to act aggressively. Radiolab did an episode on rabies that is absolutely fascinating. They talk about the “Milwaukee Protocol” for treating it, which I’d never heard of before that. It’s no longer a recommended treatment, if it ever was, but the story really stuck with me. https://www.wnycstudios.org/story/312245-rodney-versus-death https://www.wnycstudios.org/story/312245-rodney-versus-death
- sandworm101 8y agoSymptomatic rabies is one of those nightmare scenarios that docs read about in history books. A few cases have involved older relatives recognizing symptoms in kids, symptoms that modern docs would never suspect to be rabies.
- mongol 8y agoWhy is it no longer recommended? Is it not the only viable way to save someone infected to life, when the disease has progressed far enough?
- NeedMoreTea 8y agoBecause it has saved just one life. It's since been claimed that person may have had natural immunity or been unrepresentative in some other way. https://www.sciencedirect.com/science/article/pii/S0166354213000181 https://www.sciencedirect.com/science/article/pii/S016635421...
- pvaldes 8y agoAnother sad case of lack of scientific formation. Could be easily solved spending 20 minutes at the schools to study basic ecology of parasites, vectors and diseases. Microbats shouldn't be, never, ever, manipulated with bare hands. Specially if they seem to be sluggist or ill. Full stop. You need strong gloves, or much better, let it to a trained zoologist or veterinary.
- tomatotomato37 8y ago"I had no clue," Giles said. "We would wake up in the night and they would be walking on our bed" I'm sorry for the family but I can't exactly say I'm not surprised. Generally having any wild mammal hanging out where you sleep is a very bad idea. Edit: Reworded to be less arse
- spacenick88 8y agoAnd it's a very good idea to get a rabies vaccine shot if you find an unknown dog in your bed at night. Like a very very good idea
- gambiting 8y agoThis explanation of how it is to die from rabies is horrific, if anyone fancies a story that stops you from sleeping at night :P https://www.reddit.com/r/news/comments/9vdumn/utah_man_dies_from_rabies_first_in_state_in_74/e9bpd2j https://www.reddit.com/r/news/comments/9vdumn/utah_man_dies_...
- rv-de 8y agoThat's it - I'm done with nature ...
- sodosopa 8y agoGreat to hear! Here’s a support group for people who hate nature, clean air, water and do what they can to stop it in its tracks. GOP.com
- LandR 8y agoThere's no rabies in the UK, right?
- gambiting 8y agoNo, apparently it has been fully eradicated in 1922, and only deaths due to rabies were due to bites while abroad.
- pvaldes 8y agoLast death: Scotland 2002. A chiropterologist studying native bats. He had not travelled out of UK
- circlefavshape 8y agoNow chiropterologists all get vaccinated as a matter of course (source - my wife is one).
- 8y ago
- jordache 8y agothey allowed bats to walk on their beds at night? WTF
- codezero 8y agoTo be fair bats are pretty harmless when they aren’t infected with rabies.
- mirceal 8y agoTo be fair, in quite a few places bats are the main rabies infection vector.
- codezero 8y agoVery good point :)
- opencl 8y agoThe places where bats are the main rabies infection vector are generally places where rabies is extremely rare[1], such as the US with 1-2 cases per year. ~99% of human rabies cases globally are from dogs[2], unsurprisingly these are mostly in places where dogs are not usually vaccinated. [1] https://www.cdc.gov/rabies/bats/education/index.html https://www.cdc.gov/rabies/bats/education/index.html [2] http://www.who.int/news-room/fact-sheets/detail/rabies http://www.who.int/news-room/fact-sheets/detail/rabies
- 8y ago
- JulianMorrison 8y agoWhy is rabies vaccine so expensive as to be rationed?
- planteen 8y agoI got vaccinated against rabies in 2010. It was 3 shots at $300 each if I remember right. It was hard to find a clinic that stocked it. I live in Colorado, I think only two clinics in the state had it. Note that is for pre-exposure shots, not post-exposure. It's not a common vaccine, typically it is only given to vets and vet techs. I think that is a public health decision - rabies exposure is very rare in the United States. I was getting it because I was going to Peru for a caving expedition. It probably wasn't necessary for me, but the travel pharmacist said it could get it due to possible stray dog exposure in remote Peru and possible bat exposure in caves. I never saw a single bat in the caves there. But since the travel pharmacist recommended it, my insurance paid, which was nice.
- vorpalhex 8y agoHow painful of a series was it? What was the time between injections?
- planteen 8y agoNot painful at all. Just like a flu shot. The painful shots are the post-exposure ones that go in the gut. I received Imovax. It was a brilliant purple color - it was the prettiest vaccine I have ever seen. Shot #2 is 1 week after the first, shot #3 is 3-4 weeks after the first. https://www.vaccineshoppe.com/image.cfm?doc_id=5983&image_type=product_pdf https://www.vaccineshoppe.com/image.cfm?doc_id=5983&image_ty...
- appleiigs 8y agoI got post-exposure shots and they were in the arm. 5 shots: 2 shots day 1, then 1 shot day 3, 7, 14.
- 8y ago
- rlue 8y agoThere's actually an experimental treatment for rabies that can be administered if post-exposure prophylaxis fails (called the "Milwaukee Protocol"). It involves a drug-induced coma followed by a cocktail of antivirals, and the success rate is around 20% in the best case (n.b. the sample size for the study that figure was 10). Not that it would have helped here, when the diagnosis came at such a late stage. The case report for the patient treatment that pioneered the Milwaukee Protocol—the first-ever successful treatment of a rabies patient—is worth a skim, if you're into this sort of thing. [0]: https://www.nejm.org/doi/pdf/10.1056/NEJMoa050382 https://www.nejm.org/doi/pdf/10.1056/NEJMoa050382
- SolaceQuantum 8y agoI believe it’s also associated with severe health consequences and the only survivor has stated regretting the protocol... EDIT: Seems I'm misinformed. Thanks for clarifying, commenters below.
- AuthorizedCust 8y agoI don't see much regret: http://www.jeannagiese.com/my-personal-story.html http://www.jeannagiese.com/my-personal-story.html
- corpMaverick 8y ago>> Being the animal lover that I was, I was bit in my finger by a puppy that I was trying to feed when I was up in the desert doing mountain biking. A few days later, I had to get vaccinated because we could not bring the dog for observation. The vaccination itself can be risky. But it is preferable than risking rabies. I was told it is a horrible way of dying. Lesson learned.
- crescentfresh 8y ago> I had less than 4 hours left to live. Dr. ... was not ready to let me die. He researched the internet and found a few key phrases that helped him devise a treatment Well I guess in desperate times all treatments started somewhere, a quick goog is probably as good as any.
- URSpider94 8y agoThere was also a fatal case in Virginia this year, a woman who contracted the disease while traveling in India. It took several trips to the hospital before they diagnosed it correctly, since it’s not something docs are expecting to see. They tried the Milwaukee protocol unsuccessfully. https://www.cdc.gov/worldrabiesday/stories/rabies-virginia.html https://www.cdc.gov/worldrabiesday/stories/rabies-virginia.h...
- mylons 8y agopatient 0
- warent 8y agoIt's a real human, not a Hollywood film for your entertainment
- fiblye 8y agoI've had bats slip into my house late at night several times. They're cute little fuzzballs when I see them outside flapping around far away from me, but hearing a "pittpittpittpattpatt" whirling above your head at night is terrifying. My first assumption was always rabies, because why else would a tiny animal get so close to a huge and dangerous animal like me? A large number of stories I've heard involving people playing with small wild mammals end with rabies. When it comes to bats, raccoons, and possums, I was always taught to treat them as rabid because healthy ones won't ever get close to random humans if they can help it. That this guy was letting them lick his fingers is unimaginable to me.
- enceladus_ice 8y agoLuckily, it's extremely rare for opossums to contract rabies, so keep snuggling those scary beasts to your heart's content.
- bryanrasmussen 8y agowhat's the rate for opossums who get close to humans though?
- braythwayt 8y agoThis! It's related to the assertion that fewer than 1 in 100 programmers is unable to write "FizzBuz" in the programming language of their choice. The rate may be statistically insignificant amongst all programmers, but what is the rate amongst programmers looking for a job? Different question :-)
- MRD85 8y agoI really struggle with the concept that some programmers cannot write FizzBuzz. I'd expect it from someone who has finished their first programming unit.
- bryanrasmussen 8y ago
- pmarreck 8y ago> "I had no clue," Giles said. "We would wake up in the night and they would be walking on our bed." Not to judge, but isn't this getting a little too close with nature?
- briandear 8y agoIt’s interesting to me that my town, Mountain View refuses to require rabies vaccinations or licensing for cats.
- ghaff 8y agoI think that's pretty typical throughout the US.
- mrfusion 8y agoIt’s fun to ask an anti vaxxer what they would do if they were bitten by a rabid animal. You can watch cognative dissonance kick in.
- pwagland 8y agoThey'd die. But there would be no dissonance, since they would just say "no-one gets rabies anymore", so, in their eyes, the argument is a non-sequitur.
- deleted 8y ago[deleted]
- HarryHirsch 8y agoAnti-vaxxers usually say the benefits outweigh the risks and don't consider herd immunity. When you've just been bitten by a rabid animal the risk-benefit calculation is different, no cognitive dissonance there. You'd also predict that an antivaccionationist hunter has at least his dog vaccinated against rabies, you see rabid foxes and raccoons out there with your own eyes. What you'd really like to do is ask an anti-vaxxer woman who is pregnant or trying to conceive what she thinks about measles, mumps and rubella vaccine, especially rubella.
- lbriner 8y agoPlenty of women in the UK turned it down due to unconfirmed (and now debunked) links to autism. It's just what you choose to believe and whether you think the risk of autism and its outcome is worse than the risk of Rubella and its outcome.
- tomphoolery 8y agoHow would a vaccine help someone who already has rabies?
- village-idiot 8y agoThe vaccine is extremely effective if taken between the bite and when symptoms occur. If treated properly and promptly, you have basically a 100% chance of living. As symptoms begin to show up, the chance of survival drops rapidly to 0%.
- slr555 8y agoThe practical takeaway here underscores the advice in Auerbach's authoritative text Wilderness Medicine. If a person interacts with potentially rabid animals and that interaction results in even the smallest scratch or contact with saliva the victim should undergo rabies treatment and if possible have the animal undergo necroscopy. The odds of surviving rabies once it becomes symptomatic are negligible. They can throw the hail Mary from the 5 yard line in a snowstorm but the chances of winning the game with it are slim.
- kyleblarson 8y agoNote to self: don't let bats lick my hands.
- grawprog 8y agoWhen I got my rabies shots to do bat work years ago i remember the nurse that gave the shots told me the story of one of her first patients out of med school who died of rabies. Apparently, he was actually bit a bat that flew into his tent when he was camping and he didn't end up going to a doctor about it until it was too late and he slowly died. This was in canada. We've had deaths more recently than the USA from rabies. It sounds like a horrible way to die. She gave me shit for going to work with bats...even after getting the shots... Rabies is pretty intense. Even after being vaccinated you still need to get a titer shot every few years to keep your level of antibodies high enough to fight off the virus if you're exposed to it.
- aurizon 8y agoRabies enters a nerve cell at the bite site. It then travels along the nerve axon to the next cell. It does not proliferate at this time. Cell by cell, via the axon railway to the brain. It then proliferates in the brain and kills large numbers of brain cells and causes death. If you have antibodies, they can somehow block the axon travel. The Milwaukee treatment was a success - the only one? Perhaps that girl had some immunity? In any event, once it hits the brain the body starts to mount it's own immune response, and apparently the anitivirals she was given, along with the induced coma, allowed her immune system to overcome the rabies.
- prmph 8y agoSo why doesn't everyone simply get vaccinated?
- latestagetest 8y agoRabies vaccine is crazy expensive and takes multiple shots. Even then you still need immediate post-exposure treatment.