DHSS, CDC Working with Overlook Medical Center,

Westfield Health Officials to Assess Exposure Risk of Health Care Workers

 

A 73-year-old woman who developed rabies after being bitten by a dog in her native Haiti in April died today at Overlook Medical Center in Summit.

 

The New Jersey Department of Health and Senior Services and the U.S. Centers for Disease Control and Prevention (CDC) are working with Overlook Medical Center and the Westfield Regional Health Department to assess the level of exposure among the patient’s family, health care workers at the hospital and other possible contacts.

The woman developed neurological symptoms on June 25 while visiting family in Union County. She had been hospitalized at Overlook since July 2 and could have been infectious as of June 11.

 

Rabies is a deadly disease caused by a virus found in the saliva of a rabid animal and is transmitted by a bite, scratch or contact with infected saliva via exposure to an open cut or wound. Initial symptoms can include fever, pain at the site of the bite, lethargy, lack of appetite, nausea and vomiting. The incubation period is usually one to three months, but may be longer. After the illness progresses to the point of encephalitis—or infection in the brain—the disease is almost always fatal. Rabies can be prevented with a dose of rabies immune globulin and a series of rabies vaccinations.

 

The CDC notified the state and the hospital’s Infection Prevention Department Monday, July 18 that the woman was infected with the rabies virus. Additional CDC testing confirmed today that the patient was infected with a rabies virus related to an isolate from an individual infected in Haiti several years ago.

 

An assessment is being made of health care workers who may have come in contact with the patient, as well as to assess their level of exposure and the need for post-exposure prophylaxis.

 

“The risk of infection to health care workers and others who may have been in contact with the patient is extremely low. Given the infection control precautions used in hospitals, exposures should be very minimal,” said Acting Health and Senior Services Commissioner Dr. Tina Tan. Dr. Tan noted that transmission would have to occur through contact with an infected patient’s saliva into an open cut or wound on a health care worker or other contact.

 

Transmission of rabies virus from a patient to health care workers has never been documented in the U.S., according to State Public Health Veterinarian Dr. Faye Sorhage, who is at Overlook working with the hospital staff and a CDC representative.

 

“We are conducting thorough interviews and assessments of all health care personnel who may have had contact with the patient,” said Mary Pat Sullivan, RN, chief nursing officer at Overlook Medical Center.  “With standard infection control policy and procedures in place in the hospital setting, exposure risk is minimal.”

 

Rabies cases in humans are rare in the U.S. Most are caused by contact with bats or bites from dogs and other animals received in other countries. In New Jersey, raccoons and bats are hosts for the virus and cats account for the vast majority of domestic animal rabies cases.  Dogs and other domestic pets can also become infected but can be vaccinated to protect against the disease.

 

To protect yourself and your pets from rabies:

• Vaccinate your pets against rabies
• Do not feed or touch wild animals
• Avoid contact with strays or pets other than your own
• Report unusual behavior in stray or wild animals to municipal animal control
• Report all bites immediately to your local health department

 

Individuals who have been bitten or attacked by an animal should take the following precautions:

• Wash the wound immediately with plenty of water and soap
• Learn as much as you can about the animal. If the animal is with an owner, get the owner’s name and address. If it is a wild or stray animal, look to see if there are any features that will allow you to identify it later on. If possible, safely capture the animal and confine it and call your local animal control officer
• Contact your physician or local emergency room for wound care and consultation about the need for preventative treatment
• Report the incident to your local health department

 

The last case of human rabies in New Jersey was in 1997 when a Warren County man died after removing several bats from his home. The man did not seek medical attention or notify public health officials that he had been either bitten or scratched. Prompt medical attention may have saved his life.  Prior to that, the most recent human rabies case in New Jersey was in 1971.

 

In 2010, there was one human rabies case in Louisiana and it was attributed to exposure in Mexico and one in Wisconsin related to infection with a bat rabies virus.  In 2009, there were four human cases diagnosed in the US; one diagnosed in Virginia was attributed to a dog bite that occurred in India.  The other three were bat exposures in Texas, Indiana, and Michigan.  

For more information about rabies, please visit: nj.gov/health/cd/documents/faq/rabies_faq.pdf