Rabies Scare

[guppy73]

Thought I'd pass this along--made for an interesting day for me on Friday 😱: http://www.eagletribune.com/punews/local_story_116230925.html

I work at this facility but fortunately didn't have direct contact with this particular dog.

Has anyone else out there heard of something like this happening?

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[ElvisMarie6]

Yikes! I thought the leptospirosis story that was aired on local news here in CO caused a mini panic, but I'm sure its nothing like whats going to happen for you guys. That's really scary.

 

[Steelmagghia]

Oh man! I've never seen a rabies vaccine fail! We get a lot of rabies quarantines because of the bite laws in Texas, but I've yet to see any actual rabies cases. The dogs in quarantine were all either poorly socialized or goaded into biting.
I've seen parvo vaccines fail, though. And that's always sad. Especially because it seems that the mortality rate for failed vaccine parvo is higher than that for puppies who have never been vaccinated. It's pretty rare that I see that one fail though.
Man, that would suck to be those owners though.

 

[LVT2DVM]

It would be nice to get some feedback from graduate/student DVMs but Id wonder more if the vaccine was improperly administered verses it actually failed to provide immunity. I was always told even if a dog is sick or on immune suppressing meds, the animal would produce some some immune response. I definately heard of dogs who've only received a one year (initial) rabies vaccination contract rabies with exposure. Sounds suspicious. Anybody know...Whats up with that?

 

[CanadianGolden]

http://www.peteducation.com/article.cfm?cls=1&articleid=965

This site lists some possible causes of vaccine failure--I guess it could be one of several and we will probably never know.

 

[slainte]

This whole senario is case in point of why the Texas legislature needs to change the law back to making RV mandatory every year instead of every three. Whoever thought that only making RV mandatory every three years in the first place wasn't thinking clearly. Plus, there's been so much anti-vaccine hype in recent years and this case as well as so many others just prove that the benefits to human life outweigh any supposed negative side effects to the animal.

 

[slainte]

Sorry for the double post, but I just wanted to clarify that although I realize the dog was vaccinated, this case just demonstrates the need to vaccinate frequently to keep that titer up and make sure that there has been enough of an immune response. Texas government- I hope you're reading! 😉

 

[wivet2011]

Sorry for the double post, but I just wanted to clarify that although I realize the dog was vaccinated, this case just demonstrates the need to vaccinate frequently to keep that titer up and make sure that there has been enough of an immune response. Texas government- I hope you're reading! 😉

Uhm... didn't the article say that he had two RV in less than a year (May 2007, March 2008)? How frequently do you want to vaccinate? Maybe dogs that are given 3yr RV are more susceptible to infection after a years time, but that clearly wasn't the case here. Remember, there are always going to be exceptions to the rule, regardless of what vaccination protocol you use.

 

[CanadianGolden]

Sorry for the double post, but I just wanted to clarify that although I realize the dog was vaccinated, this case just demonstrates the need to vaccinate frequently to keep that titer up and make sure that there has been enough of an immune response. Texas government- I hope you're reading! 😉

I totally disagree. You can check titer levels and vaccinate as necessary. I don't think it is a good idea to blindly vaccinate with great frequency; it's not as though administering tons of vaccines is completely harmless. IMO the benefits of a carefully monitored vaccine program DO outweigh the risks, but checking titers can ensure that overvaccination doesn't occur. There is no benefit to pumping a dog full of antigens when he already has a protective titer.

In fact, if I remember correctly, the 3 year rabies vaccine had been preliminarily shown to provide protection for more than 3 years, as often seems to be the case with vaccines (as in, many animals have protective titers without further vaccination for longer periods than the vaccine is supposed to protect for).

 

[ri23]

Ironically, we just had a neuropath exam today. I imagine that there was a problem with the animal (some animals/people don't respond to certain vaccines) being that the animal had been vaccinated twice in one year.

 

[nyanko]

In fact, if I remember correctly, the 3 year rabies vaccine had been preliminarily shown to provide protection for more than 3 years, as often seems to be the case with vaccines (as in, many animals have protective titers without further vaccination for longer periods than the vaccine is supposed to protect for).

Do you know a resource that establishes a definition for protective titers for some of the more common canine and feline diseases? I see absolutely no problem with trying to minimize exposure to vaccinations to what is absolutely necessary, but from what I've come to understand it is difficult to pinpoint what one would classify as a protective titer for a lot of diseases.

 

[CanadianGolden]

I don't personally know, but there are definitely guidelines for minimum titers for at least many of the common diseases. My guess is that studies have been done in mice and dogs (and probably cats as well) to determine what titer level they need to avoid being infected. I imagine the CDC and the AVMA probably have records of these studies. (As vets, we don't have to get revaccinated for rabies every year--they use titers, so clearly there are some established guidelines.)

 

[Steelmagghia]

I don't personally know, but there are definitely guidelines for minimum titers for at least many of the common diseases. My guess is that studies have been done in mice and dogs (and probably cats as well) to determine what titer level they need to avoid being infected. I imagine the CDC and the AVMA probably have records of these studies. (As vets, we don't have to get revaccinated for rabies every year--they use titers, so clearly there are some established guidelines.)

The site you gave earlier clearly states that there are many diseases we don't know the proper titer levels for. Do you have another website that gives any more specifics? Also, you have made several statements regarding vaccines in various threads, are you planning on doing any research on it later?
Sorry, my thesis was on the FIV vaccine, so now I'm all interested in vaccine info.

 

[CanadianGolden]

The site you gave earlier clearly states that there are many diseases we don't know the proper titer levels for. Do you have another website that gives any more specifics? Also, you have made several statements regarding vaccines in various threads, are you planning on doing any research on it later?
Sorry, my thesis was on the FIV vaccine, so now I'm all interested in vaccine info.

I didn't say that it was known for all vaccines, just many common ones. I actually am doing Penn VMD/PhD (as you can see from my little profile thingy) and I am thinking about doing my PhD in Gene Therapy and Vaccines--a subset of Cell/Mol Biology. What exactly was your thesis on? I have heard that the FIV vaccine isn't very effective--or that it has a fairly high risk of causing problems that don't make it worth giving--but I really don't know much about it at all. I would definitely be interested--my mom has 2 of my childhood cats (well...from when I was in middle/high school) and they are FIV+. They were barn cats but now live indoors, and obviously either, didn't receive the vaccine, it hadn't come out when they would have gotten it, or they were infected at birth. They are now 11 and still in very good health (which I find surprising, though we confirmed FIV in one with a western--for the exorbitant sum of $160--I could have done it in my lab for $30!). Anyway I would love to hear more about your thesis.

 

[Steelmagghia]

I didn't say that it was known for all vaccines, just many common ones. I actually am doing Penn VMD/PhD (as you can see from my little profile thingy) and I am thinking about doing my PhD in Gene Therapy and Vaccines--a subset of Cell/Mol Biology. What exactly was your thesis on? I have heard that the FIV vaccine isn't very effective--or that it has a fairly high risk of causing problems that don't make it worth giving--but I really don't know much about it at all. I would definitely be interested--my mom has 2 of my childhood cats (well...from when I was in middle/high school) and they are FIV+. They were barn cats but now live indoors, and obviously either, didn't receive the vaccine, it hadn't come out when they would have gotten it, or they were infected at birth. They are now 11 and still in very good health (which I find surprising, though we confirmed FIV in one with a western--for the exorbitant sum of $160--I could have done it in my lab for $30!). Anyway I would love to hear more about your thesis.

Awesome. I'm glad someone is doing some research on it. 🙂
My thesis was on the possibility of using the FIV vaccine research to create an HIV vaccine.
It isn't as effective as some of the others (it is confirmed 84% effective), but the main issue everyone has with it is that SNAP and every other ELISA test can't tell the difference between a vaccinated cat and an infected cat, and as you found out PCR and western blots are ridiculously expensive in veterinary medicine (because most clinics don't have the machinery, they have to send samples out to special labs).
Also, it is attenuated, so an injection site sarcoma is a risk (not a big one, though, if you ask me).
Oh, and it uses subtypes A and D, and subtype B is the main one in the US. Luckily though, it protects against homologous and heterologous strains, but that is partially the reason for the low protection level.
It's only six years old. It came out in late summer of 2002, so it may be that your cats never got the vaccine.
If you'd like, I wouldn't mind sending you the links to my research (they're all available in online versions of journals because my school has almost zero veterinary research, so I had to do a LOT of searching to get everything).
You can read my paper, but I wouldn't recommend it. It goes on FOREVER.
Let me know. You can PM me or I check the threads regularly.

 

[CanadianGolden]

I would love to see your paper. 🙂 You can either post the links here (if you're brave, I guess 😉) or PM them to me.

 

[chris03333]

It would be nice to get some feedback from graduate/student DVMs but Id wonder more if the vaccine was improperly administered verses it actually failed to provide immunity.

Or did the dogs immune system have some sort of issue that it did not mount a proper titer.....or....


Don't know, could be plenty of different situations.
Was in a shelter so how much of a full history do we really have?

Personally, I was more shocked that the dog was a "popular breed"...🙄

 

[david594]

You can read my paper, but I wouldn't recommend it. It goes on FOREVER.
Let me know. You can PM me or I check the threads regularly.

If you don't post the link, can you send it to me? I am interested in reading it.

 

[nyanko]

If you don't post the link, can you send it to me? I am interested in reading it.

Thirded. 🙂

 

[slainte]

I just noticed that my posts might possibly be misinterpreted by people and I realized that perhaps I didn't explain where I am coming from thoroughly. I come from working 3 years as a tech at a lower cost clinic. Needless to say, we get a rather varied smattering of clientele. Some are very good and diligent with their animals and others are trying (or needing) to save money. For instance many rural people that we see are only willing and financially able to do the minimum required by the state. However, with confirmed rabies cases among wildlife on the rise again in Texas, this increases the chances that these ranch dogs and cats might encounter an RV+ animal and possibly be under-protected.
The vets at my clinic recommend vaccinating yearly despite the law that permits the 3 year protocol. Interestingly enough, the dog in the article had a RV vaccine for 2 back to back years. At least in Texas, this is the minimum condition for the 3 yr RV law to be applicable. So this guy had only had the minimum necessary for the 3 yr law to be applicable to him... apparently it wasn't enough.
Just wanted to clarify that I am in no way promoting pumping animals with endless amounts of vaccine antigen. I realize that there are potential side-effects of vaccination. I also know that the majority of our clients would not be willing (or able) to pay for a titer and that in these cases a yearly vaccine protocol is the safest, least expensive, and most practical method of ensuring protection for themselves and the community.
I do agree that in an ideal world no one would ever over-vaccinate, and this may be possible in more economically priveledged communities. It just seems that we need to have laws that protect everyone not just those able to pay for titers.
Finally, I realize that every animal responds differently to vaccines and that it is possible that no amount of vaccine may have prevented infection in this dog. I also just want to stress that I'm sure that there is a lot that I don't know about vaccines and it's possible that what I learn in vet school may alter my opinion. However, in my very humble opinion, based on my current personal experiences/standpoint, it just seems better to err on the side of caution for the sake of the community.

 

[alliecat44]

Also, it is attenuated, so an injection site sarcoma is a risk (not a big one, though, if you ask me).

Sorry for the hijack, but just wanted to disagree with this statement. I've been lucky enough to work with two of the world's approximately thirty veterinary surgical oncologists. Our referring vet population is huge (major city, 2000+ DVM's), but we saw HUNDREDS of these. We were/are the "go-to" place in the area for these surgeries--we even had a cat flown in from Japan for my boss to cut its tumor.

Previous protocols described 2cm margins--not nearly enough--high mortality rate within one year and rare to get clean margins. My former boss established a protocol for vaccine-associated fibrosarcomas of 5cm margins + 2 fascial planes deep. We acheived a somewhat ridiculously high cure level with surgery alone in these guys--can't remember the actual data and it hasn't been published yet, but something like 85% cure with clean margins--but these tumors are NASTY and very aggressive. And the location these vaccines have been given make surgery very invasive, indeed. Like I said, we saw literally hundreds.

Sooo, if you don't mind having, say, seven of your cat's ribs removed along with several of his dorsal spinous processes and his body wall reconstructed with mesh and/or have a partial scapulectomy and/or an amputation and/or a hemipelvectomy, then no, it's not a "big risk."

🙂 Complete hijack, sorry. Off my soapbox! I just don't want folks thinking these tumors don't happen. (They ARE occurring less now that veterinarians are more careful with their vaccination protocols. But your research sounds really interesting!

(In case you're wondering, I have a three-legged cat--not because of a VAS--and he receives all of his vaccines in the tip of his tail, just in case.) 🙂

 

[wivet2011]

I just noticed that my posts might possibly be misinterpreted by people and I realized that perhaps I didn't explain where I am coming from thoroughly. I come from working 3 years as a tech at a lower cost clinic. Needless to say, we get a rather varied smattering of clientele. Some are very good and diligent with their animals and others are trying (or needing) to save money. For instance many rural people that we see are only willing and financially able to do the minimum required by the state. However, with confirmed rabies cases among wildlife on the rise again in Texas, this increases the chances that these ranch dogs and cats might encounter an RV+ animal and possibly be under-protected.
The vets at my clinic recommend vaccinating yearly despite the law that permits the 3 year protocol. Interestingly enough, the dog in the article had a RV vaccine for 2 back to back years. At least in Texas, this is the minimum condition for the 3 yr RV law to be applicable. So this guy had only had the minimum necessary for the 3 yr law to be applicable to him... apparently it wasn't enough.
Just wanted to clarify that I am in no way promoting pumping animals with endless amounts of vaccine antigen. I realize that there are potential side-effects of vaccination. I also know that the majority of our clients would not be willing (or able) to pay for a titer and that in these cases a yearly vaccine protocol is the safest, least expensive, and most practical method of ensuring protection for themselves and the community.
I do agree that in an ideal world no one would ever over-vaccinate, and this may be possible in more economically priveledged communities. It just seems that we need to have laws that protect everyone not just those able to pay for titers.
Finally, I realize that every animal responds differently to vaccines and that it is possible that no amount of vaccine may have prevented infection in this dog. I also just want to stress that I'm sure that there is a lot that I don't know about vaccines and it's possible that what I learn in vet school may alter my opinion. However, in my very humble opinion, based on my current personal experiences/standpoint, it just seems better to err on the side of caution for the sake of the community.

I guess I'm still confused about how often you think that we should be vaccinating against rabies. He had two RV within the last year, the second of which was a three year (whether that is good for 3yrs is not the point right now, since it was given March 1, 2008). How is 2 vaccinations in the last year only meeting the minimum required for the law to be applicable in this case? Wasn't the dog only 16 months old? Theoretically then, the dog had been given every vaccination deemed neccessary according to the law, regardless of whether the particular state requires a RV every year or every 3yrs. It seems like you are suggesting that he should have been vaccinated more frequently to err on the side of caution. Clearly the vaccine, for whatever reason, did not protect him and I'm not sure that vaccinating him more often would have helped. Maybe I'm just misunderstanding you...

 

[slainte]

I was not suggesting that the dog in question should've been vaccinated more. I was simply pointing out that if this dog, that was vaccinated 2 yrs in a row (or twice in 10 months if you want to be specific) can get rabies, then there is no reason to even risk spacing out RVs any further than yearly when human health is at stake.
I realize that this particular dog could have had a bizarre personal reaction to the vaccine or perhaps the vaccine wasn't administered properly. However, considering the scare this guy caused to so many people... its best to just play it safe and RV yearly, especially in high rabies states like Texas.
I apologize for the confusion about that in my previous post.

 

[alliecat44]

You'll learn about this in vet school (trust me!), but for now, this explains why prolonged vaccination intervals are recommended, efficacious, and safe: http://www.aahanet.org/PublicDocuments/VaccineGuidelines06Revised.pdf Happy reading!

 

[StealthDog]

its best to just play it safe and RV yearly, especially in high rabies states like Texas.

So where would you draw the line? If vaccinating this dog twice in a year didn't work, then he still would have gotten rabies with yearly or every three year rabies vaccine requirements. Should we vaccinate every six months, "just in case"? Every four? Every month?

The fact that this dog still got rabies despite being vaccinated twice within a year doesn't mean that all dogs should get vaccinated more often than that in order to be considered protected from rabies. It simply means that the immune system is complicated, and that while the vast majority of dogs would be protected after a yearly vaccine, there will be idiosyncrasies among individuals. While most dogs develop protective immunity to rabies for at least one year, usually three years, and potentially five or seven years (those challenge studies are in the works), there will be those oddballs who just don't develop immunity no matter what you do.

It's sad and scary when it happens, but it's rare and there is no good way to figure out who has protective immunity and who doesn't without doing a rabies challenge on every individual.

 

[guppy73]

So, the weird saga continues. Here's an excerpt from the e-mail that went out to staff & volunteers today. I'll post updates as I hear them:

According to the director of our rabies laboratory, Chewy was "weakly positive" for rabies. In addition, there were only specific focal areas of positivity whereas in most rabies positives, the virus can be found diffusely through the brainstem and cerebellum. Dr. Wang, the director, says this is common in vaccinated animals that end up with rabies. It is attributed to the fact that the vaccine had some effect and reduced the viral replication but didn't completely prevent it.

Just to complicate matters, there were several sections of brain that didn't show any positivity. It is possible that the section sent to the CDC could be a negative specimen. We should get their preliminary results this week, and if they read it out as negative, we will send everything, including the slides we have already made, down to them to assist in the investigation.

Dr. Wang was very confident that the positive result is correct and felt that this was consistent with an animal that had been vaccinated and shown at least some immune response to the vaccine.

The good news from this is it makes it unlikely that Chewy was shedding large amounts of virus into his saliva. HOWEVER, that does NOT change anything about the public health recommendations. A bite, or saliva contaminated scratch or mucous membrane, still counts as an exposure and should be treated.

 

[wivet2011]

Very interesting... thanks for keeping us updated!