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Follow These Rabies Rules for Safety

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"Most people still think you get them in the stomach -- and you absolutely don't," says Slote. But you can get the RIG injected in unusual places -- depending on where the bites are. "Nina had three places where the fox bit or scratched her and she had to have some RIG injected into each of those spots."

The HDCV/RIG regimen is a huge advance from what might be called the Dark Ages of rabies treatment, Vitale says, when the vaccinations were so numerous they had to be given in places such as the abdomen -- and even then, didn't always work.

"It's much easier to treat patients and much easier to recommend treatment," says Alfred DeMaria, MD, director of communicable disease control at the Massachusetts Department of Public Health. "Now the risk of treatment is virtually nil."

Which is not to suggest anyone who comes in contact with a rabid animal necessarily needs treatment. It really depends on how "contact" is defined. Public health experts say the greatest danger lies in getting the saliva of a rabid animal, or its brain or nervous system tissue, into an open cut. That could happen through a bite, of course, or indirectly.

That was the case with Roland Vaillancourt, a paramedic from Greenville, N.H. One day eight years ago he noticed an odd sight: a raccoon wandering around a neighborhood in daylight. "So something was wrong," he says. "It was acting very unusual -- slow [breathing], unsteady gait. We just decided to put it down at that point."

He used a bow and arrow, and accidentally cut himself on the arrowhead, which was tainted with the raccoon's nervous system tissue. But Vaillancourt underwent PEP and didn't have any problem.

Another method of indirect exposure: getting saliva or nervous system tissue splashed onto a mucous membrane, such as the eye. But experts say it's important to note that blood, urine, and droppings from rabid animals cannot transmit the virus.

Cats and dogs were once important rabies transmitters -- but no more. Now, raccoons are king up and down the East Coast. In fact, three years ago, Canada mounted an intensive effort to keep rabid raccoons from spreading into Ontario. Planes flew over the border, dropping thousands of oral rabies vaccine doses hidden inside food bars. It failed.

Ontario's current efforts to control the disease's spread include establishment of a five-kilometer "kill" zone at two entry points -- where every raccoon seen is exterminated. There is also an outer zone in which raccoons are trapped and vaccinated. And beginning in June, a shower of vaccinated bait bars will be airdropped into the area.

A similar effort on Cape Cod, Mass., seems to have done the trick. DeMaria says raccoon rabies there have been virtually eliminated.

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