Nome and region is in the midst of a rabies epidemic
Nome and the surrounding area, including St. Lawrence Island, is fighting rabies almost as hard as it is fighting COVID-19. The dramatic increase in positive rabies cases in foxes and dogs has brought attention from Alaska rabies control specialists who have come to Nome to help lower the rate of infection. “The state recognizes that this is an unusual and serious issue in Nome and Savoonga right now,” said Dr. Kimberlee Beckmen, Alaska Department of Fish and Game’s Wildlife Health Veterinarian. She gave a presentation via Zoom as part of the Northwest Campus’s Strait Science series on March 25.
Because of the high level of rabies infection Fish and Game requested assistance from the National Rabies Management Response Program. Their job is to manage a wildlife disease outbreak. Several technicians and a rabies biologist are in Nome reducing the number of foxes.
“They’re out at night dispatching foxes,” said Dr. Beckmen. “Every one of those foxes will be tested for rabies onsite. Then we can see what the underlying rate of rabies is in these foxes and hopefully bring this particular outbreak down and reduce the exposure level to dogs and people.” Vaccinations of pets are a key link in battling rabies. Transmission of rabies to humans is mostly likely to come from pets, usually dogs, who’ve been infected with the virus by red foxes. The vaccination of dogs, and keeping the vaccinations up to date, is of primary importance. Puppies should be vaccinated by 12 weeks of age and then get a booster shot at one year. After that a dog needs a booster every three years. It’s important to keep good documentation of an animal’s vaccinations. “Most human exposures and unknown exposures especially are from dogs,” said Dr. Beckmen. “If your dog stays outside and tangles with a rabid fox you might not know about it. The dog can develop rabies and then come into contact with a child or any other person. “That unknown exposure won’t get treated because you didn’t know the dog was rabid. The foxes give the rabies to the dog and the dog then exposes people.”
There is more than one rabies virus. The disease has been around for thousands of years. Dog rabies has been eliminated in North America by vaccinating dogs. But the virus is endemic in Arctic foxes and there’s probably no way to eliminate it in them. They are the reservoir for the virus. The Siberians call it Polar Madness and Arctic dog disease. It is enzootic in the Arctic fox, which means it is always present at some low level.
The Arctic foxes pass it on to the red foxes. This happens in late winter and early spring when the Arctic foxes come off the ice and encounter red foxes as well as dogs and other wildlife. Rabies has been detected in every month in Alaska. “I want to be clear that rabies is always out there,” said Dr. Beckmen. “It’s a constant risk.”
The Arctic fox will travel extreme long distances, especially in winter when the ice is good. One fox tagged in Spitzbergen, Norway turned up in Canada. As the climate warms the red foxes have moved farther north, as have other animals. This brings them more frequently into contact with the Arctic foxes, with whom they compete. All mammals are susceptible to the rabies virus and there are documented cases of lynx, reindeer, caribou, river otters and wolverines testing positive for rabies. But the primary threat to humans comes from the red fox. Three human deaths from rabies have been recorded in Alaska. However, many people have been successfully treated for exposure to the virus.
Vaccination is compulsory for dogs and cats. Alaska is the only state which allows lay vaccinators. A non-vet can vaccinate the animal and it will be valid. The state also has an excellent system of reporting fox to dog interactions which can lead to rabies. When a person is exposed the state can treat that individual with a post-exposure prophylaxis. “The post-exposure vaccine works great,” said Dr. Beckmen. “It’s a series of vaccines, but not like it used to be. You get three shots in the arm.” In the past the post-exposure vaccine included 18 painful injections into the stomach. Pre-exposure vaccination is also an option for those who risk being exposed to the virus, such was wildlife biologists.
According to Dr. Beckmen, rabies is cyclical and will peak every three to five years. About every ten years there’s a larger, more widespread outbreak. She described the current outbreak in Nome as “remarkable.”
In 2021 there have been ten positive cases in foxes in the region. This is caused by an increase in the fox populations. “We know there are more foxes around, more chances for transmission, because there’s more contact,” she said. “And there are more young foxes with no antibodies. They’ve never been exposed before, don’t have any immunity. It seems that in Nome the virus is circulating within the resident red fox population,” she said. A number of factors can bring the foxes into contact with dogs and humans. When there is a lot of food available, easy scavenging, they breed more. There are a lot of dogs living outside so the foxes coming around for easy food make contact with the dogs.
Rabies appears in two different forms. “Furious rabies” affects the brain and the infected animal will attack inanimate objects like rocks. They attack anything that moves and display no fear of people at all. In wolves, lynx and coyotes a face full of porcupine quills can indicate rabies. The infected animal will attack a porcupine incessantly simply because it is moving. The other variant of the virus is “dumb rabies.” The animal acts blind, doesn’t appear to be aware of its surroundings. It may walk in circles. The virus affects the swallowing reflex and this stimulates the production of saliva, which is the primary agent of transmission. The animal foams at the mouth. A bite exposes the victim to the saliva and the virus it contains.
If one encounters a fox displaying rabies-like behavior what should they do? “First of all you want to protect yourself,” said Dr. Beckmen. “Get out of the area, call local authorities. You can dispatch the fox right away if it’s a clear threat.” It’s legal to protect human health. “If you do kill a fox you’ve still got to report it right away. Make sure to turn in the carcass so it can be sent to the lab and tested for rabies and disposed of properly.”
“If there’s a bite wound you need to protect people and pets from further attack,” said Dr. Beckmen. “Kill the attacking fox. Don’t shoot it in the head if possible but do what you can to stop the attack. Kill that animal. We can still detect rabies in a fox that’s been shot in the head, we just can’t rule out rabies. We can’t be certain of a negative test.” If rabies can’t be ruled out the bite victim will have to undergo treatment.
Dr. Beckmen stressed the importance of washing the wound. “Wash it thoroughly with soap and water, and then flush it with one percent iodine if possible,” she said. Cleaning the wound can reduce the risk of contracting rabies by 85 percent. “Wash out the virus and the saliva. Call for medical care and they will take the next step.”
“If you are called on to submit a specimen you want to protect yourself,” said Dr. Beckmen. “Typically just the head is what they want shipped in. You want to wear gloves and protect your face because splashing or getting any of the brain tissue into your nose or your mouth could also cause an exposure. Wear face protection, eye protection, and clothing that can be laundered or decontaminated. It’s important to send in the proper documentation. Forms are available at the State of Alaska Department of Health and Social Services website.”
The Department of Epidemiology is tasked with making sure anybody who might have been exposed is contacted. They coordinate what is to be done and if necessary arrange the post-exposure prophylaxis treatment. They also assess the status of the dog if there was one involved. They check the vaccination status of the pet to determine whether it can be quarantined or must be euthanized. If the dog is current it will get a rabies booster shot and be quarantined for 45 days. “If it has never been vaccinated it would have to be quarantined for six months with no risk of any human contact,” said Dr. Beckmen. “That is very difficult to do. That is not the preferred option.”
The disposal of potentially infected fox remains can be problematic. It’s important that they not be dumped outdoors where other foxes might prey on them. The remains should be buried or burned. It’s important that the remains not be scavenged. One way to dispose of a body is to bag it and put it into a barrel to rot.
It’s important to remove fox attractors. Garbage must be secured and pet food should not be left lying around outside. Dog yards should be fenced to keep children out as well as foxes.
Wildlife biologists are considering an oral vaccine to bring the rabies numbers down in the periphery around Nome. The oral vaccine cannot be used in freezing temperatures so it has never been tried here.