Useful Fools

Last Christmas, my extended family traveled to the Yucatan jungle (Belize - San Ignacio). 4 of us spent 5 nights in an “authentic thatched roof hut” (not our plan, of course). The consequences were potentially deadly, and very expensive. Yours truly was a fool!

The first sign of trouble was an insectivorous bat that lived in the thatch and hunted at night while we were sleeping. We could not get rid of it as it would burrow into the thatch and vanish.

The CDC reports that most human rabies in the US is caused by bat exposure, in most cases without a known bite. The recommend rabies evaluation (and probaby shots) if you ever sleep in a room with a live bat.

Result: The county rabies control MD called us and told us we were at Moderate risk (she would have said High but we had lived too long after exposure without symptoms), and told us to go right away (not even wait 12 hours) to an ER. We had to go to the local Emergency Room, wait 6 hours (’till 3AM), to get our first in the series of rabies shots. We had to go back 3 days later (still in the holidays) to get the next shot. We had 3 more shots on days 7, 14 and 28.

The shots are not painful (see note #2). They are very expensive, especially if you pay hospital rates (see note #1). My daughter had no health insurance, and her bill alone was about $8000. The health establishment was a bit confused or we my daughter would have gotten away without an ER visit.

It is believed to be hard to get the Rabies vaccine, but we found it at Walgreens, much to the shock of the local public health establishment (we were getting calls from both county and state rabies people a couple of times a day for a while). Our friendly allergy doctor’s shot nurse administered the day 7, 14 and 28 day doses.

BUT… it ain’t over ’till it’s over. There is a deadly disease in Latin America (and Arizona, but it doesn’t spread between humans there) that kills slowly. It is called Chagas disease. It kills many tens of thousands every year. It is curable (maybe) if caught in its acute phase, but it rarely has any acute symptoms.

Chagas is spread by a blood feeding insect called an “Assassin Bug” or “Kissing Bug” since it often feeds on the lips.

So we have to be tested twice, at intervals, for Chagas.

Notes:

#1 - Each vaccine does (days 0, 3, 7, 14 and 28) costs $200 retail and we were charged $425 at the ER. On day 0, one also gets Human Rabies Immunoglobins G and M. The dosage is dependent on patient weight. It appears to be very expensive but we have been not yet found the cost. It also is made from pooled human blood, giving a slight risk of prion disease (CJD, most well known in its vCJD - Mad Cow Disease - form).

#2 Shots not painful

In the past, rabies shots were very painful and a large number were needed. Today, there is little pain.

On day 0 of treatment, a 1cc vaccine does is given in the arm (painless). Also, a number of cc’s of Immunoglobins are given into large muscle areas (i.e. rear end or thigh). The dosage is dependent on weight. A maximum of 5 cc per shot is given, and that can be a little painful - like a penicillin shot, but not really significant.

On days 3,7,14 and 28, only the 1cc vaccine shot in the arm is given. Again, no pain.

#3: References:
Bats and Rabies (CDC)
Chagas Disease