Kim, Happy New Year! The basic answer to the question is: yes, VDH would recommend vaccinating those identified to be at greatest risk for developing rabies. Because the risk of rabies transmission via breast milk is not well understood and the fact that rabies is almost universally fatal, it seems reasonable to make such a recommendation. Mitigating risk in this situation are the facts that 1) it takes more virus to transmit rabies through the mucous membrane route than parenterally, and, 2) in this case the milk was diluted with that of 70 other cows. OK opted to screen people and offer PEP to those that were immunocompromised and those with oral sores. As of yesterday 113 people had received PEP through the county health department.
Mammary tissue from the rabid cow was sent to CDC has tested negative for rabies virus so far, although the tissue was somewhat decomposed. The scientific literature is scant and in the few studies cited, mammary tissue from rabid animals tested negative for rabies virus. We're not sure what this implies about the value of testing milk before treating. It seems so much is unknown at this point and that the prudent course is to treat, regardless of test results.
Carl
-----Original Message-----
From: Kim Buttery [mailto:rokimbo@comcast.net]
Sent: Sunday, January 01, 2006 10:35 PM
To: Carl Armstrong
Subject: FW: PRO/AH/EDR> Rabies, bovine, human exposure - USA (OK)
Would we recommend this action? Before testing the milk from the affected cow?
Kim Buttery
8606 Woodshill Court
Richmond, VA 23235
804-560-1478
rokimbo@comcast.net
-----Original Message-----
From: owner-promed-ahead-edr@promed.isid.harvard.edu
[mailto:owner-promed-ahead-edr@promed.isid.harvard.edu] On Behalf Of ProMED-mail
Sent: Sunday, January 01, 2006 9:53 PM
To: promed-ahead-edr@promedmail.org
Subject: PRO/AH/EDR> Rabies, bovine, human exposure - USA (OK)
RABIES, BOVINE, HUMAN EXPOSURE - USA (OKLAHOMA)
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A ProMED-mail post
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[1]
Date: 1 Jan 2006
From: Dee Hadorn <bluemohair@earthlink.net>
Source: Tulsa World, Tulsa, Oklahoma, 25 Dec 2005, [edited] <http://www.tulsaworld.com/News.asp>