Austin physician speaks on how to treat rabies amid recent fox attacks

Treating for rabies after fox attacks

Several people in Hays County have been attacked by foxes in the past week, and many of them needed treatment because of rabies. Dr. Ryan McCorkle, an emergency department physician with St. David's Medical Center, joined FOX 7 Austin's Rebecca Thomas to discuss

AUSTIN, Texas - Several people in Hays County have been attacked by foxes in the past week, and many of them needed treatment because of rabies. 

Dr. Ryan McCorkle, an emergency department physician with St. David's Medical Center, joined FOX 7 Austin's Rebecca Thomas to discuss.

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Fox bites person in Hays County, tests positive for rabies: sheriff

A fox that bit someone in Hays County has tested positive for rabies, officials say. This is the second reported fox attack in the county in the last week.

Local perspective:

Rebecca Thomas: Most people vaccinate their pets against rabies and are required to do so, so pets aren't really much of a concern. But if someone is bitten by a wild animal that has rabies and is not treated, how does the virus manifest itself in people? What happens? 

Dr. Ryan McCorkle: Well, it enters the neurons around the bite site and then moves up to your central nervous system and that's where we get the classic symptoms of hydrophobia, altered mental status when the brain starts to swell. It's usually about a week incubation period, but there've been reports of it taking up to a year lying dormant before they developed the full-blown rabies manifestation of symptoms. 

Rebecca Thomas: And can someone recover from rabies or is this fatal?

Dr. Ryan McCorkle: Rabies without treatment is almost 100% fatal. It's very rare. Between 2008 and 2018, we had about three cases in the United States. It's a lot more common all over the world, about 60,000 cases a year, 20,000 of them in India from unvaccinated animals. But if you're not treated, it is a fatal disease.

Rabid foxes in Hays County

A fox that bit someone in Hays County has tested positive for rabies, officials say. This is the second reported fox attack in the county in the last week.

Rebecca Thomas: So how do you treat someone who has been bitten by a rabid animal or an animal that is suspected of having rabies? What's the protocol?

Dr. Ryan McCorkle: So it's a licevirus and what you do is inject immunoglobulin around the side of the bite. Let's say you were bitten on the forearm, you wanna inject a pretty large amount of the vaccine around the bite hoping to bind up as much of the saliva and the wound where the virus is transmitted. After that, it's series of shots, four, that go in your upper shoulder in the deltoid muscle. You get those on the first day, then the third day. Then the seventh day and then the 14th day and that's the complete series.

Rebecca Thomas: How has rabies treatment evolved over the years? Because I've heard stories about, you know, lots and lots of shots. 

Dr. Ryan McCorkle: Rabies has fascinated humans for a long time. You see it in a variety of movies and television shows. And the classic thing is the 20 shots in your belly kind of myth. It hasn't been done since the 80s, so about 40 years since we did that, when you give it into the abdominal musculature, hoping to get into one of the lymph nodes to treat it that way. That hasn't be done in, like I said, over 40 years. Now it's just like you get any other vaccine. And it's in the upper shoulder. The only difference is you get it around the bite site as well. 

Possibly rabid fox attacks people in San Marcos

A fox attacked multiple people on Sunday, May 11, on trails in the Purgatory Creek area, says the city of San Marcos.

Rebecca Thomas: And what is the timeline? Once you've been bitten, how long do you have to get the shots before the virus takes hold? 

Dr. Ryan McCorkle: It needs to be done as quickly as possible, because in that first week it can be really key before you start to develop symptoms, and then it's very difficult after that. So as quickly after a bite as you can, but definitely in that first week. 

Rebecca Thomas: And what else should people know if they're attacked by a wild animal like a fox? 

Dr. Ryan McCorkle: The most common carriers are bats. Bats account for about 70% of rabies cases across the world, but foxes, raccoons, those kind of things. That's, if you're bitten by a wild animal that can't be captured and observed to see if it develops symptoms, then you need to go to either an emergency department or the health department and start with the vaccine as soon as you possibly can.  

Rebecca Thomas: All right, play it safe. Dr. Ryan McCorkle with St. David's Medical Center. Thank you so much for sharing your time and your expertise with us tonight.