Minnesota health officials have recommended rabies post-exposure treatment for nine people, including two minor children, after a Hereford heifer in Brown County tested positive for rabies. Several of them handled the sick animal or gave it medicine by mouth without gloves before anyone suspected the disease.
The case, announced Sept. 17 by the Minnesota Board of Animal Health, shows how rabies exposure can happen without a bite. Saliva from an infected animal can transmit the virus if it reaches the eyes, nose, mouth, or a fresh open wound, and a cow that simply seems sick or off its feed can be carrying it.
The timing matters beyond one farm. The case comes days after the CDC warned of a nationwide rise in human rabies exposures.
A Sick Heifer, Three Vet Visits and No Gloves
The owner first noticed the heifer acting oddly on Sept. 1, lying flat with its head down. A veterinarian examined the animal that day, and the owner gave it oral medication with bare hands. On Sept. 2, a second veterinarian examined the heifer and also gave oral medication without gloves.
By Sept. 3, the signs were clearly neurological. A third veterinarian found that the cow had uncoordinated hind legs and was high-stepping, vocalizing, drooling heavily, and running a high temperature. The animal was euthanized, and the board confirmed on Sept. 8 that it had tested positive for rabies.
The Minnesota Department of Health recommended rabies post-exposure treatment or booster vaccinations for the owner, the owner's daughter, two minor children, two of the veterinarians who examined the animal and three veterinary technicians.
"When we see livestock acting strangely, rabies may not be the first thing people think of to explain the behavior," said Dr. Steve Kivisto, the senior veterinarian leading the board's rabies program. "Given the severity of the disease, it's better to assume an animal is infected until proven otherwise."
The board also quarantined 13 cows and is keeping more than 40 cattle under observation. A vaccinated horse and three vaccinated dogs are also being watched, while two unvaccinated barn cats with likely exposure were euthanized.
The source has not been confirmed, but numerous skunks were seen earlier this year on neighboring land owned by a relative, the board said. Skunks and bats are the natural carriers of rabies in Minnesota.
A National Rise in Exposures Puts the Case in Context
The Brown County case fits a pattern federal officials flagged this month. In a CDC Health Alert Network advisory issued Sept. 10, the agency reported receiving 17% more rabies-related inquiries in July and August than a year earlier, including reports of mass exposure events involving more than one person.
Weekly pharmacy data through Sept. 2 showed use of rabies vaccines up an estimated 33% and rabies immune globulin up 76% compared with the same period last year. The CDC said there is no shortage, but it warned clinicians about errors in giving the treatment. MedicalDaily previously reported on that CDC warning about rabies treatment errors and on a North Carolina petting zoo where 213 people were urged to get rabies treatment after contact with infected goats.
Livestock cases remain uncommon. Fewer than 15% of rabid animals reported each year in Minnesota are domestic species, most often cattle, cats and dogs, according to the board. Wild animals, especially bats, account for most cases.
Farm Families, Veterinary Staff and Children Carry the Most Risk
The people most likely to face this kind of exposure care for sick animals up close, including farm families, hobby farmers, veterinarians, technicians, and anyone who reaches into an animal's mouth to give medicine.
Children are a particular concern because they often help with chores and may not mention contact with saliva.
"Consistent use of PPE when treating ill animals can help prevent exposure to rare illnesses such as rabies," said Dr. Stacy Holzbauer, Minnesota's state public health veterinarian. She added that state health staff are available to consult on any animal bite situation and assess rabies risk.
Warning signs in cattle can look ordinary at first. Infected cows may bellow frequently and have trouble walking or swallowing, and they may drool heavily or lie down unusually. Any mammal with sudden behavior changes or neurological signs should be handled as a possible rabies case until a veterinarian rules it out.
Gloves, Eye Protection and a Fast Call to Health Officials
Wear gloves and eye protection when treating an animal with an unexplained neurological illness, avoid putting bare hands in its mouth, and keep children away until a veterinarian has examined it.
If saliva gets into your eyes, nose, mouth, or a cut, or if an animal bites or scratches you, the CDC advises washing the area with soap and water for 15 minutes and talking with a clinician or health department promptly. Tell them what animal was involved and whether it was acting abnormally.
Rabies is nearly 100% fatal once symptoms begin but is preventable when treatment starts in time, so no one should wait for symptoms. At the same time, not every animal contact requires shots. The CDC says treatment is generally not recommended when the animal can be observed for 10 days, tests negative, or officials determine that the exposure poses no rabies risk.
Cost is a real consideration. The CDC estimates that a typical treatment course costs $11,000 to $14,000 per person, which is why a careful risk assessment matters before anyone starts the series.
Vaccination remains the strongest protection for animals. Vaccines are available for dogs, cats, ferrets, cattle, horses, and sheep, and the board places exposed animals that are not currently vaccinated under quarantine lasting 45 to 180 days. Minnesota residents with questions about possible human exposure can call the health department at 651-201-5414 and find guidance on the MDH rabies page.
MedicalDaily will report if additional Brown County animals develop signs of rabies or more people are advised to seek treatment.
Key Questions Answered
What happened in Brown County? A Hereford heifer tested positive for rabies on Sept. 8 after showing neurological signs. Health officials recommended rabies treatment or boosters for nine people who may have contacted its saliva.
Who was advised to get treatment? The owner, the owner's daughter, two minor children, two veterinarians, and three veterinary technicians.
Can you get rabies without being bitten? Yes, though it is less common. Saliva from an infected animal reaching the eyes, nose, mouth, or a fresh open wound can transmit the virus.
How did the cow get rabies? Officials have not confirmed the source. Numerous skunks were seen on neighboring land earlier this year, and skunks and bats are Minnesota's natural rabies carriers.
What signs of rabies should farmers watch for in cattle? Frequent bellowing, trouble walking or swallowing, heavy drooling, lying down unusually and other sudden behavior changes.
What should I do after contact with a sick animal's saliva? Wash the area with soap and water for 15 minutes and call a clinician or your health department right away for a risk assessment.
Is there a shortage of rabies treatment? No. The CDC says there is currently no shortage of rabies vaccine or immune globulin, even though use has risen sharply this year.
