A Rabid Kitten in Omaha: Stopping Raccoon Rabies 850 Miles From Home

On September 28, 2023, a stray kitten about 6 weeks old, found in Omaha, Nebraska, tested positive for rabies at the Nebraska Veterinary Diagnostic Center. It had died with neurologic signs after biting and scratching the people caring for it. Ten exposed people were advised to get postexposure prophylaxis (PEP). Then variant typing brought a surprise: the virus was the eastern raccoon rabies virus variant (RRVV), which CDC confirmed on October 6 — about 850 miles (1,368 km) west of where that variant was known to exist.

Why that mattered

Rabies is fatal but preventable. It spreads mainly through bites, and its incubation period can run from weeks to months. Worldwide, dogs account for 95% of the estimated 70,000 human rabies deaths each year; in the United States, thanks to the elimination of the canine variant and widely available PEP, fewer than 10 people die of rabies a year. Rabies persists in bats nationwide and in regional reservoirs of raccoons, skunks and foxes.

Raccoon rabies shows how much damage one move can do. Once confined to the Southeast, RRVV reached the mid-Atlantic in 1977 after wild raccoons were moved there from Florida, setting off one of North America's most important documented wildlife epizootics. As it spread up the East Coast, human exposures and demand for PEP soared — in New York, annual PEP treatments rose about 100-fold within 5 years of the variant's arrival. Congress has appropriated about $500 million to the U.S. Department of Agriculture (USDA) for wildlife rabies management to stop it moving west.

The kitten's origin was unknown, and it might have infected local wildlife. So Nebraska, Douglas County, CDC and USDA launched a joint response.

The response

Finding the source and any other exposures. From October 14, 2023, investigators interviewed residents, searched social media for reports of animals acting strangely, and spread the word through flyers, social media and press conferences. No other exposures turned up, and the kitten's origin was never found.

Testing wildlife. A field laboratory tested animals found dead or acting sick within 6.2 miles (10 km) of where the kitten was found, using a rapid point-of-care test, with positives and a sample of negatives confirmed at CDC. Signs of neurologic disease include drooling, paralysis, lethargy, unusual aggression or vocalizing, and nocturnal animals out in daylight.

Vaccinating wildlife. From October 23 to November 2, USDA ran a trap-vaccinate-release campaign across 37 square miles, vaccinating 757 raccoons, 42 skunks, four feral cats and one red fox. From November 1 to 4, it placed 18,000 oral rabies vaccine baits across 65 square miles of Omaha, stopping at the Missouri River and the Iowa border.

What it showed

This was the westernmost detection of raccoon rabies in a stray or wild animal in the United States. A 2017 case in an Ohio cat needed no such response: that cat was owned and had come from an area where the variant was already established, with no contact with wildlife or strays.

After 10 months of surveillance and intensive, targeted vaccination with no further cases, the variant does not appear to have taken hold in Nebraska wildlife. Quick variant typing was what triggered the response — and likely prevented an outbreak in the Midwest.

The lessons: keep domestic animals vaccinated against rabies, and type the virus in rabies-positive samples, especially from pets and from wildlife species that aren't usual carriers, to catch the next long-distance jump early.

Sources

Based on Stein SR, Beron AJ, Nelson KM, et al., "Notes from the Field: Enhanced Surveillance for Raccoon Rabies Virus Variant and Vaccination of Wildlife for Management — Omaha, Nebraska, October 2023–July 2024," Morbidity and Mortality Weekly Report 73(41), Centers for Disease Control and Prevention; a work of the United States government in the public domain. Original report.