I used to be simply petting an orange tabby cat in my Falls Church, Va., neighborhood, a cat I’d by no means met earlier than. He was very cute. And he was purring and butting his head in opposition to my hand. Until he wasn’t.
He sunk his tooth into my wrist, hissed at me and ran off. So started my private episode of Law & Order: Feline Victims Unit, full with cat mug pictures and weekly check-ins from native animal management and public well being officers. And rabies pictures. Multiple rabies pictures within the emergency room. And greater than $26,000 in well being care prices, an alarming quantity contemplating I used to be completely wholesome all through the entire ordeal.
What I discovered, moreover fascinating details about rabies, its transmission and the horrible methods one can die from it, was that anyone of us is a mere cat scratch away from monetary peril if we aren’t fortunate sufficient to have good medical insurance. Our complicated well being care system makes it too simple for an individual who ought to get medical care to postpone it or keep away from it — even when that call could possibly be deadly.
After the encounter with the cat, I headed to a close-by storefront pressing care clinic, the place a nurse handed me a kind to fill out, which the town makes use of to trace animal bites. She faxed the shape to the well being division and a police officer visited me as quickly as I returned residence.
I used to be requested: “Do you know the cat?” After some sleuthing in my neighborhood Facebook group, I developed a suspicion about whom he belongs to. But I couldn’t be 100% optimistic.
Which is why three days after the chew I used to be within the ready room within the emergency room. When an animal bites somebody, the process is to quarantine it for 10 days. If the animal doesn’t develop rabies signs throughout that point, it’s secure to say the chew sufferer received’t develop the illness both.
But if the animal can’t be recognized or captured, the advice is to start post-exposure preventive remedy for rabies. I’d want a one-time injection of human rabies immune globulin after which 4 injections of the rabies vaccine over two weeks.
An estimated 40,000 to 50,000 individuals get such therapies annually following publicity to probably rabid animals, based on the Centers for Disease Control and Prevention.
I did contemplate taking my probabilities and skipping remedy. The odds the cat that bit me was rabid had been, I’d guess, nearly zero. He was most likely somebody’s pet and didn’t seem to have any signs. But rabies is deadly. That was the road my physician, the animal management officer, my associates and public well being officers saved repeating. A small likelihood isn’t the identical as no likelihood.
I attempted to be a accountable well being care shopper and analysis cost-effective choices. The ER is the one place that may administer immune globulin, so I knew that was my first cease. But I hoped to go elsewhere for the following three appointments, the place I might obtain the rabies vaccine.
I sat on the cellphone with insurance coverage firm brokers whereas they tried to seek out an in-network supplier that stocked the rabies vaccine. They discovered nothing. My major care physician advised me individuals typically ended up doing the follow-up doses within the ER. The pressing care clinic employees advised me they didn’t preserve the vaccine in inventory however might have ordered it forward of time if that they had recognized I would want it. Since I hadn’t anticipated being bitten by a cat, I uncared for to name forward.
The employees on the ER advised me that specialised clinics for vacationers can administer the vaccine, however the process isn’t typically lined by insurance coverage. Also, to stick to the strict vaccination schedule, I wanted a location with Sunday hours, which I used to be unable to seek out.
The Fairfax County, Va., public well being division stated the county doesn’t administer rabies vaccines at its clinics. Two hospital pressing care clinics additionally advised me they couldn’t present the vaccine, despite the fact that a kind of clinics is on the identical campus because the ER.
Which left me again the place I began.
Although my insurance coverage picked up the total tab for that first emergency room go to, the hospital invoice got here to $17,294.17. My insurance coverage supplier negotiated that invoice all the way down to $898 and paid it.
For the following three visits, I obtained doses of RabAvert, made by GlaxoSmithKline. Even although I obtained the identical remedy for every of those visits, the hospital billed my insurance coverage barely completely different quantities every time: $2,810.96, $2,692.86 and $2,084.36. (If I might have purchased it from a pharmacy, it will have value about $350 a dose.)
Rabies isn’t the one potential complication of a cat chew. Many bites change into contaminated, which is why I left my pressing care go to with a 10-day provide of amoxicillin, an antibiotic. According to the police, the cat who bit me is probably going a repeat offender. A neighbor not too long ago developed a nasty an infection after a chew from a big orange tabby — nobody is certain if it’s the identical cat — and has since wanted surgical procedure. She additionally underwent the rabies remedy.
I used to be fortunate to not develop an an infection, however my insurance coverage firm did must pay one closing invoice — $206 to see my major physician after I developed a rash, seemingly from the antibiotic. If you’re protecting rating at residence, that brings the grand complete to $26,229.35.
I had hoped to donate my blood, now wealthy with rabies antibodies, for use to create extra immune globulin for future chew victims. Unfortunately, my degree of immunity seemingly isn’t excessive sufficient. Most individuals who give their plasma for this goal have undergone the rabies vaccine many occasions. A public well being employee stated he really useful plasma donation to an acquaintance of his who research endangered bats — a profession I’m unlikely to enter. In truth, if I get bitten by any wildlife sooner or later, I’ll nonetheless must trek again to the ER for 2 extra rounds of pictures.
So, I depart this expertise behind with modestly elevated immunity, little understanding of how medical payments are calculated and a brand new worry of out of doors cats — but additionally with a brand new appreciation for public well being employees.
As for the cat, the police advised me he was put beneath home arrest.
