DEAR DR. DONOHUE: In my state during the past year, there have been two cases of diagnosed rabies. Since there is a rabies vaccine for cats and dogs, and since it seems to be successful in preventing the disease in these animals, why is there not a human rabies vaccine? — J.N.

ANSWER: There is a human rabies vaccine, and it is used. Since 2001, only 21 cases of rabies have been reported in the United States. That makes rabies an extremely rare disease. It would be impractical and wasteful to immunize every single citizen against the rabies virus. Granted, rabies is a frightful illness and almost always culminates in death if not treated soon after the bite of a rabid animal. That still doesn’t make general use practical.

When a person is bitten by an animal, that person should report to a doctor immediately. The animal, if a domestic animal, will be isolated to see if it has or develops any signs of the illness. Biting wild animals should be killed with great care so that the head and brain are intact. The brain is sent to institutions where experts examine it microscopically to see any traces of the virus. Animals likely to carry the virus are raccoons, skunks, foxes, ferrets and bats. Since domestic animals are required to be immunized, they rarely are infected. They still need to be monitored.

The incubation period for rabies — the time from introduction of the virus to appearance of symptoms — is rather long, 20 to 90 days. Early signs of infection include fever, headache, nausea and vomiting. Shortly thereafter, infected people become agitated and complain of peculiar sensations at the bite site. From that point on, more dramatic symptoms occur, including hallucinations, seizures and increased salivation. Infected people develop painful spasms of the throat muscle when trying to swallow water — hydrophobia.

Early treatment of the virus is successful when begun well before rabies symptoms occur. Treatment is with the vaccine and with rabies immunoglobulin. Animal-control workers, cave explorers (because of bats), veterinarians and others who are in close contact with animals are given the vaccine.

DEAR DR. DONOHUE: With all the different nuts that are healthy to eat, why aren’t cashews ever mentioned? Are they high in cholesterol? — E.L.

ANSWER: No member of the plant family, including nuts, has any cholesterol. Nuts do contain fats, but they’re the good kind, polyunsaturated and monounsaturated — fats that don’t clog arteries.

All nuts offer most of the same kind of benefits. They provide beta carotene (vitamin A), vitamin E, folate (a B vitamin) and the minerals magnesium, potassium, zinc, copper and selenium. They protect against heart disease. They’re a good source of protein and fiber.

Cashews contain 159 calories in one ounce, about 18 cashews. One to two ounces of nuts five times a week is a healthy snack. Even though the calorie count is on the high side, nuts tend to blunt the desire for more food. It’s claimed that nut eaters stay on the slim side.

Pass me some cashews, will you? I’m hungry.

DEAR DR. DONOHUE: My husband and father have gout. They are trying to maintain a diet free of red meat, pork and shellfish. My father was told that buffalo meat is OK because they are not injected with steroids. — J.L

ANSWER: In the days before effective gout medicines, diet was the only treatment for it. Now diet takes a back seat to medicines. The diet can be summarized briefly: Decrease the intake of red meats, seafood and fish. You don’t have to give them up. Limit the intake. And that goes for buffalo meat. Don’t eat organ meats, like liver, kidney or sweetbreads. Dairy products are good for gout. Soft drinks are not. Weight loss is important. Go easy with alcohol, especially beer and hard liquor. Wine is not a problem. That’s all there is to the gout diet.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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