Compendium of Animal Rabies

Prevention and Control, 2016

Jennifer House, DVM, MPH, DACVPM

State Public Health Veterinarian

Colorado Department of Public Health and Environment

Slides Courtesy of: Catherine M. Brown,Jenn DVM, MSc, MPH

Massachusetts Department of Public Health

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JAVMA : Volume 248 : Number 5 :

March 1, 2016

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http://www.nasphv.org/Documents/NASPHVRabiesCompendium.pdf

Document Overview

• National Association of State Public Health

Veterinarians (NASPHV), Compendium of Animal Rabies

Prevention and Control Committee

• Best practice recommendations for animal rabies

prevention and control programs throughout the U.S.

• Facilitate standardization across jurisdictions

• Document is reviewed and revised as necessary.

• These recommendations do not supersede state and

local laws or requirements

• Traditionally published in JAVMA with subsequent MMWR

publication

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NASPHV Committee Members

• Catherine M. Brown DVM, MSc, MPH

• Sally Slavinski DVM, MPH

• Paul Ettestad DVM, MS

• Tom J. Sidwa DVM, MPH

• Faye E. Sorhage VMD, MPH (retiring)

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Consultants

• Jesse Blanton, PhD, Centers for Disease Control and Prevention

• Richard B. Chipman, MS, MBA, United States Department of Agriculture, Animal and

Plant Health Inspection Service, Wildlife Services,

• Rolan D Davis, MS, Kansas State University, Room

• Cathleen A. Hanlon, VMD, PhD Centers for Disease Control and Prevention (Ret.)

• Jamie McAloon Lampman, National Animal Control Association

• Joanne L. Maki, MS, DVM, PhD, Animal Health Institute

• Michael C Moore, DVM, MPH, Kansas State University

• Jim Powell, MS, Association of Public Health Laboratories

• Charles E. Rupprecht, VMD, MS, PhD, The Wistar Institute of Anatomy & Biology

• Geetha B. Srinivas, DVM, PhD, United States Department of Agriculture, Center for

Veterinary Biologics

• Nick Striegel, DVM, MPH, American Veterinary Medical Association

• Burton W Wilcke, Jr, PhD, American Public Health Association

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Development and Implementation

• Consensus guidelines based on:

– Peer reviewed literature

– Expert opinion

– Unpublished data

• Applied differently by jurisdiction

– Flexible enough to account for variability

– Specific enough to be used as regulation or law

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Accessed 3/31/2010: http://www.cdc.gov/rabies/resources/publications/2008-

surveillance/domestic-animals.html

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Accessed 3/31/2010: http://www.cdc.gov/rabies/resources/publications/2008-

surveillance/wild-animals.html

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Raccoons Skunks

Foxes Dogs/Cats

Acknowledge lack of standardized

data collection by jurisdictions

• No national data exists on

– Incubation periods

– Number of animals quarantined

– Vaccination histories of exposed animals

• Those that completed strict quarantine versus

those that didn’t

• Vaccine failures

– Epidemiologic characteristics of animals

developing rabies

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Reporting of Surveillance Data

• Every animal submitted for rabies testing

should be reported to the CDC

• Reported information: species, point location,

vaccination status, rabies virus variant (if

rabid), and exposures

• NEW: Encourage additional data elements:

– age, sex, neuter status, ownership status,

quarantine dates (if any), date of onset of any

clinical signs, and vaccination history

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Pre-exposure Vaccination

• Routine pre-exposure vaccination critical!

• Initial vaccination + booster vaccination one year later. Future booster vaccinations should be given consistent with vaccine label

• If a previously vaccinated animal is overdue for a booster, including the one-year booster, it should be revaccinated – Immediately after revaccination, the animal is

considered currently vaccinated and should be placed on a booster schedule consistent with the label of the vaccine used

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Post-Exposure Management

• Currently vaccinated dogs, cats and ferrets

• Overdue dogs and cats with documentation

of previous vaccination

• Never vaccinated dogs, cats and ferrets

• Vaccinated (maybe) but without

documentation

• Livestock

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Currently Vaccinated

• No Change from previous compendium

• Animal Management

– Immediately receive veterinary medical care

– Booster rabies vaccine

– 45 day home observation (NOT a quarantine)

– If they get sick….need to see a veterinarian

Overdue Vaccination

• Check Documentation

– (Veterinary Records)

• Animal Management

– Immediately receive veterinary medical care

– Booster rabies vaccine

– 45 day home observation (NOT a quarantine)

– If they get sick….need to see a veterinarian

Never Vaccinated

• These animals are at highest risk of developing rabies

• Animal Management – Euthanize or

– 120 Day Quarantine

• Immediate vaccination –within 96 hours of exposure

– If vaccination is delayed—consider extending quarantine to 180 days (6 months)

• Strict quarantine (isolation from animals & people)

Why 96 hours?

• Texas Animal PEP Data

– Animals exposed to rabies

– Received a single dose of PEP

– Dose administered 5 days or more after

exposure

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J Am Vet Med Assoc 2001;218:522-525.

J Am Vet Med Assoc 1996; 208(11):1827-30.

• Initially treat as unvaccinated

• Considered prospective serological monitoring – Very confident animal was previously vaccinated,

dedicated owner, local agency approval

• Day 0- Collect blood sample and give vaccine

• Day 5- Collect 2nd blood sample – Send both blood samples for End-Point RFFIT

• If robust antibody response and adequate titer level acheived, likely was previously vaccinated

Vaccinated with No Documentation

Prospective Serologic Monitoring

• Guidance document and algorithm on NASPHV website (posted with Compendium)

• Decision to use MUST be approved by local Rabies Control Authority

• Engage an approved rabies laboratory from the beginning – Sample collection and processing

– Paperwork

– Turnaround time

– Results interpretation

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Livestock

• No change to post-exposure management recommendations of livestock

• Exposures in animals intended for commercial use – Notify state and local public health authorities,

state meat inspectors and USDA Food Safety and Inspection Service (FSIS)

– Animals should not be presented for slaughter in a FSIS-regulated establishment if such animals originate from a quarantine area and have not been approved for release by the proper authority

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Reduced Quarantine Period

• Dogs and cats only – Limited data has hampered previous

recommendations • Requested information from states with raccoon,

skunk and fox strains of virus

– Published reports of incubation periods following natural infection are rare

– Vaccination at entry into quarantine may help protect minor exposures

– Combination of unpublished data, expert opinion and experience of states

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Additional Highlights

• Encourages an inter-disciplinary approach with

routine and consistent communication

• Strives to reduce the risk from introduction of

rabid animals through importation

• Facilitates implementation of routine or

emergency low cost (or free) rabies vaccination

• Facilitates voluntary surrender of animals to

prevent abandonment

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Resources

• 2016 Compendium of Animal Rabies Prevention and Control

http://www.nasphv.org/Documents/NASPHVRabiesCompendium.pd

• Prospective Serologic Monitoring Protocol

http://www.nasphv.org/Documents/NASPHVSerologicMonitoring2016.pdf

• Moore et al. Comparison of anamnestic responses to rabies vaccination in dogs and cats

with current and out-of-date vaccination status JAVMA, Vol 246, No. 2, January 15, 2015

http://avmajournals.avma.org/doi/pdf/10.2460/javma.246.2.205

• State Public Health Veterinarians:

http://www.nasphv.org/Documents/StatePublicHealthVeterinariansByState.pdf

• Centers for Disease Control and Prevention, Rabies Section www.cdc.gov/rabies/

• Atlanta Health Associates, Inc. http://www.atlantahealth.net/

• Kansas State University Rabies Laboratory http://www.ksvdl.org/rabies-laboratory/

• NYSDOH Wadsworth Center http://www.wadsworth.org/programs/id/rabies

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Jennifer House State Public Health Veterinarian, Colorado National Association of State Public Health

Veterinarians

303-692-2628

jennifer.house@state.co.us