Compendium of Animal Rabies Prevention and Control, 2016 · •Sally Slavinski DVM, MPH •Paul...
Transcript of Compendium of Animal Rabies Prevention and Control, 2016 · •Sally Slavinski DVM, MPH •Paul...
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