Compendium
of Animal Rabies Prevention and Control, 2002a
National Association of State Public Health Veterinarians, Inc. (NASPHV)
The purpose of this Compendium is to provide rabies information to veterinarians,
public health officials, and others concerned with rabies prevention and control. These recommendations serve as the basis for
animal rabies-control programs throughout the United States and facilitate
standardization of procedures among jurisdictions, thereby contributing to
an effective national rabies-control program.
This document is reviewed annually by the NASPHV Committeeb
and Consultants to the Committeec. The document is revised as necessary. Vaccination procedure recommendations are contained
in Part I; all animal rabies vaccines
licensed by the United States Department of Agriculture (USDA) and marketed
in the United States are listed in Part
II; Part III details the principles
of rabies control.
Part
I: Recommendations for Parenteral
Vaccination Procedures
A. VACCINE ADMINISTRATION
All
animal rabies vaccines should be restricted to use by, or under the direct
supervision of, a veterinarian.
B. VACCINE SELECTION
Part
II lists all vaccines licensed by USDA and marketed in the United States at
the time of publication. New vaccine
approvals or changes in label specifications made subsequent to publication
should be considered as part of this list. Any of the listed vaccines can be used for
revaccination, even if the product is not the same brand as previously administered
vaccines. Vaccines used in state and
local rabies control programs should have a 3-year duration of immunity.
This constitutes the most effective method of increasing the proportion
of immunized dogs and cats in any population.
C. ROUTE OF INOCULATION
All
vaccines must be administered in accordance with the specifications of the
product label or package insert. Adverse reactions and vaccine failures should
be reported to USDA, Animal and Plant Health Inspection Service, Center for
Veterinary Biologics at (800) 752-6255 or by e-mail at CVB@usda.gov.
The
efficacy of parenteral rabies vaccination of wildlife and hybrids (the offspring
of wild animals crossbred to domestic dogs and cats) has not been established,
and no such vaccine is licensed for these animals. Zoos or research institutions may establish
vaccination programs which attempt to protect valuable animals, but these
should not replace appropriate public health activities that protect humans.
E. ACCIDENTAL HUMAN EXPOSURE TO VACCINE
Human
exposure to parenteral animal rabies vaccines listed in Part II does not constitute
a risk for rabies infection. However, human exposure to vaccinia-vectored
oral rabies vaccines should be reported to state health officials.1
Agencies
and veterinarians may adopt the standard tag system to aid in the administration
of animal rabies control procedures.
1. RABIES TAGS
Calendar
Year
|
Color
|
Shape
|
2002
|
orange
|
oval
|
2003
|
green
|
bell
|
2. RABIES CERTIFICATE:
All agencies and veterinarians should use
the NASPHV Form #51, "Rabies Vaccination Certificate,"
which can be obtained from vaccine manufacturers or printed from this site.
Computer-forms generated independently and containing the same information
are also acceptable.
Part
II: Rabies Vaccines Licensed and Marketed in the U.S.,
2002
A. PRINCIPLES OF RABIES CONTROL
1. RABIES EXPOSURE:
Rabies is transmitted
only when the virus is introduced into bite wounds, open cuts in skin, or
onto mucous membranes.
2. HUMAN RABIES PREVENTION: Rabies in humans
can be prevented either by eliminating exposures to rabid animals or by providing
exposed persons with prompt local treatment of wounds combined with human
rabies immune globulin and vaccine. The
rationale for recommending preexposure and postexposure rabies prophylaxis
and details of their administration can be found in the current recommendations
of the Advisory Committee on Immunization Practices (ACIP)2. These recommendations, along with information
concerning the current local and regional status of animal rabies and the
availability of human rabies biologics, are available from state health departments.
3. DOMESTIC ANIMALS: Local governments
should initiate and maintain effective programs to ensure vaccination of all
dogs, cats, and ferrets and to remove strays and unwanted animals. Such procedures in the United States have reduced
laboratory-confirmed cases of rabies in dogs from 6,949 in 1947 to 114 in
2000. Because more rabies cases are
reported annually involving cats (249 in 2000) than dogs, vaccination of cats
should be required. The recommended
vaccination procedures and the licensed animal vaccines are specified in Parts
I and II of the Compendium.
4. RABIES IN WILDLIFE: The control of rabies among wildlife reservoirs
is difficult. Vaccination of free-ranging
wildlife or selective population reduction might be useful in some situations,
but the success of such procedures depends on the circumstances surrounding
each rabies outbreak. (See Part III
C. Control Methods in Wildlife.) Because of the risk of rabies in wild
animals (especially raccoons, skunks, coyotes, foxes, and bats), the AVMA,
the NASPHV, and the CSTE strongly recommend the enactment of state laws prohibiting
their importation, distribution, and relocation.
5. RABIES SEROLOGY: Evidence of circulating
rabies virus neutralizing antibodies should not be used as a substitute for
current vaccination in managing rabies exposures or determining the need for
booster vaccinations.
B. CONTROL METHODS IN DOMESTIC AND CONFINED
ANIMALS
1. PREEXPOSURE VACCINATION AND MANAGEMENT
Parenteral animal rabies vaccines should be administered only by, or under
the direct supervision of, a veterinarian. This ensures that a qualified and responsible person can be held
accountable to assure the public that the animal has been properly vaccinated.
Within twenty-eight (28) days after primary vaccination, a peak rabies
antibody titer is reached and the animal can be considered immunized.
An animal is currently vaccinated and is considered immunized if the
primary vaccination was administered at least 28 days previously and vaccinations
have been administered in accordance with this Compendium. Regardless of the age of the animal at initial vaccination, a booster
vaccination should be administered 1 year later. (See Parts
I and II for vaccines and procedures)
Because a rapid anamnestic response is expected, an animal is considered
currently vaccinated immediately after a booster vaccination.
(a) DOGS,
CATS, AND FERRETS
All dogs, cats,
and ferrets should be vaccinated against rabies and revaccinated in accordance
with Part II of this Compendium. If
a previously vaccinated animal is overdue for a booster, it should be revaccinated
with a single dose of vaccine. Immediately following the booster, the animal
is considered currently vaccinated and should be placed on an annual or triennial
schedule depending on the type of vaccine used.
(b) LIVESTOCK
Consideration should
be given to vaccinating livestock that are particularly valuable or that might
have frequent contact with humans. Horses
traveling interstate should be currently vaccinated against rabies.
(c) CONFINED
ANIMALS
(1)
WILD
No parenteral rabies
vaccine is licensed for use in wild animals. Wild animals or hybrids should
not be kept as pets.
(2)
MAINTAINED IN EXHIBITS
AND IN ZOOLOGICAL PARKS
Captive animals
that are not completely excluded from all contact with rabies vectors can
become infected. Moreover, wild animals
might be incubating rabies when initially captured; therefore, wild-caught
animals susceptible to rabies should be quarantined for a minimum of 6 months
before being exhibited. Employees
who work with animals at such facilities should receive preexposure rabies
vaccination. The use of pre- or postexposure rabies vaccinations for employees
who work with animals at such facilities might reduce the need for euthanasia
of captive animals. Carnivores and
bats should be housed in a manner that precludes direct contact with the public.
2. STRAY ANIMALS
Stray dogs, cats,
and ferrets should be removed from the community. Local health departments and animal control officials can enforce
the removal of strays more effectively if owned animals are confined or kept
on leash. Strays should be impounded
for at least 3 days to determine if human exposure has occurred and to give
owners sufficient time to reclaim animals.
3. IMPORTATION AND INTERSTATE MOVEMENT OF ANIMALS
(a) INTERNATIONAL
CDC regulates the
importation of dogs and cats into the United States. Imported dogs must satisfy rabies vaccination requirements (42 CFR,
Part 71.51[c], www.cdc.gov/ncidod/dq/lawsand/htm). The appropriate health official of the state
of destination should be notified within 72 hours of the arrival into his
or her jurisdiction of any imported dog required to be placed in confinement
under the CDC regulation. Failure
to comply with these requirements should be promptly reported to the Division
of Quarantine, CDC, (404) 639-8107.
CDC regulations alone are insufficient to prevent the introduction of
rabid animals into the country. All
imported dogs and cats are subject to state and local laws governing rabies
and should be currently vaccinated against rabies in accordance with the Compendium.
Failure to comply with state or local requirements should be referred
to the appropriate state or local official.
(b) INTERSTATE
Before interstate movement, dogs, cats, and ferrets should be currently
vaccinated against rabies in accordance with the Compendium's recommendations
(See Part III, B.1. Preexposure
Vaccination and Management). Animals in transit should be accompanied by
a currently valid NASPHV Form #51, Rabies Vaccination
Certificate. When an interstate health certificate or certificate
of veterinary inspection is required, it should contain the same rabies vaccination
information as Form #51.
4. ADJUNCT PROCEDURES
Methods or procedures
which enhance rabies control include the following:
(a)
IDENTIFICATION.
Dogs,
cats and ferrets should be identified (e.g., metal or plastic tags, microchips,
etc.) to allow for verification of rabies vaccination status.
(b) LICENSURE. Registration
or licensure of all dogs, cats, and ferrets may be used to aid in rabies control.
A fee is frequently charged for such licensure and revenues collected
are used to maintain rabies- or animal-control programs.
Vaccination is an essential prerequisite to licensure.
(c) CANVASSING OF AREA. House-to-house canvassing by animal control personnel facilitates
enforcement of vaccination and licensure requirements.
(d) CITATIONS. Citations
are legal summonses issued to owners for violations, including the failure
to vaccinate or license their animals. The
authority for officers to issue citations should be an integral part of each
animal-control program.
(e) ANIMAL CONTROL. All communities should incorporate stray animal control, leash laws,
and training of personnel in their programs.
5.
POSTEXPOSURE MANAGEMENT
ANY ANIMAL POTENTIALLY EXPOSED TO RABIES
VIRUS (See Part III.A.1. Rabies
Exposure) BY A WILD, CARNIVOROUS MAMMAL OR A BAT THAT IS NOT AVAILABLE FOR
TESTING SHOULD BE REGARDED AS HAVING BEEN EXPOSED TO RABIES.
(a) DOGS,
CATS, AND FERRETS
Unvaccinated dogs,
cats, and ferrets exposed to a rabid animal should be euthanized immediately.
If the owner is unwilling to have this done, the animal should be placed
in strict isolation for 6 months and vaccinated 1 month before being released.
Animals with expired vaccinations need to be evaluated on a case-by-case
basis. Dogs, cats, and ferrets that
are currently vaccinated should be revaccinated immediately, kept under the
owner's control, and observed for 45 days.
(b) LIVESTOCK
All species of livestock
are susceptible to rabies; cattle and horses are among the most frequently
infected. Livestock exposed to a rabid
animal and currently vaccinated with a vaccine approved by USDA for that species
should be revaccinated immediately and observed for 45 days. Unvaccinated livestock should be slaughtered
immediately. If the owner is unwilling
to have this done, the animal should be kept under close observation for 6
months.
The following are
recommendations for owners of unvaccinated livestock exposed to rabid animals:
(1) If the animal
is slaughtered within 7 days of being bitten, its tissues may be eaten without
risk of infection, provided that liberal portions of the exposed area are
discarded. Federal meat inspectors must reject for slaughter any animal known
to have been exposed to rabies within 8 months.
(2) Neither tissues
nor milk from a rabid animal should be used for human or animal consumption. Pasteurization temperatures will inactivate rabies virus, therefore,
drinking pasteurized milk or eating cooked meat does not constitute a rabies
exposure.
(3) Having more
than one rabid animal in a herd or having herbivore-to-herbivore transmission
is uncommon; therefore, restricting the rest of the herd if a single animal
has been exposed to or infected by rabies might not be necessary.
(c) OTHER
ANIMALS
Other mammals bitten
by a rabid animal should be euthanized immediately. Animals maintained in USDA licensed research
facilities or accredited zoological parks should be evaluated on a case-by-case
basis.
6. MANAGEMENT OF ANIMALS THAT BITE HUMANS
(a) A healthy dog,
cat, or ferret that bites a person should be confined and observed daily for
10 days; administration of rabies vaccine is not recommended during the observation
period. Such animals should be evaluated
by a veterinarian at the first sign of illness during confinement.
Any illness in the animal should be reported immediately to the local
health department. If signs suggestive of rabies develop, the
animal should be euthanized and the head shipped for testing as described
in (c) below. Any stray or unwanted
dog, cat, or ferret that bites a person may be euthanized immediately and
the head submitted for rabies examination.
(b) Other biting animals which
might have exposed a person to rabies should be reported immediately to the
local health department. Prior vaccination
of an animal may not preclude the necessity for euthanasia and testing if
the period
of virus shedding is unknown for that species.
Management of animals other than dogs, cats, and ferrets depends on
the species, the circumstances of the bite, the epidemiology of rabies in
the area, and the biting animal’s history, current health status, and potential
for exposure to rabies.
(c) Rabies testing should be
done by a qualified laboratory, designated by the local or state health department.
Euthanasia 3 should be accomplished in such a way as to
maintain the integrity of the brain so that the laboratory can recognize the
anatomical parts. Except in the case of very small animals, such
as bats, only the head or brain (including brain stem) should be submitted
to the laboratory. Any animal or animal
part being submitted for testing should be kept under refrigeration (not frozen
or chemically fixed) during storage and shipping.
C.
cONTROL METHODS IN WILDLIFE
The public should
be warned not to handle wildlife. Wild
mammals and hybrids that bite or otherwise expose persons, pets or livestock
should be considered for euthanasia and rabies examination. A person bitten by any wild mammal should immediately
report the incident to a physician who can evaluate the need for antirabies
treatment (See current rabies prophylaxis recommendations of the ACIP2).
State regulated wildlife rehabilitators may play a role in a comprehensive
rabies control program. Minimum standards
for persons who rehabilitate wild mammals should include rabies vaccination,
appropriate training and continuing education.
Translocation of infected wildlife has contributed to the spread of
rabies; therefore, the translocation of known terrestrial rabies reservoir
species should be prohibited.
1. TERRESTRIAL MAMMALS
The use of licensed oral vaccines for the mass vaccination of free-ranging wildlife should be considered in selected situations, with the approval of the state agency responsible for animal rabi
es control.
The distribution of oral rabies
vaccine should be based on scientific assessments of the target species and
followed by timely and appropriate analysis of surveillance data; such results
should be provided to all stakeholders. Continuous and persistent government-funded
programs for trapping or poisoning wildlife are not cost effective in reducing
wildlife rabies reservoirs on a statewide basis. However, limited control in high-contact areas (e.g., picnic grounds,
camps, suburban areas) may be indicated for the removal of selected high-risk
species of wildlife. State agriculture,
public health and wildlife agencies should be consulted for planning, coordination
and evaluation of vaccination or population-reduction programs.
2. BATS
Indigenous rabid
bats have been reported from every state except Hawaii, and have caused rabies
in at least 33 humans in the United States.
Bats should be excluded from houses and adjacent structures to prevent
direct association with humans. Such
structures should then be made bat-proof by sealing entrances used by bats.
Controlling rabies in bats by programs designed to reduce bat populations
is neither feasible nor desirable.
REFERENCE
1. Rupprecht CE, et.
al. Brief Report: Human Infection Due to Recombinant Vaccinia-Rabies Glycoprotein
virus. N Engl J Med 2001; 345:8,582-586.
2. Centers for Disease
Control and Prevention: Human rabies prevention--United States, 1999.
recommendations of the Advisory Committee on Immunization Practices
(ACIP). MMWR
1999;48(No. RR-1).
3. 2000 Report of the
AVMA Panel on Euthanasia. JAVMA 2001; 218:5,669-696.
aAddress all correspondence to:
bThe
NASPHV Committee: Suzanne R. Jenkins, VMD, MPH, Chair; Michael Auslander,
DVM, MSPH; Lisa Conti, DVM, MPH; William B. Johnson, DVM; Mira J. Leslie,
DVM; Faye E. Sorhage, VMD, MPH.
cConsultants to the Committee: James E. Childs, ScD,
CDC; Mary Currier, MD, MPH, Council of State and Territorial Epidemiologists
(CSTE); Nancy Frank, DVM, MPH, American Veterinary Medical Association (AVMA),
Council on Public Health and Regulatory Veterinary Medicine; Donna M. Gatewood,
DVM, MS; Animal and Plant Health Inspection Service, United States Department
of Agriculture; Carolin Schumacher, DVM, PhD, Animal Health Institute; Charles
E. Rupprecht, VMD, PhD, CDC; Charles V. Trimarchi, MS, New York State Health
Department. ENDORSED BY: AVMA and CSTE.
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