3 - Rabies

Question 1

who are susceptible to rabies

Answer 1

all mammals

*especially bats can transmit rabies anywhere - reservoir for rabies

• rodents are not considered reservoirs for rabies

Question 2

true or false - US has been declared free of canine rabies virus variant transmission

Answer 2

true

Question 3

what is the distribution of major rabies virus variants in the united states

Answer 3

Add photo

• east coast raccoon
• middle skunk
• fox very small region in the west and Alaska
• west coast skunk

Question 4

T/F dogs, cats, ferrets shed virus for a few days prior to and during clinical signs

Answer 4

true

Question 5

what is the incubation period of rabies

Answer 5

incubation period is highly variable
- 3-12 weeks in domestic animals (several days to 6 months)

• incubation periods of >1 have been reported in humans

Question 6

how long do dogs usually shed rabies in their saliva

Answer 6

5-10 days before clinical signs develop

Question 7

what is the clinical presentation of rabies

Answer 7

highly variable
- inappetence, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, seizures

( dumb and furious rabies are not used)

requires lab confirmation

Question 8

what are the 2 main categories of animal - human exposure with rabies

Answer 8

bite
- any penetration of the skin by teeth

non-bite
- surgical recipients
- exposure to lg amounts of aerosolized virus
- contact of open wounds with saliva from a rabid animal

Question 9

what indirect contact does not constitute rabies exposure

Answer 9

• petting or handing an animal
• contact with blood, urine, feces
• contact of saliva with intact skin

** bat exposures have special considerations

Question 10

t/f has there been human to human transmission of rabies other than organ transplant

Answer 10

true - no human to human transmission

except organ transplant

Question 11

what are the two vaccines licensed for humans in the US

Answer 11

• human diploid vaccine (HDCV)
• purified chick embryo cell vaccine (PCEVC)

*each stimulated active antibody response in 7-10 days
* neutralizing antibodies persist for several years

Question 12

what is rabies immune globulin

Answer 12

provides instant passive immunity for 21 days
- given after rabies bite

Question 13

what is pre-exposure prevention in humans for rabies

Answer 13

two doses of RV
- day 0 and 7

follow- up
- serologic testing to ensure protection 1-3 years later or booster after 3 years w/o titer testing

Question 14

what are high risk groups for rabies

Answer 14

• veterinarians and staff
• animal handlers
• rabies researchers
• certain lab workers

Question 15

what are the post- exposure preventions for rabies in humans

Answer 15

prophylaxis
- wound treatment
- RIG
- RV
* considered 100% effective

not previously vaccinated
- thorough wound cleaning
- RIG (half at bite site and half IM) with 1st RV
- four doses of RV (day 0,3,7,14 post exposure)

previously vaccinated
- thorough wound cleaning
- RV on days 0 and 3

Question 16

post exposure prophylaxis is considered what

Answer 16

a medical urgency not emergency

Question 17

how many people receive post exposure prophylaxis

Answer 17

16,000-39,000 people in the US per year

10-12 million people world wide per year

Question 18

t/f more than 200 people die from rabies in china each month

Answer 18

true

Question 19

what are the NASPHV recommendations on rabies vaccines in domestic animals

Answer 19

• all dogs, cats, and ferrets by vaccinated
• remove strays and unwanted animals
  - impound for 3 days in case of ownership or potential exposure

Question 20

explain rabies vaccines for wild animals

Answer 20

there are no licensed vaccines for wild of hybrid animals
- zoo vaccinate to protect valuable animals

Question 21

what happens if a human comes in contact with an animal rabies vaccine

Answer 21

injectable: does not constitute rabies exposure
vaccinia-vectored oral: should be reported but still not a rabies exposure

Question 22

when is an animal considered immunized after a rabies vaccine

Answer 22

28 days post initial infection
– boostered animals are considered immediately immune

• regardless of age animals should be boostered 1 year after initial vaccine

Question 23

what is the typical vaccination schedule

Answer 23

• initial vaccine at 3 months of age
• boostered 1 year later
• booster every 3 years

Question 24

how is rabies controlled and prevented in wildlife

Answer 24

Carnivores
- Oral rabies vaccines (ORV) for mass vaccination in select situations
- labeled for use in only raccoons and coyotes

Bats
- rabid animals reported in all 48 states
- reducing population is not feasible or desirable

Question 25

protocol for dog, cat and ferret exposure to a rabid animal

Answer 25

unvaccinated animals should be euth immediately or placed on strict isolation for 4 mos (dogs and cats) and 6 mos (ferrets) vaccinated animals should be vaccinated immediately and observed for 45 days --- those over due for boosters also should be boostered immediately and watcher for 45 days any signs suggestive of rabies in animals should be euth and tested

Question 26

protocol for livestock exposure to rabies

Answer 26

cattle and horses are most frequently infected pet animals same as dogs and cats commercial slaughter is prohibited for 8 months post exposure - cooking and pasteurization inactivates rabies virus *milk from rabid cow theoretically transmissible but highly unlikely all other mammals exposed to a rabid animal should be immediately euth

Question 27

explain the management of animals that bite humans

Answer 27

dogs, cats and ferrets - confined and observed for 10 days - regardless of vaccine status - if signs suggest rabies euth and test immediately * strays or unwanted animals should be euth and tested immediately other animals are evaluated on a case by case basis

Question 28

how is rabies tested for in animals

Answer 28

for all animals except bats, submit only head and brain (incld. brain stem) to diagnostics lab - refridg not frozen - not chemically fixed

Question 29

what are the regulations on movement of animals internationally and interstate

Answer 29

CDC regulates the importation of dogs and cats into the US prior to interstate movement for dogs, cats, ferrets, and horses - should be current on rabies vaccine - accompanied by current, valid rabies vaccine certificate