Rabies Bats and Parvo Clusters: Helping the Community through Animal Disease Surveillance Emily Beeler DVM MPH, Veterinary Public Health Program, Los Angeles County Department of Public Health ebeeler@ph.lacounty.gov March 2017 Animal Care Conference, Sacramento, CA FIRST HOUR - RABIES and RABIES CONTROL Rabies virus Transmitted by bite from infected animal. Over 99% fatal once symptoms begin. Virus dies quickly outside of the body. Incubation in humans: 10 days 7 years. Bat rabies in humans usually 1-3 month incubation. Incubation in pets: Usually 1-3 months, but may be longer. Rabies vaccination of pets Animal Control Officers are Public Health Champions. Enforcement of vaccination and licensing reduced LA County rabid dog count from 100s per year in early 1900s to 0 now. 1 vaccination is not enough. A few pets vaccinated just 1 or 2 times in life have still gotten rabies. California Rabies Vaccination Compendium: cdph.ca.gov/healthinfo/discond/pages/animalrabiesvaccinecompendium.aspx Rabies Vaccinations and Post-Exposure treatment for people Rabies Pre-exposure prophylaxis (PreEP): o Who should get it? Anyone frequently handling animals i.e. Animal Control staff! o How many shots? Human rabies vaccine given in upper arm three times - Day 0, 7, and 21 or 28 o CDC page: cdc.gov/rabies/specific_groups/travelers/pre-exposure_vaccinations.html o Get blood titer checked every 2 years Rabies post-exposure prophylaxis (PEP) o Who should get it? Anyone with confirmed exposure or likely exposure to rabies o How many shots? Unvaccinated people: Rabies vaccine in upper arm on days 0, 3, 7, and 14 AND one dose human antirabies immune globulin (HRIG) into bite wound and other muscles one time given in first week of treatment. Vaccinated people: rabies vaccines given in upper arm twice Day 0 and 3. o CDC page: cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm Rabies risk to pets and people Pets may be exposed to rabies through rabid wildlife. Current risk in California = bats>skunks>foxes>raccoons, coyotes, opossums. Rabid dogs may be imported from other countries Rabid bats have been increasing in Los Angeles County BATS special case. Teeth tiny, bites small and heal over quickly. Any bat encounter should be reviewed carefully because of risk of unrecognized bite (Ex. bat found in bedroom, near pet, near child). Best to test bat if any chance of exposure to person or pet. Dog Importation Dogs coming in from all over the world to CA many from countries that have canine rabies. Many not inspected. Top breeds - French bulldogs, Yorkies, Maltese Concern - Global puppy trade fraud teeth inspection reveals dogs are younger than stated age, not really vaccinated Concern International dog rescues more likely to choose sick or street dogs, may not budget for importation quarantine or monitor for diseases in imported animals.
10 8 6 4 2 Rabies in California - Dogs and Cats 1983-2015 Dogs Cats 2012-2015 California - 6 rabid cats. All 6 had bat variant of rabies. 2012-2014 California - 3 rabid dogs. All 3 had the skunk variant of rabies. Two had been vaccinated 6-8 months before onset. 0 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Quarantines Incident Purpose of Quarantine Minimum Quarantine Length Dog, cat or ferret bite to person. (Bite = skin broken by tooth) Determine if biting animal was contagious for rabies on the day of the bite. (Most rabid animals will already be 10 days. Do NOT booster vaccination during QT. showing symptoms when contagious, but not all.) Horse, goat, sheep bite to person Determine if biting animal was contagious for rabies on the day of the bite. 30 days Pet bitten by / exposed to wild mammal. * Pet current on rabies vaccination at time of incident Pet bitten by / exposed to wild mammal. * Pet unvaccinated or NOT current on rabies vaccination at time of incident. Determine if the pet was exposed to rabies by the wild animal. *This is done by watching it throughout the rabies incubation period). QT not needed if wild animal tests negative for rabies. Determine if the pet was exposed to rabies by the wild animal. QT not needed if wild animal tests negative for rabies. Consultations Know your local public health Agency Dr Curtis Fritz, California State Public Health Veterinarian: 916-552-9740, vetph@cdph.ca.gov 30 days - if wild animal confirmed rabid or if not tested for rabies. Booster vaccination ASAP! 180 days - if wild animal confirmed rabid or if not tested for rabies. Booster vaccination ASAP! * Per California law - bites from rabbits, squirrels, rats, mice and other rodents are not reportable incidents, even though they are mammals, they are not rabies vectors.
ANIMAL BITES & RABIES RISK Recommendations for Los Angeles County* When the biting animal is available for evaluation by quarantine or testing, the results may determine if the animal is rabid and the bite victim needs Rabies Post-Exposure Prophylaxis (PEP). The species of the animal and its health may also help determine rabies risk. HIGH RISK OF RABIES Bats / Abnormally Acting Wildlife / Foreign Animals REPORT BITE TO VETERINARY PUBLIC HEALTH IMMEDIATELY. Rabies Post-Exposure Prophylaxis (PEP) is FREQUENTLY indicated. MODERATE RISK OF RABIES Sick Local Dogs or Cats / Normally Acting Non-Bat Wildlife (such as skunks, foxes, raccoons, coyotes, opossums) Report bite to Veterinary Public Health. PEP is SOMETIMES indicated. LOW RISK OF RABIES Healthy Local Dogs or Cats / Livestock / Horses Report bite to Veterinary Public Health. PEP is RARELY indicated. NOT REPORTABLE Squirrels / Rabbits / Small Rodents (rats, mice) / Birds / Snakes Bites from these animals are not reportable because they do not spread rabies. PEP is NOT indicated. REPORTING FAX (Preferred): (213) 481-2375. Download form at www.publichealth.lacounty.gov/vet/docs/forms/biteformmed.pdf Online: www.publichealth.lacounty.gov/vet/biteintro.htm Phone: (877) 747-2243 or (213) 989-7060 (Vet Public Health/M-F, 7:30 am-5 pm) www.publichealth.lacounty.gov/vet/animalcontrollist.htm CONSULTATIONS Consultation regarding rabies risk Mon-Fri: 7:30 am-5 pm Veterinary Public Health: (877) 747-2243 or (213) 989-7060 or vet@ph.lacounty.gov Ask to speak to the Veterinarian On-Duty. Consultation on individual patient care decisions Mon-Fri: 7:30 am-5 pm. Consultations also available after-hours for emergencies. Acute Communicable Disease Control: (213) 240-7941 Ask to speak to the Physician On-Duty *The rabies risk in Los Angeles County may shift over time. Other counties may have different rabies risks. Dec 2013 November-December 2013 LA County Department of Public Health Rx for Prevention 7
Rabies Law Quiz for Animal Care Agencies 1. In which cases do we need to quarantine the pet? (circle all that apply): a. A cat that bit a person in the arm, visible wound on arm b. A dog that fought with a raccoon, raccoon ran away c. A dog that fought with a raccoon, the raccoon tested negative for rabies d. A cat that was unattended in a back yard where a confirmed rabid bat was found 2. At what age is rabies vaccination considered valid in dogs in California? a. 2 months b. 3 months c. 4 months 3. A cat bit an Animal Care Attendant on the thumb in the treatment room. How long is the bite quarantine for the cat? a. 5 days b. 10 days c. 14 days 7. A 7-year old dog carries a bat home in its mouth. The bat tests positive for rabies. The dog had an up-to-date rabies certificate before the incident. The vet booster s the dog s rabies vaccination right away. How long do we need to quarantine this dog? a. 10 days b. 30 days c. 180 days 8. A bat is found in a room where a 4-year old girl was sleeping. The parents cannot find a bite wound on the girl. Do we need to test this bat for rabies? YES or NO 9. A woman calls and says she woke and found a bat flying around her bedroom. What should she do? a. Open the front door it will fly out b. Try to kill it with a broom and then discard it c. Cover it with a bucket or close it in a room and wait for Animal Control to come pick it up for rabies testing. 4. California state law allows private practice veterinarians to write exemptions for rabies vaccination. TRUE or FALSE 5. California State Law accepts rabies-titer blood tests on a dog as a substitute for vaccination. TRUE or FALSE See other side for answers. 6. An unvaccinated 5-month old puppy carries a bat in its mouth into the house. The bat tests positive for rabies. The puppy is immediately vaccinated. Per California law, this puppy must be either euthanized or quarantined. The length of the quarantine would be: a. 10 days b. 30 days c. 180 days Veterinary Public Health Program Los Angeles County Department of Public Health. March 2017 EB
Quiz answers: 1. a, b, d 2. b 3. b 4. False. 2012 state law stated that vet and animal owner must submit exemption request to local public health agency or their surrogate (often Animal Control) for approval. 5. False 6. c 7. b 8. YES! Bat bites are tiny. The bat could have bitten the girl. Bat bites can be very tiny and hard to see. This girl may have been exposed to rabies. 9. c. This bat MUST be tested for rabies. The woman may have been bitten while asleep and not know it. Veterinary Public Health Program Los Angeles County Department of Public Health. March 2017 EB
CDPH Rabies page data, guidelines and much more! cdph.ca.gov/healthinfo/discond/pages/rabies.aspx