Compendium of Animal Rabies Control, 1993 National Association of State Public Health Veterinarians, Inc.

SUGGESTED CITATION: Centers for Disease Control and Prevention. Compendium of animal rabies control, 1993. MMWR 1993;42(No.RR-3):{inclusive page numbers}.

CIO Responsible for this Publication Epidemiology Program Office

The purpose of this Compendium is to provide rabies information to veterinarians, public health officials, and others concerned with rabies 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 and revised as necessary. Immunization 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 Immunization Procedures

1. Vaccine Administration

All animal rabies vaccines should be restricted to use by, or under the direct supervision of, a veterinarian. B. Vaccine Selection

In comprehensive rabies control programs, only vaccines with a 3-year duration of immunity should be used. This constitutes the most effective method of increasing the proportion of immunized dogs and cats in any population. (See Part II.) C. Route of Inoculation

All vaccines must be administered in accordance with the specifications of the product label or package insert. If administered intramuscularly, it must be at one site in the thigh. D. Wildlife Vaccination

Vaccination of wildlife is not recommended since no rabies vaccine is licensed for wild animals. Because of their susceptibility to rabies, neither wild nor exotic carnivores, nor bats should be kept as pets. Hybrids (offspring of wild animals bred with domestic dogs or cats) are considered wild animals. E. Accidental Human Exposure to Vaccine

Accidental inoculation may occur during administration of animal rabies vaccine. Such exposure to inactivated vaccines constitutes no rabies hazard. F. Identification of Vaccinated Animals

All agencies and veterinarians should adopt the standard tag system. This practice will aid the administration of local, state, national, and international control procedures. Animal license tags should be distinguishable in shape and color from rabies tags. Anodized aluminum rabies tags should be no less than 0.064 inches in thickness.

1. Rabies Tags

2. Rabies Certificate. All agencies and veterinarians should use the NASPHV form #50 or #51, "Rabies Vaccination Certificate," which can be obtained from vaccine manufacturers. Computer-generated forms containing the same information are acceptable.

Part III: Rabies Control

1. Principles of Rabies Control

1. 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 appropriate passive and active immunization. The rationale for recommending pre-exposure and postexposure rabies prophylaxis and details of their administration can be found in the current recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Public Health Service (PHS). 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.

2. Domestic Animals. Local governments should initiate and maintain effective programs to ensure vaccination of all dogs and cats and to remove strays and unwanted animals. Such procedures in the United States have reduced laboratory confirmed rabies cases in dogs from 6,949 in 1947 to 155 in 1991. Since more rabies cases are reported annually involving cats 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.

3. Rabies in Wildlife. The control of rabies among wildlife reservoirs is difficult. Selective population reduction may be useful in some situations, but the success of such procedures depends on the circumstances surrounding each rabies outbreak. (See C. Control Methods in Wild Animals.) B. Control Methods in Domestic and Confined Animals

4. Pre-exposure Vaccination and Management. Animal rabies vaccines should be administered only by, or under the direct supervision of, a veterinarian. This is the only way to ensure that a responsible person can be held accountable to assure the public that the animal has been properly vaccinated. Within 1 month 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 it was vaccinated at least 30 days previously and all vaccinations have been administered in accordance with this Compendium. Regardless of the age at initial vaccination, a second vaccination should be given 1 year later. (See Parts I and II for recommended vaccines and procedures.)

1. Dogs and Cats. All dogs and cats should be vaccinated

against rabies at 3 months of age and revaccinated in accordance with Part II of this Compendium.

b. Ferrets. Ferrets may be vaccinated against rabies at 3 months of age and revaccinated in accordance with Part II of this Compendium.

c. Livestock. It is neither economically feasible nor justified from a public health standpoint to vaccinate all livestock against rabies. However, consideration should be given to the vaccination of livestock, especially animals that are particularly valuable and/or may have frequent contact with humans, in areas where rabies is epizootic in terrestrial animals. (See Part II for recommended vaccines.)

d. Other Animals

1. Wild Animals. No rabies vaccine is licensed for use in wild

animals. Because of the risk of rabies in wild animals (especially raccoons, skunks, coyotes, and foxes), the AVMA, the NASPHV, and the CSTE strongly recommend the enactment of state laws prohibiting the importation, distribution, relocation, or keeping of wild animals and wild animals crossbred to domestic dogs and cats as pets.

2) Animals Maintained in Exhibits and in Zoological Parks. Captive animals not completely excluded from all contact with rabies vectors can become infected. Moreover, wild animals may be incubating rabies when initially captured; therefore, wild-caught animals susceptible to rabies should be quarantined for a minimum of 180 days before exhibition. Employees who work with animals at such facilities should receive pre-exposure rabies immunization. The use of pre- or postexposure rabies immunizations of employees who work with animals at such facilities may reduce the need for euthanasia of captive animals. 2. Stray Animals. Stray dogs or cats should be removed from the community, especially in areas where rabies is epizootic. Local health departments and animal control officials can enforce the removal of strays more effectively if owned animals are confined or kept on a leash. Strays should be impounded for at least 3 days to give owners sufficient time to reclaim animals and to determine if human exposure has occurred. 3. Quarantine

1. International. CDC regulates the importation of dogs and

cats into the United States, but present PHS regulations (42 CFR No. 71.51) governing the importation of such animals are insufficient to prevent the introduction of rabid animals into the country. All dogs and cats imported from countries with enzootic rabies should be currently vaccinated against rabies as recommended in this Compendium. The appropriate public health official of the state of destination should be notified within 72 hours of any unvaccinated dog or cat imported into his or her jurisdiction. The conditional admission of such animals into the United States is subject to state and local laws governing rabies. Failure to comply with these requirements should be promptly reported to the director of the respective quarantine center.

b. Interstate. Dogs and cats should be vaccinated against rabies according to the Compendium's recommendations at least 30 days prior to interstate movement. Animals in transit should be accompanied by a currently valid NASPHV Form #50 or #51, Rabies Vaccination Certificate. 4. Adjunct Procedures. Methods or procedures that enhance rabies control include:

1. Licensure. Registration or licensure of all dogs and cats

may be used to control rabies. 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.

b. Canvassing of Area. House-to-house canvassing by animal control personnel facilitates enforcement of vaccination and licensure requirements.

c. 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.

d. Animal Control. All communities should incorporate stray animal control, leash laws, and training of personnel in their programs. 5. Postexposure Management. Any animal bitten or scratched by a wild, carnivorous mammal (or a bat) not available for testing should be regarded as having been exposed to rabies.

1. Dogs and Cats. Unvaccinated dogs and cats bitten by 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. Dogs and cats that are currently vaccinated should be revaccinated immediately and confined and observed for 90 days.

b. Livestock. All species of livestock are susceptible to rabies; cattle and horses are among the most frequently infected of all domestic animals. Livestock bitten by a rabid animal and currently vaccinated with a vaccine approved by USDA for that species should be revaccinated immediately and observed for 90 days. Unvaccinated livestock should be slaughtered immediately. If the owner is unwilling to have this done, the animal should be kept under very 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 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. However, since pasteurization temperatures will inactivate rabies virus, drinking pasteurized milk or eating cooked meat does not constitute a rabies exposure.

3) It is rare to have more than one rabid animal in a herd, or herbivore to herbivore transmission, and therefore it may not be necessary to restrict the rest of the herd if a single animal has been exposed to or infected by rabies.

c. Other Animals. Other animals bitten by a rabid animal should be euthanized immediately. Such animals currently vaccinated with a vaccine approved by USDA for that species may be revaccinated immediately and placed in strict isolation for at least 90 days. 6. Management of Animals that Bite Humans. A healthy dog or cat that bites a person should be confined and observed for 10 days; it is recommended that rabies vaccine not be administered 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 humanely killed, its head removed, and the head shipped under refrigeration for examination by a qualified laboratory designated by the local or state health department. Any stray or unwanted dog or cat that bites a person may be humanely killed immediately and the head submitted as described above for rabies examination. Other biting animals that 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 and cats depends on the species, the circumstances of the bite, and the epidemiology of rabies in the area. C. Control Methods in Wild Animals

The public should be warned not to handle wild animals. Wild carnivorous mammals and bats (as well as the offspring of wild animals crossbred with domestic dogs and cats) that bite people should be humanely killed and the head submitted for rabies examination. A person bitten by any wild animal should immediately report the incident to a physician who can evaluate the need for antirabies treatment. (See current rabies prophylaxis recommendations of the ACIP.)

1. Terrestrial Mammals. 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 (picnic grounds, camps, suburban areas) may be indicated for the removal of selected high-risk species of wild animals. The state wildlife agency and state health department should be consulted for coordination of any proposed population reduction programs.

2. Bats

1. Indigenous rabid bats have been reported from every state

except Alaska and Hawaii and have caused rabies in at least 18 humans in the United States. It is neither feasible nor desirable, however, to control rabies in bats by programs to reduce bat populations.

b. Bats should be excluded from houses and surrounding structures to prevent direct association with humans. Such structures should then be made bat-proof by sealing entrances used by bats.

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