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Public Veterinary Medicine: Public Health Rabies Surveillance in the United States During 2001

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Public Veterinary Medicine: Public Health Rabies Surveillance in the United States During 2001 2002pvmkrebs.qxd 12/4/2002 2:11 PM Page 1690 Public Veterinary Medicine: Public Health Rabies surveillance in the United States during 2001 John W. Krebs, MS; Heather R. Noll, MPH; Charles E. Rupprecht, VMD, PhD; James E. Childs, ScD Summary: During 2001, 49 states and Puerto Rico reported abies in the United States and other developed 7,437 cases of rabies in nonhuman animals and 1 case in a nations is primarily a disease that affects and is human being to the Centers for Disease Control and R Prevention, an increase of < 1% from 7,364 cases in nonhu- maintained by wildlife populations (Fig 1). During man animals and 5 human cases reported in 2000. More than 2001, wild animals accounted for more than 93% of all 93% (6,939 cases) were in wild animals, whereas 6.7% (497 cases of rabies reported to the Centers for Disease cases) were in domestic species (compared with 93.0% in Control and Prevention (CDC). Although the wildlife wild animals and 6.9% in domestic species in 2000). The number of cases reported in 2001 increased among bats, species most frequently reported rabid remain rac- cats, skunks, rodents/lagomorphs, and swine and decreased coons, skunks, bats, and foxes, the relative contribu- among dogs, cattle, foxes, horses/mules, raccoons, and tions of those species have continued to change in sheep/goats. The relative contributions of the major groups recent decades (Fig 2) because of fluctuations in epi- of animals were as follows: raccoons (37.2%; 2,767 cases), zootics of rabies among animals infected with several skunks (30.7%; 2,282), bats (17.2%; 1,281), foxes (5.9%; 1 437), cats (3.6%; 270), dogs (1.2%; 89), and cattle (1.1%; distinct variants of the rabies virus. 82). Nine of the 19 states where the raccoon-associated vari- Vaccination campaigns and other rabies-control ant of the rabies virus has been enzootic reported decreases programs implemented during the 1940s and 1950s in the numbers of rabid raccoons during 2001. Among states with extensive wildlife rabies control pro- caused a substantial decline of rabies in domestic ani- grams, Ohio reported (other than rabies in bats) 1 case of rabies mals in the United States and all but eliminated the cir- in a raccoon that was associated with the epizootic of rabies in culation of canine variants of the rabies virus in dogs raccoons and 1 case in a bovid that was infected with a bat vari- (Canis lupus, formerly known as C familiaris) by the ant of the rabies virus, compared with no cases reported in any terrestrial animals during 2000. Texas reported 1 case associat- 1960s. Programs initiated to interrupt transmission of a ed with the dog/coyote variant of the rabies virus (compared canine variant that re-emerged in south Texas during with no cases in 2000) and 20 cases associated with the gray the late 1970s and early 1980s have substantially fox variant of the virus (a decrease of 50% from reported cases reduced the spread of this variant, maintained in unvac- in 2000). Reports of rabid skunks in Massachusetts and Rhode Island, states with enzootic raccoon rabies, exceeded reports of cinated dogs and coyotes (Canis latrans), as well as a rabid raccoons for the fifth consecutive year. A similar situation second canine variant found mainly in gray foxes may soon exist in the state of Maine (32 rabid skunks and 34 (Urocyon cinereoargenteus) in west and central Texas. rabid raccoons during 2001). Regulations now in place in Texas and other states that Nationally, the number of rabies cases in skunks during 2001 increased by 2.7% over those reported in 2000. Texas prohibit translocation of certain wild animal species for reported the greatest number of rabid skunks ever documented hunting and other restocking purposes have substan- during a single year by any state, as well as the greatest numer- tially reduced the likelihood of accidental introductions ical increase in rabid skunks (778 cases in 2001, compared with of rabies virus variants into unaffected areas.1-3 550 in 2000; an increase of 228 cases, or 41.5%) and the largest overall state total of rabies cases (1,043) during 2001. Arizona Various public health activities have contributed to reported the greatest percentage increase in rabid skunks reduced transmission of rabies virus from terrestrial (247.1%), representing an increase from 17 rabid skunks in animals to human beings. These activities have includ- 2000 to 59 in 2001. Nineteen of these cases were infected with ed vaccination of domestic animals, vaccination pro- a bat variant of the rabies virus, documenting a spillover event grams targeting wildlife, and ongoing education pro- followed by unprecedented detection of temporal enzootic 4 transmission of a bat variant in a terrestrial species. The number grams. However, a small but increasing number of of cases of rabies reported in bats during 2001 (1,281 cases) rabies cases in human beings have resulted from infec- increased 3.3% and surpassed the previous year’s record (1,240 cases) as the largest number of reported cases ever recorded for this group of mammals. Cases of rabies reported in dogs (89) From the Viral and Rickettsial Zoonoses Branch, Division of Viral and cattle (82) decreased by 21.9 and 1.2%, respectively; these and Rickettsial Diseases, National Center for Infectious Diseases, are the lowest numbers reported for rabid cattle and dogs since Centers for Disease Control and Prevention, 1600 Clifton Rd NE, the dawn of national rabies record keeping (ca 1938). Cases in Atlanta, GA 30333. cats (270) increased by 8.4% over those reported in 2000, The authors thank the state and territorial health and agriculture depart- whereas rabies among sheep and goats declined 70%, from 10 ments and laboratories for their contributions of rabies surveillance cases in 2000 to 3 cases (goats only) in 2001. Rabies among data; the governments of Canada and Mexico for supplying sum- horses and mules declined 1.9% (52 cases in 2000 to 51 cases maries of rabies surveillance data; Karoyle Colbert, Biometrics in 2001). Reported cases of rabies in mongooses in Puerto Rico Activity, Division of Viral and Rickettsial Diseases, National Center for increased 18.6%, compared with the previous year (70 cases in Infectious Diseases, and Van Munn, Information Resources 2001 from 59 cases in 2000), whereas cases of rabies in dogs Management Office, Office of Program Services, Office of the Director, declined 15.3% (15 to 13). One case of rabies in a human being Centers for Disease Control and Prevention, for assistance with graph- reported by California during 2001 was the result of infection with a canine variant of the rabies virus acquired outside the ics; and John P. O’Connor, Office of the Director, Division of Viral and United States. Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, for editing and critical input. 1690 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 221, No. 12, December 15, 2002 2002pvmkrebs.qxd 12/4/2002 2:11 PM Page 1691 Figure 1—Cases of animal rabies in the United States, by year, Figure 3—Distribution of major terrestrial reservoirs of rabies in 1955 to 2001. the United States. through transmission of the virus into previously unin- fected populations.9,10 Natural barriers such as moun- tain ranges or bodies of water that restrict animal movements or result in low population densities can slow the spread of rabies. Nevertheless, unusual animal dispersal patterns and human-mediated translocation of infected animals have resulted in more rapid and unexpected introduction of rabies into new areas.1-3,8-10 Raccoons (Procyon lotor) have been recognized as a reservoir for rabies in the southeastern states since the 1950s. An outbreak that began during the late 1970s in the mid-Atlantic states was attributed to the translocation by humans of infected raccoons from the Southeast.11 Although previously identifiable as sepa- rate foci (prior to 1994), the mid-Atlantic and south- Figure 2—Cases of rabies in wild animals in the United States, by year and species, 1955 to 2001. eastern foci have merged, and raccoon rabies is now enzootic in all of the eastern coastal states as well as Alabama, Pennsylvania, Vermont, West Virginia, and tion with variants of the rabies virus associated with possibly Ohio. 5,6 bats, a wildlife group difficult to target for rabies con- At least 3 variants of rabies virus are responsible trol by conventional methods. Prevention of rabies for disease in skunks (primarily Mephitis mephitis) in resulting from infection with bat-associated variants is California and the north central and south central further challenged by the frequent absence of exposure states. A long-standing reservoir for rabies virus exists histories involving a bat bite. Since 1990, 24 of 26 in red and arctic foxes (Vulpes vulpes and Alopex lago- human cases of indigenously acquired rabies were asso- pus, respectively) in Alaska. Rabies spread during the ciated, by genetic analysis, with variants of the rabies 1950s to affect foxes across Canada and, intermittent- virus maintained by bats. Only 2 of these cases involved ly, foxes in adjoining areas of the New England states. 2,5,6 a report of a definite history of animal bite. The Rabies persists in foxes in Alaska, although reports of most likely route of infection remains transmission by rabid foxes have declined in Canada. Two variants of bite during contact with a bat that either was ignored or rabies virus are present in geographically limited pop- unnoticed and subsequently forgotten. ulations of gray foxes (U cinereoargenteus) in Arizona Rabies infections of terrestrial animals in most and Texas.
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