Vermont Rabies Control Resource Manual 2018 Health Surveillance HealthVermont.gov Table of Contents Introduction ............................................................................................................... 3 Section 1: Rabies in Vermont ........................................................................................5 A. Vermont Rabies Control Overview B. Vermont Rabies Epidemiology Section 2: Vermont-Specific Rules and Statutes .......................................................... 13 A. Reportable and Communicable Diseases Rule B. 20 VSA Chapter 193: Domestic Pet or Wolf-Hybrid Control C. Animal Rabies Vaccination Rules Section 3: National Guidelines .................................................................................... 50 A. Compendium of Animal Rabies Prevention and Control, 2016 B. Human Rabies Prevention—United States, 2008 C. Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies, 2010 Section 4: Vermont Recommendations ....................................................................... 111 A. School Animal Policy Guide Section 5: Rabies Exposure Protocols ......................................................................... 116 A. Human Rabies Exposure Management by Animal Type B. Management of Potential Human Exposures to Rabies C. Rabies Exposure Management for Bat-related Incidents D. Management of Potential Pet Exposures to Rabies Section 6: Rabies Testing and Reporting Forms ........................................................... 121 A. Rabies Specimen Lab Testing and Shipping Instructions B. Request for Rabies Examination C. Rabies Postexposure Prophylaxis Report Form D. Town Health Officer Animal Bite Report Form Vermont Rabies Control Resource Manual 2018 Introduction to Rabies Control Resource Manual Introduction Vermont Rabies Control Resource Manual 2018 is a resource guide for veterinarians, wildlife officials, health care and public health professionals, and others to help prevent and control rabies in Vermont. It contains essential information such as: Vermont-specific rules and regulations on animal bite and treatment reporting and rabies vaccination; national guidelines for postexposure treatment, vaccination and animal quarantine; recommendations for schools on developing an animal policy; and forms and instructions for reporting and animal testing. The table below outlines the contents of each of the five sections. Section 1. Rabies in Vermont Vermont Rabies An overview of rabies, procedures for when a human or pet is bitten by a Control Overview potentially rabid animal, instructions for submitting specimens for rabies testing. Vermont Rabies Tables, charts, and a map showing the detection of rabies in Vermont by animal Epidemiology type, town, and year from 2005 to 2017. Section 2. Vermont-Specific Rules and Statutes Reportable and Rules to protect the public though early and prompt reporting of infectious diseases Communicable to the Health Department. From the Code of Vermont Rules [CVR 13-140-007]. Diseases Rule 20 VSA Chapter 193: Vermont statute on licensing and rabies control in domestic pets and wolf-hybrids. Domestic Pet or Wolf- From Vermont Statutes, Title 20: Internal Security and Public Safety, Chapter 193. Hybrid Control Animal Rabies Rules on administration of rabies vaccination to domestic pets, wolf-hybrids and Vaccination Rules livestock. Section 3. National Guidelines Compendium of Animal Published by the National Association of State Public Health Veterinarians, the 2016 Rabies Prevention and report recommends approaches to rabies prevention and control in animals. Control, 2016 Human Rabies Published in the CDC’s Morbidity and Mortality Weekly Report (2008), the report Prevention – United presents guidelines for rabies postexposure and pre-exposure prophylaxis in States, 2008 humans. Use of a Reduced (4- Dose) Vaccine Schedule Published in the CDC’s Morbidity and Mortality Weekly Report (2010), the report for Postexposure summarizes updates to the 2008 guidelines, including a reduced 4-dose rabies Prophylaxis to Prevent vaccine schedule. Human Rabies, 2010 Section 4. Vermont Recommendations School Animal Policy Provides guidance to schools on developing an animal policy to reduce the risk of Guide human exposure to rabies and other diseases from animals. Section 5. Rabies Exposure Protocols Human Rabies Recommendations for rabies postexposure management in humans by animal type Exposure Management (domestic pets, livestock, wild carnivores, rodents, etc.) by Animal Type Management of A flowchart used to determine course of action when a person is exposed to a Potential Human potentially rabid animal. Exposures to Rabies Rabies Exposure A flowchart used to determine human postexposure management for bat-related Management for Bat- incidents. related Incidents Management of A flowchart used to determine course of action when a pet is exposed to a Potential Pet Exposures potentially rabid animal. to Rabies Section 6. Rabies Testing and Reporting Forms Rabies Specimen Lab Instructions for preparing, packaging and shipping rabies specimens to the Vermont Testing and Shipping Department of Health Laboratory. Instructions Request for Rabies After approval from Infectious Disease Epidemiology, submit this form with Examination specimens to the Health Department Laboratory to request rabies testing. Rabies Postexposure For health care professionals, after administering rabies postexposure prophylaxis, Prophylaxis Report submit this form to the Health Department. Form Town Health Officer For health care professionals, veterinarians, and other adults, use this form to Animal Bite Report report an animal bite to the Town Health Officer. Form For questions about this book, please call 802-863-7240 or e-mail [email protected]. Introduction to Vermont Rabies Control Resource Manual 2018 Back to table of contents Section 1. Rabies in Vermont A. Vermont Rabies Control Overview B. Vermont Rabies Epidemiology Vermont Rabies Control Resource Manual 2018 page 5 Rabies Control Overview What’s in this overview? • Rabies disease and vaccination overview. • Procedure when a human or pet is bitten by a potentially infected wild or domestic animal. • Recommendations for capturing a bat if there has been a possibility of exposure. • Instructions for getting pre-approved specimens tested for rabies at the Vermont Department of Health Laboratory. • Contact information for the USDA Vermont Rabies Hotline, Vermont Department of Health Epidemiology Program, Vermont Department of Health Laboratory, and Vermont Fish and Wildlife Game Wardens. Rabies is a fatal viral disease most commonly found in wildlife. In Vermont, rabies is most commonly found in racoons, foxes, bats, skunks and woodchucks, but domestic animal and human infection is possible. All species of mammals are susceptible to rabies infection. Though there has never been a documented human case of rabies in Vermont, between 1992 and 2017, 73 domestic animals tested positive for rabies – 29 cows, 25 cats, 9 horses, 5 dogs, 4 sheep and 1 pig – and hundreds of cases have been identified among wildlife. The Vermont Department of Health is responsible for leading efforts to prevent rabies infections in humans and for the management of animals that may have exposed humans. Included in this role are: 1. Assessing human and domestic animal rabies exposures 2. Coordinating the management of wildlife that may have exposed humans or domestic animals 3. Coordinating the collection and submission of specimens for testing 4. Providing recommendations for pre- and post-exposure prophylaxis. 5. Performing rabies testing on animal specimens. The USDA Vermont Rabies Hotline (1-800-4-RABIES/802-223-8690) offers general rabies and wildlife information to the public. Rabies is primarily transmitted through bites. Rabies is a disease of the central nervous system. Rabid animals may show unusual aggression, extreme depression, or bizarre behavior, but you cannot tell whether an animal has rabies simply by looking at it. Animals are not infectious until the virus is present in their saliva, around the time of illness onset. 108 Cherry Street • PO Box 70 • Burlington, VT 05402 • HealthVermont.gov Rabies is mainly transmitted through bites when teeth penetrate the skin. Rare non-bite exposures can occur if wet infectious saliva or nervous tissue contacts a fresh open wound or mucous membranes of the eyes, nose or mouth. All salivary exposures by raccoons, skunks, foxes, coyotes, and other wild mammalian carnivores must be considered possible exposures to the rabies virus. Any animal not available for testing must be considered as potentially rabid. Indirect contact (petting or handling an animal, contact with blood, urine, feces or skunk spray) is not an exposure. Promptly following the bite of a potentially rabid animal, the wound should be cleansed with soap and running water and irrigated with a virucidal agent such as a povidone-iodine. Tetanus prophylaxis and measures to control bacterial infection may be administered as indicated. The need for rabies postexposure prophylaxis (rPEP) should be assessed with a medical provider and initiated as soon as possible after exposure to wildlife unless the animal has been tested and shown not to be rabid. Initiation of rPEP is reportable to Vermont Department of Health by health care professionals (section 5.5.2 of the "Reportable and Communicable Diseases Rule" [CVR 13-140-007]). It is the responsibility of