September 11, 2000
Volume XXXIII, No. 33

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Study of rabies patterns shows
need for public education
 

Cadeuses

Medicine

Do you reach to pet a dog that’s behaving aggressively toward you? Do you attempt to pick up an animal that appears to be injured? You may be in for a rude awakening—and be in need of rabies treatment.

The best advice is to stay away from unfamiliar animals if possible, said Dr. Toni Miles, professor of family practice at the Health Science Center. Dr. Miles is co-author of a paper, recently released in the Journal of the American Veterinary Medicine Association, that explores patterns of animal bites and exposures in Pennsylvania, where Dr. Miles previously lived.

Investigators studied more than 16,000 animal-related potential rabies exposures reported in Pennsylvania during a 12-month period. They found the highest incidence of animal bites (324 per 100,000) occurred in children younger than age 5. Three fourths of the victims required wound treatment, half received anti-microbial drugs, and 29 percent were given tetanus shots. Nineteen percent of victims had wounds sutured, were admitted to hospitals or were referred for plastic surgery.

Researchers sought to evaluate the animal exposure reporting system in Pennsylvania and identify opportunities to reduce administration of rabies treatment, also known as rabies "post-exposure prophylaxis" (PEP).

"To err on the side of caution, PEP sometimes is administered without confirmation of rabies exposure," said Dr. Miles. "Rabies PEP is expensive and not without potential adverse effects, including local reactions at the injection site or systemic problems such as muscle aches, fever or vomiting."

Although 75 percent of potential rabies exposures were to dogs, individuals exposed to cat bites were six times more likely to receive rabies PEP, researchers noted. Forty-four percent of the 556 PEP treatments were for exposures to cats, 30 percent for dogs, 7 percent for raccoons, 4 percent for bats, 2.5 percent for squirrels, 2.1 percent for groundhogs, 2 percent for foxes and 8 percent for other species.

Half of all Americans will experience the unpleasantness of an animal bite, but many of the bites will go unreported, the researchers wrote. "The primary reason for reporting animal bites to local health departments is the immediate need to follow up on possible rabies exposure," Dr. Miles said.

About 10,000 potential rabies exposures were reported to the Texas Department of Health in 1999, according to the department’s Zoonosis Control Division. Four percent of the individuals tested positive for the disease, and rabies PEP was administered to 428. Positive cases of rabies by animal were skunk, 192; bat, 90; fox, 56; cat, 21; dog, 13; equine, 9; bovine, 8; raccoon, 4; and coyote, 2.

Researchers conclude that interventions such as dog bite prevention education, vaccination of pets against rabies, appropriate use of PEP and reduction of feral cat populations should be instituted, enhanced or better enforced in communities nationwide.

Study co-authors, now at the University of California Cooperative ExtensionTulare County, are Dr. Dale Moore, Dr. William Sischo and
Allison Hunter.

— Will Sansom