WVC 2017: Rabies Awareness Challenge 2017

Rich Ford, DVM, MS, DACVIM, DACVPM (Hon), conducted an educational audience participation session about rabies at the 2017 Western Veterinary Conference in Las Vegas.

His goal was to educate veterinarians about rabies both in the United States and worldwide, including its prevalence, applicable laws, and vaccine exemptions. Of all the vaccinations veterinarians give to cats and dogs, Dr. Ford reminded the audience that only rabies is regulated by law.

It is essential that veterinarians know their responsibilities as they pertain to the law and public health in their state. At this national meeting, he discussed legal trends that apply to most states. For the past year, Merial, in conjunction with the National Association of State Public Health Veterinarians (NASPHV; nasphv.org), has sponsored a state-by-state rabies education awareness campaign. At the time of publication, information about laws and regulations in more than 30 states could be found at rabiesaware.org.

Rabies vaccination requirements are dictated by each state’s department of health. The Compendium of Animal Rabies Prevention and Control is a periodically updated publication of guidelines devised by the NASPHV. State public health veterinarians work for state health departments and deal with zoonotic disease control—focusing on protecting health—whereas state veterinarians work for state agriculture departments and primarily target livestock diseases (some of which can be zoonotic).

Rabies Prevalence and Incidence

Even though rabies is uncommon in the United States, the World Health Organization estimates that worldwide it kills between 50,000 and 60,000 people per year. Forty percent of those affected are under 15 years of age, and 99% of victims have contracted the virus from a dog.

The incidence of canine rabies has plummeted in the United States over the past 30 years. Since 1986, there have been more reported cases of feline rabies than canine rabies. In 2014, about 500 cases of rabies were reported in domestic animals; 272 of those cases were in cats and 59 in dogs. In comparison, there were about 5000 cases of rabies in wild animals.

Variations In the Law

According to Dr. Ford, rabies laws vary widely among states. Take, for example, eastern Pennsylvania, which has the highest concentration of feline rabies in America. Pennsylvania law requires rabies vaccination for pet cats. Contrast that with neighboring New Jersey, where the prevalence of feline rabies is lower, even though there is no law requiring cats to be vaccinated. Another example is Ohio, which is the only state east of the Mississippi River not to have a requirement for canine or feline rabies vaccination. Further, within each state, some cities and counties have laws that take precedence over state mandates, leading to confusion about the interpretation, application, and necessary actions required to manage vaccinations, bites, and cases of exposure.

Most states stipulate that only a licensed veterinarian can administer a rabies vaccination, but some allow a veterinary technician to give the vaccine provided that the technician is under the “direct supervision” of a licensed veterinarian. By contrast, in a handful of states, a veterinarian must be accredited and licensed to give a rabies vaccine, and in some jurisdictions, an owner can legally administer a rabies vaccine.

The minimum age an animal can receive a rabies vaccine is 12 weeks. Most states consider an animal to be “currently” vaccinated against rabies 28 days after the initial vaccination. In contrast, most states have a zero-tolerance policy for overdue rabies vaccination and consider an animal unprotected if its vaccine is given a day late. However, once that animal receives a vaccine, it is immediately considered “currently vaccinated.”

When revaccinating a dog that is overdue, most states allow the veterinarian discretion to choose either a 1-year or 3-year vaccine. Usually, pet owners do not have to start the series again. If it’s been 5 years since the last vaccine, a 3-year vaccine can be given that is valid for 3 years.

Exposure Defined

What about rabies “exposure”? Some states define exposure carefully, and others do not. Usually, the final determination of exposure is made by an animal control officer and not a public health veterinarian or the state health department.

In general, if a currently vaccinated pet is exposed to rabies, most states require a 4-month quarantine. For unvaccinated pets, a 6-month strict quarantine is often required—at the owner’s expense. The only other option is to euthanize and test. Several states are currently reviewing quarantine regulations for rabies-exposed dogs and cats that are overdue for vaccination. With valid documentations of prior vaccination, a 45-day home observation period is becoming more common. Some states also allow prospective serologic monitoring because in the United States, a rabies titer is not recognized as an index of immunity in lieu of revaccination.

Vaccine Exemptions

About 15 states recognize a veterinarian’s authority to exempt a pet from rabies vaccination; the rest do not. In those states, even a dying or ill pet is legally required to be current on rabies vaccination. Because the law, and not common sense, dictates rabies regulations, Dr. Ford reminded the group to avail themselves of the rabiesaware.org resource to ensure that they all know their obligations in their practice state.

Dr. Thompson is a small animal veterinarian, animal health executive, editor, and writer. She has held numerous positions with oversight responsibilities for editorial and business direction, including for Veterinary Learning Systems (publisher of Veterinary Technician and Compendium), Vetstreet.com, HealthyPet, and NAVC.