Rabies is a deadly disease that is transmittable to humans. Georgia Rabies Control Law-O.C.G.A.-13-19 mandates that every cat and dog be vaccinated for rabies by a licensed Veterinarian to protect them and to prevent the spread of this fatal disease. Town & Country West Veterinary is abided by this law, and we ask all our clients to make sure their pets are up to date with their rabies vaccine to prevent any issues when needing to be seen at our office. Being up to date with this vaccine, not only protects you and your pet, but also our staff.

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We have put together the following material to provide current information on the control of rabies in Georgia. It discusses its principles, control methods, management of animals exposed, management of animals that bite humans, most commonly asked questions, and important phone numbers to have.

 

If your pet is not up to date with their rabies vaccine, we invite you to call us at (770) 528-6363 to make an appointment as soon as possible. Thank you!

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RABIES OVERVIEW

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Rabies is a viral infection transmitted in the saliva of infected mammals. The virus enters the central nervous system of the host, causing an encephalomyelitis that is almost always fatal. Although all species of mammals are susceptible to rabies virus infection, only a few species are important as reservoirs for the disease in nature. In the United States, several distinct rabies virus variants have been identified in terrestrial mammals, including major terrestrial reservoirs in raccoons, skunks, foxes, and coyotes. In addition to the terrestrial reservoirs for rabies, several species of insectivorous bats also serve as reservoirs for the disease.

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Wildlife is the most important potential source of infection for both humans and domestic animals in the United States. Reducing the risk of rabies in domestic animals and limiting contact with wild animals are central to the prevention of human rabies. Vaccination of all domestic dogs, cats, and ferrets, coupled with the systematic removal of stray animals that are at risk of exposure to rabid wildlife, are basic elements of a rabies control program. Georgia law (Rabies Control Law-O.C.G.A.-31- 19) requires that all owned dogs and cats be vaccinated against rabies by a licensed veterinarian using approved vaccines in accordance with the national Compendium of Animal Rabies Prevention and Control. Domestic ferrets also need to be vaccinated against rabies according to the national Compendium of Animal Rabies Prevention and Control and Georgia law (O.C.G.A.-27-5-5).

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In the United States, indigenously acquired rabies among humans has declined markedly in recent years. The decline is, in part, due to vaccination and animal control programs begun in the 1940s that have practically eliminated the domestic dog as a reservoir of rabies and also to the development of effective human rabies vaccines and rabies immune globulin. During 2003-2013, a total of 34 cases of human rabies were reported in the United States (last case in Georgia in 2000). Among the 33 cases for which rabies virus variants were obtained, 19 (58%) were associated with insectivorous bats, most commonly the Mexican free-tailed, silver-haired, and eastern pipistrelle bats. Of these 34 human cases, 15 (44%) occurred during August-November, coincident with a seasonal increase in prevalence of rabid bats detected in the United States. Despite the substantial number of cases of human rabies attributable to bat exposure, the importance of these exposures is often overlooked or underestimated. In many of these cases, the bat bite was presumably not recognized nor the risk of rabies appreciated in order to seek appropriate medical attention.

 

Human rabies is a completely preventable disease if the risk of acquisition is appreciated and appropriate rabies post-exposure prophylaxis (consisting of wound care as well as both active and passive immunization) is obtained. Because rabies is a fatal disease, the goal of public health (in coordination with the medical community) is, first, to prevent human exposure to rabies by education and animal control measures and, second, to prevent the disease by administering rabies post-exposure prophylaxis (PEP) if exposure occurs. Tens of thousands of people are successfully treated each year after being bitten by an animal that may have rabies.

 

Although the decision to provide post-exposure prophylaxis rests with the patient and his or her physician, valuable consultations can be provided by the Georgia Poison Center, District and County health departments, or the Epidemiology Program, Department of Public Health

 

 

PRINCIPLES OF RABIES CONTROL

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As a zoonotic disease, the foundations of rabies control rest upon preventing the disease in animals, preventing the disease in humans, and decreasing the likelihood of exposure between humans and animal rabies vectors. Public education regarding rabies exposure risk is paramount. The following principles apply:

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· Rabies Exposure. Rabies is transmitted only when the virus is introduced into bite wounds, open cuts in skin, or onto mucous membranes.

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· 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 post-exposure prophylaxis (including both passive antibody administration and active immunization with cell culture vaccines). In addition, pre-exposure vaccination should be offered to persons in high-risk groups, such as veterinarians, animal handlers, and certain laboratory workers.

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· Domestic Animals. Local governments should initiate and maintain effective programs to ensure vaccination of all dogs, cats, and ferrets and to remove strays and unwanted animals from the community. Recommended vaccination procedures and the licensed animal vaccines are specified in the Compendium of Animal Rabies Prevention and Control. In addition, adjunct procedures which enhance rabies control include: 1) identification systems (e.g., metal/plastic tags, microchips; please refer to individual County requirements) to verify animal rabies vaccination status; 2) local domestic animal licensure requirements; 3) requirement of interstate health certificates prior to domestic animal travel; 4) implementation of regulations governing imported domestic animals; and 5) establishment of a local animal control agency responsible for stray control, leash laws, and issuance of citations for failure to vaccinate animals.

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All dogs, cats, and ferrets should be vaccinated against rabies and revaccinated in accordance with vaccine manufacturer recommendations.

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Vaccines should be FDA-approved and given by a licensed veterinarian. Check with local rabies authority for specific county regulations on annual or triennial booster vaccinations. There are no State-level requirements for vaccine type or manufacturer.

 

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CONTROL METHODS IN ANIMALS

 

Animal Vaccination Protocols

 

In Georgia, parenteral animal rabies vaccines should be administered only by a licensed veterinarian. This is the only way to ensure that a responsible person can be held accountable and to assure the public that the animal has been properly vaccinated. Within 28 days 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 the primary vaccination was administered at least 28 days previously and vaccinations have been administered in accordance with the Compendium of Animal Rabies Prevention and Control. Regardless of the age of the animal at initial vaccination, a second vaccination should be administered 1 year later. Because a rapid anamnestic response is expected, an animal is considered currently vaccinated immediately after a booster vaccination.

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· Dogs, Cats, and Ferrets. All dogs, cats, and ferrets should be vaccinated against rabies and revaccinated in accordance with the Compendium of Animal Rabies Prevention and Control. For many licensed vaccines, the age at primary vaccination is 3 months, but be aware that for some newer combination rabies vaccines, this age is 8 weeks. If a previously vaccinated animal is overdue for a booster, it should be revaccinated with a single dose of vaccine and placed on an annual or triennial schedule, depending on the type of vaccine used.

 

 

MANAGEMENT OF ANIMALS EXPOSED TO RABIES

 

Any animal potentially exposed to rabies virus by a wild, carnivorous mammal or a bat that is not available for testing should be regarded as having been exposed to rabies.

 

Dogs, Cats, and Ferrets

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· Unvaccinated dogs, cats, and ferrets exposed to 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 4 months for dogs and cats and 6 months for ferrets. The quarantined animal should be vaccinated either upon entry to isolation OR 1 month before being released. Isolation in this context refers to confinement in an enclosure that precludes direct contact with humans and other animals.

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· Dogs and cats overdue for a booster who are exposed to a rabid animal, but have documentation of having received at least one licensed rabies vaccination it its lifetime should be revaccinated immediately, kept under the owner’s control, and observed at home for 45 days for clinical signs of rabies. This new recommendation is based on the National Association of State Public Health Veterinarians (NASPHV) Compendium of Animal Rabies Prevention and Control 2016. The animal should then resume a vaccination schedule based on labeled use of the booster received. At the first sign of illness or behavioral change in the animal, the local rabies control agency should be notified and the animal should be evaluated by a veterinarian. If clinical signs are suggestive of rabies, the animal should be immediately euthanized and tested for rabies.

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· Animals without documentation of prior vaccination and exposed to a rabid animal should be treated as unvaccinated (refer to Unvaccinated protocol above). If the exposed animal is a dog or cat, and there is a strong indication that the animal may have been previously vaccinated, the Progressive Serological Monitoring (PSM) Protocol may be followed to document an anamnestic response to the booster vaccine, indicating prior vaccination. This new recommendation is based on the National Association of State Public Health Veterinarians (NASPHV) Compendium of Animal Rabies Prevention and Control 2016.

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· Currently vaccinated dogs, cats, and ferrets should be revaccinated immediately, kept under the owner's control, and observed at home for 45 days for clinical signs of rabies. During the observation period the animal should not be permitted to roam freely and should be restricted to leash walks, if applicable. At the first sign of illness or behavioral change in the animal, the local rabies control agency should be notified and the animal should be evaluated by a veterinarian. If clinical signs are suggestive of rabies, the animal should be immediately euthanized and tested for rabies.

 

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MANAGEMENT OF ANIMALS THAT BITE HUMANS

 

Dogs, Cats, and Ferrets

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· Rabies virus may be excreted in the saliva of infected dogs, cats, and ferrets during illness and/or for only a few days prior to illness or death. A healthy dog, cat, or ferret that bites a person should be confined and observed for 10 days, REGARDLESS OF THE ANIMAL’S VACCINATION STATUS. Administration of rabies vaccine is not recommended during the confinement period to avoid confusing signs of rabies with possible side effects of vaccine administration.

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· Confinement (sometimes referred to as quarantine) conditions should prevent direct contact with other animals or persons. The confinement shall be conducted under the authority of the designated local rabies control agency in which the place, manner, and provisions of the confinement are specified. For example, confinement may take place in a kennel in a veterinary hospital, animal control facility, commercial boarding establishment, or a pen at home, depending on local requirements.

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· At the first sign of illness or behavioral change in the animal, the local rabies control agency should be notified and the animal should be evaluated by a veterinarian. If clinical signs are suggestive of rabies, the animal should be immediately euthanized and tested for rabies and the exposed person notified.

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· Any stray or unwanted dog, cat, or ferret that bites a person should be euthanized immediately (or following the locally-specified impoundment period to give owners sufficient time to claim animals) and the head submitted for rabies examination.

 

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FREQUENTLY ASKED QUESTIONS (FAQ) ABOUT RABIES

 

What is the incubation period of rabies in animals and humans?

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The incubation period is the time between exposure and onset of clinical signs of disease. The incubation period may vary from a few days to several years, but typically lasts 1 to 3 months. This period is quite long because the rabies virus spreads slowly through the nerves to the spinal cord and brain. There are no signs of illness during the incubation period; rabies virus is not transmissible during this time. When the virus reaches the brain, it multiplies rapidly and passes to the salivary glands. At this point, clinical signs of rabies are evident and rabies virus can be transmitted via saliva.

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How can I protect my pet from rabies?

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First, visit your veterinarian with your pet on a regular basis and keep rabies vaccinations up-to-date for all dogs, cats, and ferrets. Second, maintain control of your pets by keeping cats and ferrets indoors and keeping dogs under direct supervision. Third, spay or neuter your pets to help reduce the number of unwanted pets that may not be properly cared for or vaccinated regularly. Lastly, call animal control to remove all stray animals from your neighborhood since these animals may be unvaccinated or ill.

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Why does my pet need the rabies vaccine?

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Although the majority of rabies cases occur in wildlife, most humans are given rabies vaccine as a result of exposure to domestic animals. This explains the tremendous cost of rabies prevention in domestic animals in the United States. While wildlife are more likely to be rabid than are domestic animals in the United States, the amount of human contact with domestic animals greatly exceeds the amount of contact with wildlife. Your pets and other domestic animals can be infected when they are bitten by rabid wild animals. When "spillover" rabies occurs in domestic animals, the risk to humans is increased. Pets are therefore vaccinated by your veterinarian to prevent them from acquiring the disease from wildlife and thereby transmitting it to humans.

 

The animal I’m treating is overdue for their rabies booster. Should I administer a 1 year or 3-year booster vaccine to overdue animals?

 

A 1 year or 3-year booster vaccine can be given to animals with an expired vaccine as long as the animal was initially vaccinated at the appropriate age with a 1-year vaccine. Veterinarians should check with their local rabies authority to see if the county has any regulations on 1 vs 3-year booster vaccines. Boosters should be administered, according to county specifications, if the animal is overdue for any length of time.  

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My dog just fought with a raccoon and I picked him up to see whether he had any wounds. Am I at risk for rabies?

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This would be considered of minimal risk but the first line of defense is to always wash hands with soap and water. Non-bite exposures (other than organ or tissue transplants) have rarely been proven to cause rabies and post-exposure prophylaxis is not indicated unless saliva or other potentially infectious material was directly introduced into fresh, open cuts in the skin or onto mucous membranes. Rabies virus is inactivated by desiccation, ultraviolet irradiation, and other factors and does not persist in the environment (e.g., on a dog’s fur).

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Can a vaccinated animal ever get rabies?

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Rabies is rare in vaccinated animals. If such an event is suspected, it should be reported immediately to District public health officials and the State Epidemiology Program. The laboratory diagnosis should be confirmed and the virus characterized by a rabies reference laboratory. A thorough epidemiologic investigation should be conducted.

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Can I use rabies titers as a substitute for current vaccination or in the management of domestic animals exposed to rabies?

 

No, rabies titers alone are only one marker of immunity and may not indicate absolute protection. Titers do not directly correlate with protection because other immunologic factors also play a role in preventing rabies and our abilities to measure and interpret those other factors are not well developed. Titers may only be used as documented in Appendix B: Progressive Serological Monitoring Protocol to determine past vaccination status of an animal with undocumented vaccine history.

 

Will the rabies vaccine make me sick?

 

Adverse reactions to rabies vaccine and immune globulin are not common. Newer vaccines in use today cause fewer adverse reactions than previously available vaccines. Mild, local reactions to the rabies vaccine, such as pain, redness, swelling, or itching at the injection site, have been reported. Rarely, symptoms such as headache, nausea, abdominal pain, muscle aches, and dizziness have been reported. Local pain and low-grade fever may follow injection of rabies immune globulin.

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What if I cannot get rabies vaccine on the day I am supposed to get my next dose?

 

Consult with your doctor or state or local public health officials for recommended times if there is going to be a change in the recommended schedule of shots. Rabies prevention is a serious matter and changes should not be made in the schedule of doses if at all possible.

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Should I be concerned about rabies when I travel outside the United States?

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Yes. Rabies and rabies-like viruses occur in animals anywhere in the world. When traveling, it is always prudent to avoid approaching any wild or domestic animal.  The developing countries in Africa, Asia, and Latin America have additional problems in that dog rabies is common there and human PEP may be difficult to obtain. The importance of rabid dogs in these countries, where tens of thousands of people die of the disease each year, cannot be overstated. Unlike programs in developed countries, dog rabies vaccination programs in developing countries have not always been successful. Before traveling abroad, consult a health care provider, travel clinic, or health department about your risk of exposure to rabies and how to handle an exposure should it arise. Medical assistance should be obtained as soon as possible after an exposure.

 

Can rabies be transmitted from one person to another?

 

The only documented cases of rabies caused by human-to-human transmission, although extremely rare, occurred among recipients of transplanted corneas and other solid organs. Organ and tissue transplantation resulting in rabies transmission has occurred among 16 transplant recipients from corneas (n=8), solid organs (n=7), and vascular tissue (n=1). The 16 cases occurred in six countries: the United States (5 cases: one cornea, three solid organs, and one vascular tissue), Germany (4 cases), Thailand (2 cases), India (2 cases), Iran (2 cases), and France (1 case). Investigations revealed that the donors had died of an illness compatible with or proven to be rabies. Stringent guidelines for acceptance of donor corneas have reduced this risk. No documented laboratory-diagnosed cases of human-to-human transmission have been documented from a bite or non-bite exposure other than the transplant cases. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (i.e., urine, blood, and feces) does not constitute an exposure and does not require PEP. In addition, contact with someone who is receiving rabies PEP does not constitute rabies exposure and does not require post-exposure prophylaxis.

 

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IMPORTANT PHONE NUMBERS TO HAVE

 

RABIES CONSULTATIONS

Georgia Poison Center- (Atlanta) 404-616-9000

*Toll Free Number: 800-222-1222

County/District Health Departments: See local phone directory

County Animal Control: See local phone directory

Epidemiology Program, DPH: 404-657-2588

CDC Clinician Information Line: 800-CDC-INFO (800-232-4636)

 

STATE PUBLIC HEALTH LABORATORIES

Georgia Public Health Laboratory (Decatur): 404-327-7900

GPHL Waycross Regional Laboratory: 912-285-6000

 

SOURCES FOR HUMAN RABIES VACCINE

Sanofi Pasteur: 800-VACCINE (800-822-2463)

(Imovax® Rabies - HDCV) www.vaccineplace.com/products/

Novartis Vaccines and Diagnostics 800-CHIRON8 (800-244-7668)

(RabAvert® - PCEC) www.rabavert.com

 

** This information was extracted from the Georgia Department of Public Health.