depar depar depar depar department of health and human ser tment of health and human ser tment of health and human ser tment of health and human ser tment of health and human services vices vices vices vices# Part I: Rabies Prevention and Control
A. Principles of Rabies Prevention and Control. 1. . . . . Rabies Exposure. Rabies is transmitted only when the virus is introduced into bite wounds, open cuts in skin, or onto mucous membranes from saliva or other potentially infectious material such as neural tissue (2). Questions about possible exposures should be directed to state or local public health authorities.

# 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 the administration of human rabies immune globulin and vaccine.
The rationale for recommending preexposure and postexposure rabies prophylaxis and details of their administration can be found in the current recommendations of the Advisory Committee on Immunization Practices (ACIP) (2). These recommendations, along with information concerning the current local and regional epidemiology of animal rabies and the availability of human rabies biologics, are available from state health departments.

# 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. Such procedures in the United States have reduced laboratory-confirmed cases of rabies in dogs from 6,949 in 1947 to 94 in 2004 (3). Because more rabies cases are reported annually involving cats (281 in 2004) than dogs, vaccination of cats should be required. Animal shelters and animal control authorities should establish policies to ensure that adopted animals are vaccinated against rabies. The recommended vaccination procedures and the licensed animal vaccines are specified in Parts II and III of the compendium, respectively. 4. Rabies in Vaccinated Animals. Rabies is rare in vaccinated animals (4)

# Compendium of Animal Rabies Prevention and Control, 2006- National Association of State Public Health Veterinarians, Inc. (NASPHV)
Rabies is a fatal viral zoonosis and a serious public health problem (1). The recommendations in this compendium serve as a basis for animal rabies prevention and control programs throughout the United States and facilitate standardization of procedures among jurisdictions, thereby contributing to an effective national rabies-control program. This document is reviewed annually and revised as necessary. These recommendations do not supersede state and local laws or requirements. Principles of rabies prevention and control are detailed in Part I; Part II contains recommendations for parenteral vaccination procedures; all animal rabies vaccines licensed by the United States Department of Agriculture (USDA) and marketed in the United States are listed in Part III. Rabies vaccinations may also be administered under the supervision of a veterinarian to animals held in animal control shelters prior to release. Any veterinarian signing a rabies certificate must ensure that the person administering vaccine is identified on the certificate and is appropriately trained in vaccine storage, handling, and administration and in the management of adverse events. This practice assures that a qualified and responsible person can be held accountable to ensure 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 this compendium.
Regardless of the age of the animal at initial vaccination, a booster vaccination should be administered 1 year later (see Parts II and III for vaccines and procedures). No laboratory or epidemiologic data exist to support the annual or biennial administration of 3-year vaccines following the initial series. Because a rapid anamnestic response is expected, an animal is considered currently vaccinated immediately after a booster vaccination. a. Dogs, Cats, and Ferrets. All dogs, cats, and ferrets should be vaccinated against rabies and revaccinated in accordance with Part III of this compendium. If a previously vaccinated animal is overdue for a booster, it should be revaccinated. Immediately following the booster, the animal is considered currently vaccinated and should be placed on an annual or triennial schedule depending on the type of vaccine used. b. Livestock. Consideration should be given to vaccinating livestock that are particularly valuable or that might have frequent contact with humans (e.g., in petting zoos, fairs, and other public exhibitions) (11,12). Horses traveling interstate should be currently vaccinated against rabies. c. Confined Animals. The following are recommendations for owners of livestock exposed to rabid animals: 1) If the animal is slaughtered within 7 days of being bitten, its tissues may be eaten without risk of infection, provided that liberal portions of the exposed area are discarded. Federal guidelines for meat inspectors require that any animal known to have been exposed to rabies within 8 months be rejected for slaughter. 2) Neither tissues nor milk from a rabid animal should be used for human or animal consumption (20). Pasteurization temperatures will inactivate rabies virus; therefore, drinking pasteurized milk or eating cooked meat does not constitute a rabies exposure. 3) Having more than one rabid animal in a herd or having herbivore-to-herbivore transmission is uncommon; therefore, restricting the rest of the herd if a single animal has been exposed to or infected by rabies might not be necessary. c. Other Animals. Other mammals bitten by a rabid animal should be euthanized immediately. Animals maintained in USDA-licensed research facilities or accredited zoological parks should be evaluated on a case-by-case basis.
6. Management of Animals that Bite Humans. a. Dogs, Cats, and Ferrets. 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 (21)(22)(23)(24). A healthy dog, cat, or ferret that bites a person should be confined and observed daily for 10 days; administration of rabies vaccine to the animal is not recommended during the observation period to avoid confusing signs of rabies with possible side effects of vaccine administration. Such animals should be evaluated by a veterinarian at the first sign of illness during confinement. Any illness in the animal should be reported immediately to the local health department.
If signs suggestive of rabies develop, the animal should be euthanized and the head shipped for testing as described in Part I.A.7. Any stray or unwanted dog, cat, or ferret that bites a person may be euthanized immediately and the head submitted for rabies examination. b. Other Biting Animals. Other biting animals which might have exposed a person to rabies should be reported immediately to the local health department. Management of animals other than dogs, cats, and ferrets depends on the species, the circumstances of the bite, the epidemiology of rabies in the area, the biting animal's history, current health status, and potential for exposure to rabies. Prior vaccination of these animals may not preclude the necessity for euthanasia and testing. 7. Outbreak Prevention and Control. The emergence of new rabies virus variants or the introduction of non indigenous viruses poses a significant risk to humans, domestic animals and wildlife (25)(26)(27)(28)(29)(30)(31). A rapid and comprehensive response should include all or some of the following measures: a. Characterize the virus at a national or regional reference laboratory. b. Identify and control the source of the introduction. c. Enhance laboratory-based surveillance in wild and domestic animals. d. Increase animal rabies vaccination rates. e. Restrict the movement of animals. f. Evaluate the need for vector population reduction. g. Coordinate a multi-agency response. h. Provide public and professional outreach and education.  (41). No laboratory or epidemiologic data exist to support the annual or biennial administration of 3-year vaccines following the initial series. C. Adverse Events. Currently, no epidemiologic association exists between a particular licensed vaccine product and adverse events, including vaccine failure (42,43 Computer-generated forms containing the same information are also acceptable.