Compendium of Animal Rabies Control, 1995 National Association of State Public Health Veterinarians, Inc. *

The purpose of this Compendium is to provide rabies information to veterinarians, public health officials, and others concerned with rabies control. These recommendations serve as the basis for animal rabies-control programs throughout the United States and also facili- tate standardization of procedures among jurisdictions, thereby contributing to an effective national rabies-control program. This document is reviewed annually and revised as necessary. Recommenda- tions for immunization procedures are contained in Part I; all animal rabies vaccines licensed by the U.S. Department of Agriculture (USDA) and marketed in the United States are listed in Part II; Part III details the principles of rabies control.

Part I: Recommendations for Immunization Procedures

1. Vaccine Administration

All animal rabies vaccines should be restricted to use by, or under the direct supervision of, a veterinarian.

B. Vaccine Selection

In comprehensive rabies-control programs, only vaccines with a 3-year duration of immunity should be used. This procedure constitutes the most effective method of increasing the proportion of immunized dogs and cats in any population. (See Part II.)

C. Route of Inoculation

All vaccines must be administered in accordance with either the specifications of the product label or the package insert. If adminis- tered intramuscularly, vaccine must be administered at one site in the thigh.

D. Wildlife Vaccination

Parenteral vaccination of captive wildlife is not recommended because the efficacy of rabies vaccines in such animals has not been established and no vaccine is licensed for wildlife. For this reason and because virus-shedding periods are unknown, bats and wild or exotic carnivores should not be kept as pets. Zoos or research insti- tutions may establish vaccination programs that attempt to protect valuable animals, but these programs should not be in lieu of appro- priate public health activities that protect humans. The use of licensed oral vaccines for the mass immunization of wildlife should be considered in selected situations, with the approval of the state agency responsible for animal rabies control.

E. Accidental Human Exposure to Vaccine

Accidental inoculation may occur during administration of animal rabies vaccine. Such exposure to inactivated vaccines constitutes no risk for acquiring rabies.

F. Identification of Vaccinated Animals

All agencies and veterinarians should adopt the standard tag system. This practice will aid persons who administer local, state, national, and international rabies control procedures. Animal license tags should be distinguishable in shape and color from rabies tags. Anodized aluminum rabies tags should be no less than 0.064 inches in thickness.

1. Rabies Tags

2. Rabies Certificate. All agencies and veterinarians should use the NASPHV form #51, Rabies Vaccination Certificate, which can be obtained from vaccine manufacturers. Computer-generated forms containing the same information are acceptable.

Part II: Vaccines Marketed in the United States and NASPHV Recommenda- tions Table_1

Part III: Rabies Control

1. Principles of Rabies Control

1. 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 passive and active immuniza- tion. Both the rationale for recommending preexposure and postexposure rabies prophylaxis and details of their adminis- tration can be found in the current recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Public Health Service (PHS). These recommendations are avail- able from state health departments, along with information concerning the current local and regional status of animal rabies and the availability of human rabies biologics.

2. Rabies in Domestic Animals. Local governments should initiate and maintain effective programs to ensure vaccination of all dogs and cats and to remove strays and unwanted animals. Such procedures in the United States have reduced laboratory- confirmed rabies cases in dogs from 6,949 in 1947 to 130 in 1993. Because more rabies cases are reported annually involving cats than dogs, vaccination of cats should be required. The recommended vaccination procedures and the licensed animal vaccines are specified in Parts I and II of the Compendium.

3. Rabies in Wildlife. The control of rabies among wildlife reservoirs is difficult. Selective population reduction may be useful in some situations, but the success of such procedures depends on the circumstances surrounding each rabies outbreak. (See C. Control Methods in Wildlife.)

2. Control Methods in Domestic and Confined Animals

1. Preexposure Vaccination and Management. Animal rabies vaccines should be administered only by, or under the direct super- vision of, a veterinarian. This is the only way to ensure that a responsible person can be held accountable to assure the public that an animal has been properly vaccinated. Within 1 month 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 it was vaccinated at least 30 days previously and if all vaccinations have been administered in accordance with this Compendium. Regardless of the age at initial vaccination, a second vaccination should be given 1 year later. (See Parts I and II for recommended vaccines and procedures.)

1. Dogs and Cats. All dogs and cats should be vaccinated against rabies at 3 months of age and revaccinated in accordance with Part II of this Compendium.

2. Ferrets. Ferrets can be vaccinated against rabies at 3 months of age and revaccinated in accordance with Part II of this Compendium.

3. Livestock. It is neither economically feasible nor justi- fied from a public health standpoint to vaccinate all livestock against rabies. However, consideration should be given to the vaccination of livestock, especially animals that are particularly valuable and/or might have frequent contact with humans, in areas where rabies is epizootic in terrestrial animals.

4. Other Animals

1. Wild. No rabies vaccine is licensed for use in wild animals. Because of the risk for rabies among wild animals (especially raccoons, skunks, coyotes, foxes, and bats), the American Veterinary Medical Association (AVMA), the National Associa- tion of State Public Health Veterinarians, Inc. (NASPHV), and the Council of State and Territorial Epidemiologists (CSTE) recommend the enactment of state laws prohibiting the importation, distribu- tion, relocation, or keeping of wild animals and wild animals that are crossbred to domestic dogs and cats as pets.

2. Maintained in Exhibits and in Zoological Parks. Captive animals that are not completely excluded from all contact with rabies vectors can become infected. Moreover, wild animals can be incubating rabies when initially captured; therefore, wild- caught animals susceptible to rabies should be quarantined for a minimum of 180 days before exhi- bition. Persons (e.g., employees) who work with animals at such facilities should receive preexpo- sure rabies immunization. The use of preexposure or postexposure rabies immunizations of persons who work with animals at such facilities might reduce the need for euthanasia of captive animals.

2. Stray Animals. Stray dogs and cats should be removed from the community, especially in areas where rabies is epizootic. Local health departments and animal control officials can enforce the removal of strays more effectively if owners either confine their animals or keep them on leash. Strays should be impounded for at least 3 days to determine if human exposure has occurred and to give owners sufficient time to reclaim animals.

3. Quarantine

1. International. CDC regulates the importation of dogs and cats into the United States, but current PHS regulations ** governing the importation of such animals are insuffi- cient to prevent the introduction of rabid animals into the country. All dogs and cats imported from countries with enzootic rabies should be currently vaccinated against rabies as recommended in this Compendium. Appro- priate public health officials of the state of destination should be notified within 72 hours of any unvaccinated dog or cat imported into their jurisdiction. The conditional admission of such animals into the United States is subject to state and local laws governing rabies. Failure to comply with these requirements should be reported promptly to the Division of Quarantine, CDC (404) 6398107.

2. Interstate. Before interstate movement, dogs and cats should be currently vaccinated against rabies in accor- dance with the Compendium's recommendations. (See B.1. Preexposure Vaccination and Management.) Animals in tran- sit should be accompanied by a currently valid NASPHV Form #51, Rabies Vaccination Certificate.

4. Adjunct Procedures. Methods or procedures that enhance rabies control include the following:

1. Licensure. Registration or licensure of all dogs and cats can be used to aid in rabies control. A fee is frequently charged for such licensure, and revenues collected are used to maintain rabies or animal control programs. Vacci- nation is an essential prerequisite to licensure.

2. Canvassing of Area. House-to-house canvassing by animal control personnel facilitates enforcement of vaccination and licensure requirements.

3. Citations. Citations are legal summonses issued to owners for violations, including the failure to vaccinate or license their animals. The authority for officers to issue citations should be an integral part of each animal con- trol program.

4. Animal Control. All communities should incorporate stray animal control, leash laws, and training of personnel in their programs.

5. Postexposure Management. Any animal bitten or scratched by a wild, carnivorous mammal (or a bat) not avail- able for testing should be regarded as having been exposed to rabies.

1. Dogs and Cats. Unvaccinated dogs and cats exposed to a rabid animal should be euthanized immediately. If the owner is unwilling to do this, the animal should be placed in strict isolation for 6 months and vaccinated 1 month before being released. Dogs and cats that are currently vaccinated should be revaccinated immediately, kept under the owner's control, and observed for 45 days.

2. Livestock. All species of livestock are susceptible to rabies; cattle and horses are among the most frequently infected of all domestic animals. Livestock that is exposed to a rabid animal and is currently vaccinated with a vaccine approved by USDA for that species should be revaccinated immediately and observed for 45 days. Unvac- cinated livestock should be slaughtered immediately. If the owner is unwilling to do this, the animal should be kept under close observation for 6 months. The following are recommendations for owners of unvacci- nated 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 liberal portions of the exposed area are discarded. Federal meat inspectors must reject for slaughter any animal known to have been exposed to rabies within 8 months.

2. Neither tissues nor milk from a rabid animal should be used for human or animal consumption. However, because pasteurization temperatures will inactivate rabies virus, drinking pasteurized milk or eating cooked meat does not constitute a rabies exposure.

3. It is rare to have more than one rabid animal in a herd or to have herbivore-to-herbivore transmission; therefore; it may not be necessary to restrict the rest of the herd if a single animal has been exposed to or infected by rabies.

3. Other Animals. Other animals bitten by a rabid animal should be euthanized immediately. Such animals currently vaccinated with a vaccine approved by USDA for that species can be revaccinated immediately and placed in strict isolation for at least 90 days.

6. Management of Animals That Bite Humans. A healthy dog or cat that bites a person should be confined and observed for 10 days; it is recommended that rabies vaccine not be adminis- tered during the observation period. 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 humanely killed, its head removed, and the head shipped under refriger- ation for examination by a qualified laboratory designated by the local or state health department. Any stray or unwanted dog or cat that bites a person may be humanely killed immedi- ately and the head submitted as described above for rabies examination. Other biting animals that might have exposed a person to rabies should be reported immediately to the local health department. Prior vaccination of an animal may not preclude the necessity for euthanasia and testing if the period of virus shedding is unknown for that species. Manage- ment of animals other than dogs and cats depends on the species, the circumstances of the bite, and the epidemiology of rabies in the area.

3. Control Methods in Wildlife

The public should be warned not to handle wildlife. Wild mammals (as well as the offspring of wild species cross-bred with domestic dogs and cats) that bite or otherwise expose humans, pets, or live- stock to rabies should be considered for euthanasia and rabies exami- nation. A person bitten by any wild mammal should immediately report the incident to a physician who can evaluate the need for antirabies treatment. ***

1. Terrestrial Mammals. Continuous and persistent government- funded programs for trapping or poisoning wildlife are not cost effective in reducing wildlife rabies reservoirs on a statewide basis. However, limited control in high-contact areas (e.g., picnic grounds, camps, or suburban areas) might be indicated for the removal of selected high-risk species of wildlife. The state wildlife agency and state health depart- ment should be consulted for coordination of any proposed population reduction programs.

2. Bats. Indigenous rabid bats have been reported from every state except Alaska and Hawaii and, since 1951, have been associated with at least 21 human deaths in the United States. However, it is neither feasible nor desirable to control rabies in bats through programs to reduce bat populations. Bats should be excluded from houses and surrounding structures to prevent direct association with humans. Such structures should then be made bat-proof by sealing entrances used by bats.

THE NASPHV COMMITTEE: Suzanne R. Jenkins, VMD, MPH, Chair; Keith A. Clark, DVM, PhD; John G. Debbie, MS, DVM; Russell J. Martin, DVM, MPH; Grayson B. Miller, Jr., MD; F. T. Satalowich, DVM, MSPH; Faye E. Sorhage, VMD, MPH. CONSULTANTS TO THE COMMITTEE: James E. Childs, ScD, (Centers for Disease Control and Prevention {CDC}); Robert B. Miller, DVM, MPH (APHIS, USDA); Patrick Morgan, DVM, DrPH (AVMA Council on Public Health and Regulatory Veterinary Medicine); Charles E. Rupprecht, VMD, PhD (CDC); R. Keith Sikes, DVM, MPH; Richard A. Zehr (Veterinary Biologics Section, Animal Health Institute). ENDORSED BY: American Veterinary Medical Association (AVMA); Council of State and Territorial Epidemiologists (CSTE). Address all correspondence to: Suzanne R. Jenkins, VMD, MPH, Office of Epidemiology, Virginia State Department of Health, P.O. Box 2448, Richmond, VA 23218. ** 42 CFR No. 71.51. *** Centers for Diesase Control and Prevention. Rabies Prevention -- United States, 1991. MMWR 1991;40(No. RR-3):1-19.

Table 1. Vaccines Marketed in the United States and NASPHV Recommendations
============================================================================================================================================

                                                                         For use  Dosage        Age at         Booster         Route of
                                                                           in      (mL)        primary       recommended      inoculation
Product name        Produced by                Marketed by                                    vaccination *
--------------------------------------------------------------------------------------------------------------------------------------------
A) INACTIVATED
--------------------------------------------------------------------------------------------------------------------------------------------
TRIMUNE             Fort Dodge                 Fort Dodge                 Dogs      1            3 mos &      Triennially          IM +
                    License No. 112                                       Cats      1           1 yr later    Triennially          IM

ANNUMUNE            Fort Dodge                 Fort Dodge                 Dogs      1             3 mos       Annually             IM
                    License No. 112                                       Cats      1             3 mos       Annually             IM

DURA-RAB 1          ImmunoVet                  ImmunoVet, Vedco, Inc.     Dogs      1             3 mos       Annually             IM
                    License No. 302-A                                     Cats      1             3 mos       Annually             IM

DURA-RAB 3          ImmunoVet                  ImmunoVet, Vedco, Inc.     Dogs      1            3 mos &      Triennially          IM
                    License No. 302-A                                     Cats      1           1 yr later    Triennially          IM

RABCINE 3           ImmunoVet                  SmithKline Beecham         Dogs      1            3 mos &      Triennially          IM
                    License No. 302- A         Animal Health              Cats      1           1 yr later    Triennially          IM

ENDURALL-K          SmithKline Beecham         SmithKline Beecham         Dogs      1             3 mos       Annually             IM
                    License No. 189            Animal Health              Cats      1             3 mos       Annually             IM

ENDURALL-P          SmithKline Beecham         SmithKline Beecham         Dogs      1             3 mos       Annually          IM or SQ &
                    License No. 189            Animal Health              Cats      1             3 mos       Annually             SQ

RABGUARD-TC         SmithKline Beecham         SmithKline Beecham         Dogs      1            3 mos &      Triennially          IM
                    License No. 189            Animal Health              Cats      1           1 yr later    Triennially          IM
                                                                          Sheep     1             3 mos       Annually             IM
                                                                          Cattle    1             3 mos       Annually             IM
                                                                          Horses    1             3 mos       Annually             IM

DEFENSOR            SmithKline Beecham         SmithKline Beecham         Dogs      1            3 mos &      Triennially       IM or SQ
                    License No. 189            Animal Health              Cats      1           1 yr later    Triennially          SQ
                                                                          Sheep     2             3 mos       Annually             IM
                                                                          Cattle    2             3 mos       Annually             IM

RABDOMUN            SmithKline Beecham         Mallinckrodt Veterinary,   Dogs      1            3 mos &      Triennially       IM or SQ
                    License No. 189            Inc.                       Cats      1           1 yr later    Triennially          SQ
                                                                          Sheep     2             3 mos       Annually             IM
                                                                          Cattle    2             3 mos       Annually             IM

RABDOMUN-1          SmithKline Beecham         Mallinckrodt Veterinary,   Dogs      1             3 mos       Annually          IM or SQ
                    License No. 189            Inc.                       Cats      1             3 mos       Annually             SQ

SENTRYRAB 1         SmithKline Beecham         Synbiotics Corp.           Dogs      1             3 mos       Annually             IM
                    License No. 225                                       Cats      1             3 mos       Annually             IM

CYTORAB             Coopers Animal Health,     Coopers Animal Health,     Dogs      1             3 mos       Annually             IM
                    Inc., License No. 107        Inc.                     Cats      1             3 mos       Annually             IM

TRIRAB              Coopers Animal Health,     Coopers Animal Health,     Dogs      1            3 mos &      Triennially          IM
                    Inc., License No. 107        Inc.                                           1 yr later
                                                                          Cats      1             3 mos       Annually             IM

EPIRAB              Coopers Animal Health,     Coopers Animal Health,     Dogs      1            3 mos &      Triennially          IM
                    Inc., License No. 107        Inc.                     Cats      1           1 yr later    Triennially          IM

RABVAC 1            Solvay Animal Health,      Solvay Animal Health,      Dogs      1             3 mos       Annually          IM or SQ
                    Inc., License No. 195-A      Inc.                     Cats      1             3 mos       Annually          IM or SQ

RABVAC 3            Solvay Animal Health,      Solvay Animal Health,      Dogs      1            3 mos &      Triennially       IM or SQ
                    Inc., License No. 195-A      Inc.                     Cats      1           1 yr later    Triennially       IM or SQ
                                                                          Horses    2             3 mos       Annually             IM

PRORAB 1            Intervet, Inc.             Intervet, Inc.             Dogs      1             3 mos       Annually          IM or SQ
                    License No. 286                                       Cats      1             3 mos       Annually          IM or SQ
                                                                          Sheep     2             3 mos       Annually             IM

RM IMRAB 1          Rhone Merieux, Inc.        Rhone Merieux, Inc.        Dogs      1             3 mos       Annually          IM or SQ
                    License No. 298                                       Cats      1             3 mos       Annually          IM or SQ

RM IMRAB BOVINE     Rhone Merieux, Inc.        Rhone Merieux, Inc.        Cattle    2             3 mos       Annually          IM or SQ
PLUS                License No. 298                                       Horses    2             3 mos       Annually          IM or SQ
                                                                          Sheep     2             3 mos       Triennially       IM or SQ

RM IMRAB 3          Rhone Merieux, Inc.        Rhone Merieux, Inc.        Dogs      1            3 mos &      Triennially       IM or SQ
                    License No. 298                                       Cats      1           1 yr later    Triennially       IM or SQ
                                                                          Sheep     2            3 mos &      Triennially       IM or SQ
                                                                                                1 yr later
                                                                          Cattle    2             3 mos       Annually          IM or SQ
                                                                          Horses    2             3 mos       Annually          IM or SQ
                                                                          Ferrets   1             3 mos       Annually             SQ
--------------------------------------------------------------------------------------------------------------------------------------------
B) COMBINATION      (inactivated rabies)
--------------------------------------------------------------------------------------------------------------------------------------------
ECLIPSE 3 KP-R      Solvay Animal Health,      Solvay Animal Health,      Cats      1             3 mos       Annually             IM
                    Inc., License No. 195-A      Inc.

ECLIPSE 4 KP-R      Solvay Animal Health,      Solvay Animal Health,      Cats      1             3 mos       Annually             IM
                    Inc., License No. 195-A      Inc.

CYTORAB RCP         Coopers Animal Health,     Coopers Animal Health,     Cats      1             3 mos       Annually             IM
                    Inc., License No. 107        Inc.

FEL-O-VAX           Fort Dodge                 Fort Dodge                 Cats      1            3 mos &      Triennially          IM
PCT-R               License No. 112                                                             1 yr later

RM FELINE 4 +       Rhone Merieux, Inc.        Rhone Merieux, Inc.        Cats      1            3 mos &      Triennially          SQ
IMRAB 3             License No. 298                                                             1 yr later

RM FELINE 3 +       Rhone Merieux, Inc.        Rhone Merieux, Inc.        Cats      1            3 mos &      Triennially          SQ
IMRAB 3             License No. 298                                                             1 yr later

RM EQUINE           Rhone Merieux, Inc.        Rhone Merieux, Inc.        Horses    1             3 mos       Annually             IM
POTOMAVAC           License No. 298
+ IMRAB
--------------------------------------------------------------------------------------------------------------------------------------------
* >= 3 months of age and revaccinated 1 year later.
+ Intramuscularly.
& Subcutaneously.
============================================================================================================================================

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