Challenging rabies cases:

2015

Theresa Burns DVM MSc PhD, Centre for Coastal HealthMelissa McLaws DVM PhD, BC Centre for Disease Control

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Recommended rabies vaccination protocol for dogs and cats

• Vaccinate at 12 to 16 weeks of age• Vaccinate at 1 year of age• Vaccinate every 1 or 3 years (as indicated on the vaccine label)

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Unvaccinated (no documented rabies vaccination in the animal’s lifetime)

• Administer a rabies vaccination• stimulate protective immunity for both the immediate exposure event

and potential future exposure events• equivocal evidence that vaccination soon after rabies exposure may decrease

the likelihood of developing clinical rabies• evidence that in exposed animals that do go on to develop rabies, post-

exposure rabies vaccination may reduce incubation times and hasten death

• Test suspect animal (i.e. bat) if available

• Isolation and observation• 90 days if receive rabies vaccination within 7 days• 180 days if NOT receive rabies vaccination within 7 days• OR euthanasia

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Vaccinated but out of date (longer than label claim since animal’s last vaccination)

• Administer a rabies vaccination• stimulate an anamnestic response and protective immunity • evidence that most animals that are previously vaccinated, but out of date,

develop an antibody titre after being administered a booster and that the response is not inferior to currently vaccinated animals by day 15

• evidence that in exposed animals that do go on to develop rabies, post-exposure rabies vaccination may reduce incubation times and hasten death

• Test suspect animal (i.e. bat) if available

• Isolation and observation decisions on a case-by-case • usually no further action if receive booster within 7 days• usually 90 days isolation if booster is not received

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Case 1: A “classic” cat-bat (VIHA/FHA)• Lady at cabin, sleeping in bed with her 2 cats (VIHA)• Woke up to find bat that could not fly in bedroom• Appeared to be wounds on bat• Bat was euthanized and placed in the freezer

• Lady noticed a small mark on her cheek• Vaccination status on cats unknown• Husband called PHV directly around 2PM• By this time owner and cat’s were on the ferry heading home (FHA) • Luckily, the lady had packed the bat in her cooler

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Case 2: Bat in animal shelter (VCH)• A bat was surrendered to an animal shelter on a weekend• Bat was ‘acting normally’• Shelter contacted wildlife rescue organization to pick up the bat• Sometime later the bat was ‘no longer there’• During an attempted escape, the bat would have had to pass through cat

housing area

• 30 cats in shelter• Some in individual cages• Some ‘free-range’ within the housing area

• All cats unvaccinated• Shelter staff contacted PHV for advice within a few hours of bat

sighting

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Case 3: Bat/cat/person (NHA)

• Bat displaying unusual behaviour attacked cat and person• Person contacted NHA directly• Bat was euthanized and submitted to CFIA• Rabies positive

• Veterinarian called PHV for advice on managing the cat• Cat previously vaccinated but out of date- 1 vaccine in 2008• Cat received rabies vaccine booster ~4 days after bat encounter• Outdoor cat, concern re owner’s ability to isolate it

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Case 4 and 5: Puppies and kittens• Vaccines are labelled for use in puppies and kittens more than 12 weeks of age • Puppies and kittens less than 12 weeks of age do not require rabies

vaccination for import into Canada• Case 4 (FHA)

• 10 week old puppy purchased from pet store in Peru and imported to Canada• Puppy unvaccinated • Puppy unwell since purchase

• Diarrhea, salivation (frothing), champing of jaws and tremors. • Treated in a veterinary hospital for 3 days

• Isolation protocol implemented at 48 hour mark of hospitalization• Four staff handled puppy- 2 had been vaccinated against rabies some years earlier

• Both owners had rabies vaccines as children as Peru has endemic canine rabies• Puppy reported to have been in kennel without human contact during transport

• Case 5 (IHA)• 10 week old unvaccinated puppy• Brought dead bat in house

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Case 6: Raccoon bite in a person (VCH)

• Person attacked by a racoon while feeding it • Visited emergency room • Physician informed that no racoon rabies in BC so PEP unnecessary

• Person called their veterinarian with further questions• Veterinarian suggested there may be a rabies risk

• Person contacted PHV directly within 24 hours of event

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Comments?

Contributors:BCCDC: Drs. Eleni Galanis, Melissa McLaws, Jennifer KoemanMinistry of Agriculture: Drs. Brian Radke, Jane PritchardMinistry of Environment: Dr. Helen SchwantjeCollege of BC Veterinarians: Dr. John BrocklebankCentre for Coastal Health: Drs. Carl Ribble and Tyler Stitt, Stefan Iwasawa