Human rabies postexposure prophylaxis and rabid terrestrial animals in Ontario, Canada: 2014-2016.

D Middleton,B Warshawsky,S Johnson,L Friedman,S Buchan

doi:10.14745/ccdr.v45i78a02

Abstract

The number of rabid terrestrial animals in Ontario has decreased markedly since the 1970s and 1980s. However, the number of recommended rabies postexposure prophylaxis (RPEP) courses has not decreased proportionally. The decision to recommend RPEP for terrestrial animal exposures should be based on a risk assessment that considers the prevalence of rabies in these animals within a jurisdiction, among other factors. To explore trends in RPEP recommendations for exposures to terrestrial animals in Ontario in relation to the recency of terrestrial animal rabies cases by public health unit (PHU) jurisdiction. RPEP recommendation data for the 36 Ontario PHUs were obtained from the Ontario integrated Public Health Information System and animal rabies data by PHU were obtained from the Ministry of Natural Resources and Forestry. We calculated the annual RPEP recommendation rates for terrestrial animals by PHU for 2014 to 2016, and plotted the 2016 rates in relation to the year of the most recently identified rabid terrestrial animal in the PHU. Between 2014 and 2016, the annual RPEP recommendation rates for terrestrial animal exposures by PHU ranged from 3.0 to 35.2 per 100,000 persons, with a median of 11.9 RPEP recommendations per 100,000 persons. In 2016, ten PHUs had not identified a rabid terrestrial animal in their jurisdiction for more than15 years. Five of these PHUs had RPEP recommendation rates above the provincial median. Along with other factors, consideration of the occurrence of rabies in terrestrial animals in a jurisdiction can assist in the risk assessment of dogs, cats or ferrets that are not available for subsequent observation.

Highlights

Rabies in humans as a result of exposure to a terrestrial animal has not been identified for over 50 years in Canada
Along with other factors, consideration of the occurrence of rabies in terrestrial animals in a jurisdiction can assist in the risk assessment of dogs, cats or ferrets that are not available for subsequent observation
Our analysis found that the recency of the last rabid terrestrial animal did not seem to be associated with the respective rabies postexposure prophylaxis (RPEP) recommendation rates by public health unit (PHU)

Summary

Introduction

Rabies in humans as a result of exposure to a terrestrial animal has not been identified for over 50 years in Canada In Ontario, Canada the number of terrestrial animals identified with rabies has been very low in recent years (Figure 1) with two exceptions. These exceptions were an epizootic of the raccoon strain of rabies in central west Ontario, which was identified in late 2015 and originated from a translocated raccoon, and an ongoing enzootic of the Arctic fox strain of rabies in south west and central west Ontario [1]. The marked decrease in terrestrial animal rabies in Ontario has been attributed to the wildlife rabies vaccination program run by the Ontario Ministry of Natural Resources and Forestry, which began. The decision to recommend RPEP for terrestrial animal exposures should be based on a risk assessment that considers the prevalence of rabies in these animals within a jurisdiction, among other factors

Methods

Results

Discussion

Conclusion