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Veterinary Information

 

The following information includes information of concern for wildlife rehabilitators. Included is information about suggested protocols for various species.

Some information was published in the late 1990's and has since changed or specified vaccines are not available or used.  Consult the CDC website for the most current protocols on rabies vaccines and recommendations. 

 

Contents:

 


Procedures and Guidelines for Wildlife Rehabilitators Who Handle Rabies-Vector Species

by Jo Balliet, LWR
Wounded Knee Wildlife Refuge, Inc.  Tabernacle, NJ

 

Protocol for working with raccoons:

  1. Only pre-immunized handlers should work with raccoons.

  2. All raccoons should be considered rabies exposed.

  3. Latex examination or household gloves should be worn at all times while working with nursing raccoons. Soiled bedding, bottles and nipples, and soiled housing should be handled with latex gloves.

  4. Raccoon litters should not be housed together until such time that killed rabies vaccine inoculation has been boostered; a minimum of three (3) weeks. (See publication #1 of the Pacific Wildlife Project publication list.)

  5. Inoculation should be considered at intake, regardless of age.

  6. To each litter, assign a bottle/nipple which we carry a number corresponding to the number assigned to the housing tank. (Aquarium tanks are recommended for neonates for many reasons, including ease of disinfecting.)

  7. After use, thoroughly disinfect each bottle (externally) with Novalsan Surgical Scrub (while hands are still gloved), dry, encase in a plastic sandwich bag, and refrigerate. If empty, the bottle should be cleaned internally in the normal manner before storage. Sterilize bottles and nipples at least once daily.

  8. After care of litter, disposal of latex examination gloves is a must. Latex household gloves shall be disinfected in the manner described above.

  9. Do not hold the animal near your face. (Prevents accidental mucous membrane transmission.)

  10. Do not place soiled gloves, bottles, or bedding near your face.

  11. If unknown mucous membrane invasion is questionable, the use of a face mask and safety glasses is recommended. (One doesn't go scuba diving without the necessary equipment!)

  12. Use latex household gloves during all phases of outdoor cage and accessory cleaning. Disinfect gloves frequently.

  13. Each raccoon's assigned admission number should follow it from intake to release.

NOTE: Excluding vaccination, these procedures should be applied to all mammal species with the possible exception of squirrels and rabbits.

 


 

Unfolding the Mysteries of Pre-Exposure Rabies Vaccines

by Jo Balliet, LWR New Jersey

 

INTRODUCTION:

Wildlife rehabilitators who work with mammal species should strongly consider participation in a pre-exposure rabies immunization program. As rehabilitators, we are in the "frequent" risk category as classified by the U.S. Department of Health and Human Services. Included in that category are rabies diagnostic laboratory technicians. The Department recommends a course of pre exposure rabies vaccine, followed at two years by a serology (serum titer) test and, if necessary, a booster shot. (See BOOSTER DOSE).

 

VACCINE SUPPLY AND ADMINISTRATION:

The vaccine, manufactured by Pasteur Merieux Serums and Vaccines S.A., Lyon, France, is distributed by Connaught Laboratories, Inc., Swiftwater, Pennsylvania (1-800-822-2463). It is pre-packaged for the route in which it is to be administered; 1.0 ml for IM (intramuscular) injections. There have been reported cases of inadequate protection when the ID route was used. (Pers. conv., Getson, 1989, Nash, 1992.) This could have been the result of improper administration.

 

Intradermal (ID) injections must be administered between layers of the skin, not subcutaneously (beneath the skin). The vaccine instruction sheet clearly states, "If the intradermal inoculation was not performed satisfactorily (vaccine injected subcutaneously), another dose should be given intradermally at a different site."

 

When scheduling the ID route of pre-exposure vaccine administration through your primary caregiver, confirm that the vaccine will be given as directed by the manufacturer. Keep in mind that the ID route of administration is for pre-exposure only. The IM injection is effective for pre- and post-exposure but is much more expensive per injection. If unable to acquire the less expensive ID pre-exposure inoculation through your primary caregiver, ask to join the vaccine program of the local health department or a veterinary hospital. If eligible to use a military hospital, contact the communicable disease section of that facility for information. Some HMO programs will cover the cost of the vaccination and its administration.

 

**NOTE:  Intradermal vaccine was discontinued for use in the USA and Canada.  Some studies as to its effectiveness are currently underway (June 2010)

 

ORGANIZING A PRE-EXPOSURE VACCINE PROGRAM:

Team up with regional rehabilitators and their volunteers and set up your own vaccine program. Contact the distribution laboratory at the telephone number listed above for a price quote. A donor/supporter of your rehabilitation program may be a medical caregiver who will administer your program or can fefer you to other medical personnel who will donate their services. Or contact an RN in a regional hospital's immunization clinic or ICU. You may be surprised at the cooperation you will receive because you rehabilitate wildlife.

 

When all participants are signing up and an RN's volunteer services have been confirmed, your will need a volunteer physician to oversee your program and order the vaccine. Collect the cost of the vaccine up front so funds will be available when it's shipped. Finally, if you are ot comfortable with having the vaccine administered at your facility, contact your veterinarian concerning use of his/her animal hospital facility. With the cooperation of our veterinary, our vaccine program begins at 10am on Sunday morning which coincides with the kennel person's presence to open and close the facility. Each participant of the vaccine program is asked to sign a release agreement prior to receiving the vaccine. The release agreement lists the physician, vaccine administrator, animal hospital, hospital owner, wildlife refuge, refuge director, and other agents involved. A parent or guardian must sign for minors. All agreements are witnessed and dated. By By prior agreement with all agents involved, releases are kept on file at the refuge. Along with thank you notes to everyone who donated professional services, a small gift would be appreciated. The cost can be alleviated by rounding off the cost of vaccine per per person up to the nearest $5.00.

 

IMPORTANCE OF VACCINE:

Pre-exposure rabies vaccine is recommended for the following reasons:

  1. Unknown exposure

  2. Inability to receive timely post-exposure treatment

  3. Reduction in the number of post-exposure injections

  • Without pre-exposure immunization:

    a. Rabies immunoglobulin (20 IU/kg BW)

        Day 0 (Divided doses around bite wound and/or in buttocks)

    b. Rabies vaccine (1 ml IM) on days 0, 3, 7, 14, and 28 in deltoid region of the arm

VS:

  • With pre-exposure immunization:

  • a. Rabies vaccine (1 ml IM) on days 0 and 3.

 

If exposure to rabies occurs, post-exposure vaccine is necessary but with a reduced treatment regimen. The need for globulin has been eliminated and you have already received the first three (3) of five rabies vaccine injections at a lower cost. Also important for the rehabilitator is the savings in time, inconvenience, and possible mental anguish concerning unknown exposure.

 

NEGATIVE REACTIONS:

Varying reactions to the vaccine have been reported. Swelling, redness, itching, or pain at the injection site are the most commonly reported reactions. Possible systemic reactions are headache, nausea, muscle aches, abdominal pain, or dizziness.

Following a booster dose, immune-complex complaints such as rash, nausea, vomiting, fever, fatigue, or arthritis have appeared between days 2-21 in up to 6% of recipients. No reaction has been life threatening. (Pasteur Merieux, 1991.)

 

BOOSTER DOSE:

In areas of high rabies incidence, Merieux recommends a booster every two years, or serologic testing at two years and a booster if the titer level is inadequate. The author had adequate titers for five (5) years following the initial vaccine. After a booster, the subsequent eight (8) years have shown adequate titers. In this case, rabies vaccine has proven to be an inexpensive, blue chip investment of protection and mental security while rehabilitating mammal in a rabies epizootic area.

 

TITER TESTING:

The following information concerning the titer test is provided for your primary caregiver. The RFFIT (pronounced "riffit") test it the only reliable rabies titer test. Serum specimens may be sent to the following laboratory:

Department of Veterinary Diagnosis

Veterinary Medical Center

Kansas State University

Manhattan, KA 66506 Two (2) mls of serum should be shipped on ice by overnight express mail. Include billing information as well as where the results should be sent. The cost is $22.50 (1995)

 

CONCLUSION:

As a wildlife rehabilitation center, we did not anticipate becoming involved in a broad scale pre-exposure rabies vaccine program. When it became evident that one was needed, our human medical and legal advisors/board members recommended that one should be made available when warranted. Since 1990, approximately 140 people have participated in our pre-exposure rabies vaccine program. Beyond the refuge volunteers, those participants have included veterinarians, animal health technicians, pest control personnel, and other licensed rehabilitators. The decision to have titers evaluated is up to the individual.

 

Important: Please contact your county health department or health officer for guidance relating to post-exposure rabies vaccines.

 


CENTRES FOR DISEASE CONTROL (CDC) Atlanta

 

Rabies Information

Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like raccoons, skunks, bats, and foxes.

 

The rabies virus infects the central nervous system, ultimately causing disease in the brain and death. The early symptoms of rabies in people are similar to that of many other illnesses, including fever, headache, and general weakness or discomfort. As the disease progresses, more specific symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation (increase in saliva), difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of these symptoms.

 

Compendium of animal rabies prevention and control, 2008

http://www.nasphv.org/Documents/RabiesCompendium.pdf

 

Rabies Vaccines

Parenteral animal rabies vaccines should be administered only by or under the direct supervision of a veterinarian. Rabies vaccinations also may be administered under the supervision of a veterinarian to animals held in animal-control shelters before 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, administration, and in the management of adverse events. This practice ensures that a qualified and responsible person can be held accountable for properly vaccinating the animal.

Rabies Vaccines Licensed and Marketed in the U.S., 2008

 

Rabies Vaccination Recommendations

 

Preexposure Vaccinations

People who work with rabies in laboratory settings and animal control and wildlife officers are just a few of the people who should consider rabies preexposure vaccinations.

If you are traveling to a country where rabies is widespread, you should consult your doctor about the possibility of receiving preexposure vaccination against rabies.

Consider preexposure vaccination if:

  1. Your planned activity will bring you into contact with wild or domestic animals, for example if you are a biologist, veterinarian, or agriculture specialist working with animals.

  2. You will be visiting remote areas where medical care is difficult to obtain or may be delayed, for example, hiking through remote villages where dogs are common.

  3. Your stay is longer than 1 month in an area where dog rabies is common. The longer your stay, the greater the chance of an encounter with an animal.

Although preexposure vaccination does not eliminate the need for additional therapy after a rabies exposure, it simplifies management by eliminating the need for rabies immune globulin and decreasing the number of doses of vaccine needed. This is of particular importance for persons at high risk for exposure to rabies in areas where immunizing products might not be available or where lesser quality biologics might be used which would place the exposed person at increased risk for adverse events.

Preexposure prophylaxis may also protect people whose postexposure therapy is delayed and provide protection to people who are at risk for unapparent exposures to rabies.

 

Rabies Preexposure Prophylaxis Guide

Risk Category

Nature of Risk

Typical

Population

Preexposure

Recommendations

Continuous

Virus present continuously, often in high concentrations. Specific exposures likely to go unrecognized. Bite, nonbite, or aerosol exposure.

Rabies research laboratory workers; rabies biologics production workers.

Primary course. Serologic testing every 6 months; booster vaccination if antibody titer is below acceptable level.

Frequent

Exposure usually episodic, with source recognized, but exposure also might be unrecognized. Bite, nonbite, or aerosol exposure.

Rabies diagnostic lab workers, spelunkers, veterinarians and staff, and animal-control and wildlife workers in rabies-enzootic areas. All persons who frequently handle bats.

Primary course. Serologic testing every 2 years; booster vaccination if antibody titer is below acceptable level.

Infrequent

Exposure nearly always episodic with source recognized. Bite or nonbite exposure.

Veterinarians and terrestrial animal-control workers in areas where rabies is uncommon to rare. Veterinary students. Travelers visiting areas where rabies is enzootic and immediate access to appropriate medical care including biologics is limited.

Primary course. No serologic testing or booster vaccination.

Rare (population

at large)

Exposure always episodic with source recognized. Bite or nonbite exposure.

U.S. population at large, including persons in rabies-epizootic areas.

No vaccination necessary.

 

Primary vaccination

Three 1.0-mL injections of HDCV or PCEC vaccine should be administered intramuscularly (deltoid area) -- one injection per day on days 0, 7, and 21 or 28. Vaccine preparations for intradermal administration are no longer available in the United States.

 

Booster doses

 

Continuous risk

People who work with rabies virus in research laboratories or vaccine production facilities are at the highest risk for unapparent exposures. Such persons should have a serum sample tested for rabies antibody every six months. Intramuscular booster doses of vaccine should be administered to maintain a serum titer corresponding to at least complete neutralization at a 1:5 serum dilution by the RFFIT.

 

Frequent risk

This group includes other laboratory workers such as those performing rabies diagnostic testing, spelunkers, veterinarians and staff, and animal-control and wildlife officers in areas where animal rabies is enzootic. The frequent-risk category also includes persons who frequently handle bats, regardless of location in the Unites States. Persons in the frequent risk group should have a serum sample tested for rabies antibody every 2 years; if the titer is less than complete neutralization at a 1:5 serum dilution by the RFFIT, the person also should receive a single booster dose of vaccine.

 

Infrequent risk

Veterinarians, veterinary students, and terrestrial animal-control and wildlife officers working in areas where rabies is uncommon to rare (infrequent exposure group) and at-risk international travelers fall into this category and do not routine preexposure booster doses of vaccine after completion of primary preexposure vaccination.

 

Rabies vaccines and immunoglobulin available in the United States

Type

Name

Route

Indications

Human Diploid Cell Vaccine (HDCV)

Imovax® Rabies

Intramuscular

Preexposure or Postexposure

Purified Chick Embryo Cell Vaccine (PCEC)

RabAvert®

Intramuscular

Preexposure or Postexposure

 


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Disclaimer:  The advice found on these pages is NOT intended as a do it yourself guide.  All native wildlife needs to be in the skilled hands of a licensed wildlife rehabilitator,  and any medical care must be provided by licensed veterinarians.

If you have an emergency with an injured wild animal, contact your local animal control or humane society for immediate assistance.  

This page last updated 11/27/2012 02:05 AM