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Rabies surveillance in Allegheny County, 2015-2016

Seresin, Daniel (2017) Rabies surveillance in Allegheny County, 2015-2016. Master Essay, University of Pittsburgh.

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Abstract

Background:
Rabies is a virtually incurable and almost universally fatal disease in humans. The Allegheny County Health Department (ACHD) maintains an animal bite surveillance program as part of rabies prevention efforts. ACHD monitors the health of both the victim and animal so that victims can receive rabies post-exposure prophylaxis (PEP) if they are at risk for contracting rabies, which must be administered before symptoms develop. The purpose of this study was to describe of the burden of animal bites and rabies in Allegheny County and to determine if physicians were following the treatment protocols recommended by ACHD.
Methods:
This study included all data on bites collected by ACHD for 2 years (2015-2016). This included n = 3722 total bites after bites were removed for being due to animals that do not carry rabies (n=15). We eliminated duplicates from the records. We examined frequencies and distributions of characteristics of the bites and victims. All statistical analyses were conducted using SAS v9.4. Mapping of bite locations was performed using ArcMap 10.5.1.
Results:
There were 3722 total bites reported to ACHD in 2015-2016, with dogs (72.6%) and cats (22.5%) and bats (1.6%) responsible for the vast majority of reported bites. Of all the bites, 20 resulted in a confirmed exposure to an animal that tested positive for rabies, all of which were due to wild animals or feral cats. One person exposed to rabies refused treatment with PEP, but did not develop rabies. An additional 172 persons received PEP primarily due to being exposed to an animal where rabies status could not positively be confirmed as positive for negative, although 27 of these 172 persons received PEP unnecessarily.
Conclusions:
The animal bite reporting system remains successful in preventing human cases of rabies in Allegheny County, which constitutes a significant success for public health. The primary vector for human exposure in Allegheny County is from wild animals, suggesting that stronger communication on the risks posed by approaching wild animals may be beneficial. Physicians in Allegheny County are prescribing their patients PEP too often when there is no risk of rabies, causing undue stress and financial burden.

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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Seresin, Danieldes173@pitt.edu
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairMendez, Daraddm11@pitt.eduddm11UNSPECIFIED
Committee MemberBarron, Geraldgbarron@pitt.edugbarronUNSPECIFIED
Committee MemberMertz, KristenKristen.Mertz@alleghenycounty.usUNSPECIFIEDUNSPECIFIED
Date: 14 December 2017
Date Type: Submission
Number of Pages: 40
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 17 Jul 2018 17:29
Last Modified: 17 Jul 2018 17:29
URI: http://d-scholarship.pitt.edu/id/eprint/33629

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