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Animal bite and rabies surveillance in Allegheny county, Pennsylvania, 2017

Short, Erica (2018) Animal bite and rabies surveillance in Allegheny county, Pennsylvania, 2017. Master Essay, University of Pittsburgh.

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Abstract

Background: Animal bites result in significant medical costs due to injury and infection. One per cent of emergency department visits in the United States are related to animal bites. Relatedly, 60-70 dogs, over 250 cats, and thousands of wild animals test positive for rabies in the U.S. each year. However, Pennsylvania has not had a human rabies case since 1984. Animal bite and rabies surveillance by local health departments, such as the Allegheny County Health Department (ACHD), is critical to rabies prevention efforts as staff recommend rabies post-exposure prophylaxis vaccination when necessary.

Methods: All animal bite report data and rabies test results from 2017 were obtained from the ACHD’s Oracle database. Data were imported into Microsoft Excel and deduplicated, and values were reclassified if the information was inconsistently reported. Analysis was completed using SAS, and figures were created in Excel.

Results: There were 1,883 mammal bites reported to ACHD in 2017, with dogs (71%) and cats (24%) involved in the majority of bites. Victims ranged from <1 to 100 years of age. In most 5-year age groups, females had more reported bites than males. Only 4 bite incidents involved an animal that tested positive for rabies; 3 involved stray cats and 1 involved a bat. Antibiotics were prescribed for 63% of reported bites, and a tetanus shot was given for 31%. A total of 104 (6%) people completed the rabies vaccine series (HRIG/HDCV), including the 4 people who were exposed to rabies positive animals. There were 13 people who completed HRIG/HDCV unnecessarily, ultimately costing between $39,000-$91,000.

Conclusion: The bite reporting system and current medical practices have continued to prevent human rabies in Allegheny County. The frequency of rabies positive animals fluctuates over time, but is relatively consistent. Requiring vaccination as a part of pet licensing may be a way to improve pet vaccination rates. Analysis of bite treatments indicated physicians may need decision help regarding animal bite post-exposure prophylaxis protocols to avoid unnecessary prescription of antibiotics, administration of tetanus boosters, and vaccination with the expensive HRIG/HDCV series. The high rabies case fatality rate and medical costs associated with animal bites and prophylaxis make continued surveillance and outreach important to protecting public health.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Short, Ericaees79@pitt.eduees79
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancyglynnn@edc.pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberMertz, KristenKristen.Mertz@alleghenycounty.usUNSPECIFIEDUNSPECIFIED
Committee MemberSaladino, Richardsaladinora1@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberSchroeder, Betsybschroede@pa.govUNSPECIFIEDUNSPECIFIED
Date: 14 December 2018
Date Type: Submission
Number of Pages: 54
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 28 Sep 2019 23:10
Last Modified: 28 Sep 2019 23:10
URI: http://d-scholarship.pitt.edu/id/eprint/35570

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