On November 28, 1982, a dairy cow from Lancaster County,
Pennsylvania, was admitted to the Large Animal Hospital of the
School
of Veterinary Medicine (New Bolton Center), University of
Pennsylvania, with a 2-day history of hind-limb paresis, head
tremor,
and diarrhea. No other animals in the herd were sick. Since the
farmer reported having removed a bat from the cow 2 months earlier,
the differential diagnosis on admission included rabies. The cow
was
agitated, stopped eating, and was subsequently euthanized. The
brain
was submitted for rabies testing and, on December 1, was reported
as
fluorescent-antibody positive.
Working closely with personnel from the Chester County Health
Department and the Pennsylvania State Department of Health, 47
persons
were identified with possible exposure to the rabid cow or its
secretions or to blood, cerebrospinal fluid, or tissues. These
included 12 veterinarians, six nurses, eight veterinary students,
eight nursing students, two laboratory technicians, eight barn
staff,
and three other employees. Twenty-nine persons were exposed in the
barn, 12 in the necropsy room, three in the laboratory, and three
elsewhere. Thirty-two persons were determined to have sufficient
exposure to justify post-exposure prophylaxis. Four persons on the
farm, the referring veterinarian, and the truck driver who
transported
the cow, also underwent rabies post-exposure prophylaxis.
The dairy herd from which this cow originated has been placed
under a 90-day quarantine. It was recommended that the
unvaccinated
cats and a dog on the farm be humanely destroyed.
Because of an approximately 5-fold increase in the incidence of
animal rabies in Pennsylvania last year, especially among skunks
and
raccoons, the Pennsylvania State Department of Health and the
Pennsylvania Bureau of Animal Industry had issued a rabies alert
several months earlier. Rabies appears to be moving northward from
Virginia and Maryland and poses a threat to domestic animals and
humans. Four dogs were confirmed as rabid in Pennsylvania in 1982.
In May 1982, several New Bolton Center staff and students
received
pre-exposure rabies prophylaxis under a voluntary Chester County
Health Department program. By October 1982, the University of
Pennsylvania had also initiated a rabies pre-exposure prophylaxis
immunization program, which now includes the faculty and staff of
the
Veterinary Hospital.
Reported by L Glickman VMD, University of Pennsylvania School of
Veterinary Medicine, H Russell, VMD, J Maher, MD, Chester County
Health Dept, M McCarthy, EJ Witte, VDM, CW Hays, MD, State
Epidemiologist, Pennyslvania State Dept of Health, G Landis, DVM,
Pennsylvania Dept of Agriculture; Div of Viral Diseases, Center for
Infectious Diseases, CDC.
Editorial Note
Editorial Note: This episode demonstrates the potential impact of
a
rabies case on a veterinary teaching hospital. Since veterinary
practitioners often refer such clinical cases to a teaching
hospital
for further evaluation, many individuals commonly examine each
animal;
thus, when rabies is diagnosed, many persons have been exposed and
require antirabies prophylaxis. Other instances in which rabies
cases
in teaching hospitals resulted in large numbers of exposed persons
have been previously reported. (1-3).
The need for veterinary schools to provide pre-exposure rabies
prophylaxis for persons with animal contact--including students,
faculty, staff, and animal handlers--cannot be overemphasized.
Veterinarians are urged to consider any animal with neurologic
signs
of unknown etiology as a rabies suspect. Pet owners should be
informed of the rabies epizootic in wildlife and be advised to
contact
their veterinarians concerning recommendations for rabies
vaccination. Livestock owners should also consider the economics
of
rabies vaccination for their animals.
References
CDC. Suspected vaccine-induced rabies in cats--Georgia.
Veterinary
Public Health Notes, June 1979:1-2.
CDC. Multiple rabies exposures--Colorado. Veterinary Public
Health
Notes, January 1980:1-2.
CDC. Rabid calf exposes 18 persons. Veterinary Public Health
Notes, February 1975:3.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
