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Exposure to a Rabid Cow -- Pennsylvania

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

  1. CDC. Suspected vaccine-induced rabies in cats--Georgia. Veterinary Public Health Notes, June 1979:1-2.

  2. CDC. Multiple rabies exposures--Colorado. Veterinary Public Health Notes, January 1980:1-2.

  3. CDC. Rabid calf exposes 18 persons. Veterinary Public Health Notes, February 1975:3.



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