Animal bite epidemiology and surveillance for rabies postexposure prophylaxis

Objectives-To understand the epidemiology of animal bites and exposure, eva luate the animal exposure reporting system for surveillance of rabies poste xposure prophylaxis (PEP), and identify opportunities to reduce PEP. Design-Period prevalence survey. Study Population-Pennsylvania residents in 1995. Procedure-Data from animal bite reports from Pennsylvania county health off ices were summarized for 1995. Animal bite incidences for the state, counti es, various age groups, and various population densities were calculated. A nimal species, treatment, location of wounds, and PEP recommendations were evaluated for exposures. Results-More than 16,000 animal-related potential rabies exposures were rep orted from 65 of 67 counties in Pennsylvania. The highest incidence was in children less than 5 years old (324/100,000). Of the 75% of victims requiri ng wound treatment, 50% received antimicrobials, 29% received-a tetanus tor oid, and 19% had wounds sutured, were admitted to hospitals, or were referr ed for plastic surgery, Although 75% of exposures were to dogs, victims exp osed to cats were 6 times as likely to receive PEP (relative risk, 6.1; 95% confidence interval, 5.1 to 7.4). Thirty percent of 556 PEP were given for exposures to dogs, 44% for cats, 7% for raccoons, 4% for bats, 2.5% for sq uirrels, 2.1% for groundhogs, 2% for foxes, and 8% for exposures to other s pecies. Fifty nine percent of owned dogs were up-to-date on rabies vaccinat ions compared with 41% of owned cats. Conclusion-Interventions, such as dog bite prevention education, vaccinatio n of pets against rabies, appropriate use of PEP, and reduction of feral ca t populations, should be instituted, enhanced, or better enforced in commun ities.