Lecture 11: State Public Health Veterinarian

What is the purpose of a state public health veterinarian?

to address zoonotic public health issues such as zoonosis, vector-borne, antibiotic resistance, food & water safety, and rabies

What is the purpose of the 10 essential public health services?

Systematically identifies, investigates, and diagnoses health problems, hazards

Epidemiology is mostly involved in _______ to monitor health and investigate and diagnose root causes.

assessment

What is the chain of reporting?

lab → health departments/providers → CDC → investigations, recommendations, policy changes

In surveillance, it is important to know your _____.

normal

What are you able to do from a public health perspective if you have good surveillance?

• Interventions to stop disease

• Prevent future outbreaks

Surveillance allows quick response. What are examples of quick response?

• K-PHAST Training

• Specialized trainings: MRC, ERRT

• Strike teams

What are the characteristics of a rabies program?

• Maintain rabies data

• Animal bite consultants & follow up (rabies post exposure prophylaxis, animal quarantine)

• Qualified persons for rabies vx

• BATA: rabies tested bat identification program

What are the stipulations of an animal bite if rabies is concerned?

• Physicians are required to report to LHD (within 12 hrs of tx or next working day)

• If not treated, parent or guardian required to report

• LHD designates quarantine site (10-180 days at owners expense)

• Pet owner responsible for cost of quarantine or test, damages, and/or PEP

What happens if a companion animal bites a person compared to wildlife?

• Companion animal: quarantine 10 days, observe 10 days, only euthanize and test if signs of rabies

• Wildlife: euthanize immediately and test

True or false: Rabies post exposure prophylaxis (PEP) is highly effective.

true

What are rabies treatment/prevention options for humans?

• Rabies PEP

• HRIG: human Ig: immediate protective antibodies (passive immunity)

• Rabies vx: 4 shots (active immunity)

• Immunosuppressed: 5 doses

• 2 vx if previously vaccinated (No HRIG)

How can rabies prevention go wrong?

• vaccinated patients given RIG

• RIG and vx given in same location

• RIG given too many times

• Patients don’t come in on schedule

What constitutes PEP recommendation?

• Exposure to saliva while wearing improper/no PPE

• Multiple exposures to patient while symptomatic/infectious

• Close contacts who cared for patient while symptomatic/infectious

• Ensured inclusion of laboratory personnel

What is the response of an urgent but not emergency rabies PEP?

unvaccinated: HRIG around wound and rabies vx in deltoid

vaccinated: NO HRIG, 2 doses rabies vx in deltoid