Human Exposure to Rabid Free‐Ranging Cats: A Continuing Public Health Concern in Pennsylvania

Rabid free‐ranging cats have been a public health concern in Pennsylvania since raccoon variant rabies first was recognized in the state in the early 1980s. Over the last decade, between 1.5 and 2.5% of cats submitted to Pennsylvania's state laboratories for rabies testing have been positive. In this report, we describe the extent of rabies in free‐ranging cats in Pennsylvania. We also present two examples of human exposure to rabid free‐ranging cats that occurred in Pennsylvania during 2010–2011 and the public health actions taken to address rabies exposure in the humans and animals. We then describe the concerns surrounding the unvaccinated and free‐ranging cat population in Pennsylvania and possible options in managing this public and animal health problem.     

Knowledge of Rabies Prevention in Vietnamese Public Health and Animal Health Workers

Rabies is an invariably fatal, but preventable zoonotic disease. Despite a national programme for its prevention and control, the number of rabies associated deaths in Vietnam has increased in recent years. A cross‐sectional survey was undertaken in 2012 to assess and compare the knowledge, awareness and practices of 189 public health workers (PHW) and animal health workers (AHW) attending a joint training course for professionals from provinces in northern Vietnam with the highest number of deaths from rabies. Questionnaires facilitating self‐evaluation were provided, and total knowledge scores were calculated (maximum 38 points) and categorized into: ‘high’ (>30 points), ‘moderate’ (21–30) and ‘low’ (<21). The response rate was 100%, and among the 189 participants, 56% were PHW compared to 44% who were AHW. Although most respondents knew rabies could be transmitted through the bite of an animal, most commonly a dog, and that rabies is a preventable disease, significant differences between groups were identified. Major areas included poor knowledge of common rabies reservoirs, wound management and guidance on post‐exposure prophylaxis. Overall, the total mean knowledge scores for PHW was significantly higher (P = 0.011) compared to those for AHW, but both scores fell within the ‘moderate’ knowledge range. However, proportionately more PHW than AHW achieved ‘high’ knowledge scores (P = 0.0098). To our knowledge this is the first published study to simultaneously assess the knowledge and awareness of animal health and public health professionals attending joint training activities aimed at strengthening rabies prevention and control. To ensure effective prevention and control of rabies requires that AHW and PHW not only coordinate and collaborate, but have a common knowledge and understanding of rabies prevention and control measures. This study provides important baseline data in a relatively unexplored area of research that can focus future interventions and research.     

上海市犬只狂犬病认定免疫点主要管理做法分析

强化犬只狂犬病免疫工作是从源头控制狂犬病的最有效措施.近年来,上海市按照《上海市养犬管理条例》的要求,通过严把免疫资质准入、规范内部管理、落实疫情报告责任、推进免疫质量考核等举措,使犬只狂犬病认定免疫点的布局日趋合理,文明服务更加规范,这已成为上海市民犬只狂犬病免疫的主渠道,免疫数量和质量逐年提升,构筑了良好的免疫屏障...     

Impact of Rabies Vaccination History on Attainment of an Adequate Antibody Titre Among Dogs Tested for International Travel Certification,Israel – 2010–2014

Rabies is endemic in wildlife or domestic carnivore populations globally. Infection of domestic dogs is of particular concern in many areas. In regions where domestic animals are at risk of exposure to rabies virus, dogs should be routinely vaccinated against rabies to protect both pet and human populations. Many countries require demonstration of an adequate level of serum rabies neutralizing antibodies to permit entry of dogs during international travel. We analysed rabies titres of dogs seeking travel certification in Israel to assess demographic and vaccine history factors associated with antibody titres below the acceptable threshold for travel certification. Having received only one previous rabies vaccination and a longer duration since the most recent vaccination was received were primary risk factors for not achieving an adequate rabies virus neutralizing antibody titre for travel certification. These risk factors had stronger effects in younger animals, but were consistent for dogs of all ages. In particular, these findings reiterate the importance of administering at least two rabies vaccinations (the primo vaccination and subsequent booster) to ensure population‐level protection against rabies in dogs globally.     

Knowledge,Attitudes and Practices of Primary Care Physicians in the Franche‐Comte Region (France) Regarding the Risk of Rabies

Rabies remains a public health concern and is associated with a mortality rate of nearly 100%. An observational survey was undertaken in 2010 to assess the knowledge, attitudes and practices of primary care physicians (PCPs) in our area regarding the risk of rabies. Standardized questionnaires were sent to a random sample of 400 PCPs practicing in the Franche‐Comté region (eastern France), requesting their voluntary and anonymous participation. The questionnaires requested socio‐demographic details and self‐evaluation. Seven clinical situations were selected to assess the attitudes of physicians. The response rate was 38.5%. Most of the PCPs were based in rural and semi‐rural areas, 76% knew where their nearest rabies centre was located and 75% of them claimed their knowledge of the risk of rabies was poor. While most of them (>80%) knew which animals transmitted the disease as well as the severity criteria for bites, only 12% knew that there was no contraindication for the rabies vaccine in the event of exposure to the disease. Responses to the seven clinical situations showed that most of them did not know the precise indication for the rabies vaccine and rabies immunoglobulin. Primary care physicians are usually aware of the risk of rabies, but their knowledge of how to manage rabies exposure and prevention often requires updating. The health authorities should provide more detailed information to PCPs and to the general population about the risk of rabies.     

Knowledge,Attitudes and Practices of Law Enforcement Officers on Rabies and Animal Control Issues in Kansas

Rabies is a deadly zoonoses endemic in the United States, including Kansas. Animal control programmes that emphasize vaccination of dogs and cats, removal of stray animals and enforcement of licensure programmes have historically been essential in reducing the risk of rabies exposures to humans (Beran, 1991). Kansas does not mandate the use of animal control officers [ACOs] and in areas where there is no designated animal control officer, law enforcement officers [LEOs] are required to fill that role. Little is known about LEOs' knowledge of rabies, their current practices in responding to animal‐related calls or if they receive any specialized training to perform the duties of an ACO. A web‐based, voluntary and anonymous survey was sent to law enforcement officers in Kansas in January 2014. The survey included questions about animal control practices and a self‐assessment of rabies knowledge. The response rate was 16.2%. All respondents indicated LEOs will respond to animal‐related calls, even if there was an ACO available in their department or jurisdiction. A majority of respondents indicated they had not received training on safe animal handling (62.9%, 61/97) or zoonoses prevention (85.6%, 83/97), even though a strong majority considered such training important (89.7% and 79.4%, respectively). Most respondents (>80%) were able to correctly identify animals capable of transmitting rabies but were less aware of how rabies was transmitted or the severity of rabies in humans. Our results demonstrate that Kansas LEOs perform animal control duties, many without the proper training, even though most consider such training to be important to be able to perform their duties safely. Training on safe animal handling and zoonoses prevention should be provided to all LEOs in Kansas to enable them to safely execute their duties and provide timely and accurate information to citizens regarding rabies prevention.     

A cross‐sectional study of intestinal parasitoses in dogs and children of the periurban area of La Plata (Buenos Aires,Argentina): Zoonotic importance and implications in public health

A cross‐sectional study was performed between school term dates 2014 and 2015 to diagnose intestinal parasites in dogs and children living with them. The socio‐environmental characteristics and hygiene practices of the children were also evaluated in terms of risk factors for parasitic infection of periurban neighbourhoods of La Plata (Buenos Aires, Argentina). Serial coproparasitological samples of 78 dogs and 211 children were analysed by means of concentration and flotation techniques. Socio‐environmental variables and hygiene practices of children were evaluated through semi‐structured questionnaires which were answered by every family. The study showed that 82.1% of dogs were parasitized. The specific richness was of 11 species; Ancylostoma caninum (69.2%), Uncinaria stenocephala (41.0%), Trichuris vulpis (28.2%) and Toxocara canis (21.8%) were the most prevalent. The study also revealed that 67.8% of children were positive. Also, 11 species were identified and the most prevalent were Blastocystis sp. (36.0%), Enterobius vermicularis (27.5%) and Giardia lamblia (21.3%). The risk for parasitosis was higher in 6‐year‐old children and older (OR = 1.9, 95% IC: 1.0–3.7) and in those who did not wash their hands or did it occasionally after playing with their pets (OR = 2.8, 95% IC: 1.4–5.5). Blastocystis sp. and Entamoeba coli infection risks were greater in children whose parents had a basic level of education (OR = 3.4, 95% IC: 1.3–8.7 and OR = 3.6, 95% IC: 0.8–15.9, respectively). In addition, the risk of infection for E. coli was higher in children who lived in floodable houses (OR = 4.4, 95% IC: 0.9–16.6). Likewise, the risk of infection for E. vermicularis was greater in children with onychophagia (OR = 1.6, 95% IC: 0.7–3.7) and in 6 year olds and older whose parents completed only primary studies (OR = 3.6, 95% IC: 1.4–9.1). The results obtained show the existence of a worrying epidemiological scenario that stresses the importance of zoonotic parasitosis as a serious problem of public health.     

Prevention and Control of Rabies in an Age of Global Travel: A Review of Travel‐ and Trade‐Associated Rabies Events – United States, 1986–2012

Rabies prevention and control efforts have been successful in reducing or eliminating virus circulation regionally through vaccination of specific reservoir populations. A notable example of this success is the elimination of canine rabies virus variant from the United States and many other countries. However, increased international travel and trade can pose risks for rapid, long‐distance movements of ill or infected persons or animals. Such travel and trade can result in human exposures to rabies virus during travel or transit and could contribute to the re‐introduction of canine rabies variant or transmission of other viral variants among animal host populations. We present a review of travel‐ and trade‐associated rabies events that highlight international public health obligations and collaborative opportunities for rabies prevention and control in an age of global travel. Rabies is a fatal disease that warrants proactive coordination among international public health and travel industry partners (such as travel agents, tour companies and airlines) to protect human lives and to prevent the movement of viral variants among host populations.     

Outcome and toxicity associated with a dose‐intensified,maintenance‐free CHOP‐based chemotherapy protocol in canine lymphoma: 130 cases

A dose‐intensified/dose‐dense chemotherapy protocol for canine lymphoma was designed and implemented at the Veterinary Hospital of the University of Pennsylvania. In this study, we describe the clinical characteristics, prognostic factors, efficacy and toxicity in 130 dogs treated with this protocol. The majority of the dogs had advanced stage disease (63.1% stage V) and sub‐stage b (58.5%). The median time to progression (TTP) and lymphoma‐specific survival were 219 and 323 days, respectively. These results are similar to previous less dose‐intense protocols. Sub‐stage was a significant negative prognostic factor for survival. The incidence of toxicity was high; 53.9 and 45% of the dogs needed dose reductions and treatment delays, respectively. Dogs that required dose reductions and treatment delays had significantly longer TTP and lymphoma‐specific survival times. These results suggest that dose density is important, but likely relative, and needs to be adjusted according to the individual patient's toxicity for optimal outcome.     

Sero‐epidemiology of Canine Leptospirosis in Trinidad: Serovars,Implications for Vaccination and Public Health

A sero‐epidemiological study on canine leptospirosis was conducted in house, stray, farm and hunting dogs, as well as in suspect cases of clinical canine leptospirosis. Serum samples were collected from apparently healthy (vaccinated and non‐vaccinated), house dogs. A questionnaire was administered to the owners to elicit information on risk factors for leptospirosis. The microscopic agglutination test was used to screen for leptospirosis using 17 international serovars. Reciprocal titres of between 100 and <800 were considered as evidence of past exposure while reciprocal titres of 800 or greater were classified as suggestive of acute/current infection. Of a total of 419 serum samples tested, 61 (14.6%) were seropositive for Leptospira agglutinins, 23 (5.5%) had mixed infections and 16 (3.8%) had current infection. Amongst 50 suspected cases of clinical leptospirosis, 24 (48.0%) were seropositive and only 13 (26.0%) had current infection compared with 10 (6.3%) and three (1.9%) of 160 apparently healthy house dogs respectively. The difference was statistically significant (P < 0.05; χ²). Twelve (25.5%) of 47 hunting dogs, 10 (20.4%) of 49 farm dogs and five (4.4%) of 113 stray dogs were seropositive (P < 0.05; χ²). Overall, a total of nine serovars were detected with serovars mankarso, icterohaemorrhagiae RGA, autumnalis and copenhageni being involved in 29 (47.5%), 20 (32.8%), 25 (41.0%) and 10 (16.4%) respectively in 61 seropositive dogs (P < 0.05; χ²). Serovar mankarso was most predominant in seropositive apparently healthy dogs, 37.8% (14/37), suspected clinical cases of leptospirosis, 62.5% (15/24) compared with serovar icterohaemorrhagiae with a frequency of 21.6% (8/37) and 50.0% (12/24), the difference being statistically significant (P < 0.05; χ²). Although all vaccines used for prevention of canine leptospirosis in the country contain serovars canicola and icterohaemorrhagiae, serovar mankarso was mostly associated with infection and disease and may be a good candidate for inclusion in the vaccine used locally. The public health risk posed to owners of dogs infected with Leptospira cannot be over‐emphasized considering the zoonotic nature of the disease.     

Comparisons of 3‐, 2‐Dimensional,and M‐Mode Echocardiographical Methods for Estimation of Left Chamber Volumes in Dogs with and without Acquired Heart Disease

Background: Real‐time 3‐dimensional echocardiography (RT3D) is a recent technique based on volumetric scanning, eliminating the need for geometric modeling of the cardiac chambers and minimizing the errors caused by foreshortened views. Hypothesis: Estimations of left ventricular (LV) end‐diastolic (EDV) and end‐systolic volume (ESV), and left atrial (LA) size, differ depending on the echocardiographic technique of estimation. Animals: Fifty‐one dogs with acquired heart disease and 34 healthy control dogs. Methods: Prospective observational study by M‐mode (Teichholz method), Simpson's modified 2‐dimensional (2D) method, and RT3D methods for estimation of LV volumes. LA size was evaluated by 2D and RT3D methods. Results: RT3D showed good agreement with 2D for EDV and ESV, whereas Teichholz method overestimated LV volumes in comparison with the other 2 methods by approximately a factor 2. There were no statistically significant differences among the 3 methods in estimating ejection fraction. Comparison between RT3D assessment of LA end‐systolic volume per kilogram (LAs/kg) and LA to aortic ratio (LA/Ao) measured by 2D relative to each other showed that the RT3D method underestimated LAs/kg at lower values, and overestimated it at higher values. The difference between methods increased with increasing LA size. Conclusions and Clinical Importance: There was good agreement between RT3D and 2D methods of estimating EDV and ESV, whereas the Teichholz method overestimated LV volumes by approximately a factor 2. In comparison with RT3D, LA/Ao underestimated LA size, especially when LA was enlarged.     

On the winter enhancement of adaptive humoral immunity: hypothesis testing in desert hamsters (Phodopus roborovskii: Cricetidae,Rodentia) kept under long‐day and short‐day photoperiod

We tested the winter immunity enhancement hypothesis (WIEH) on male desert hamsters (Phodopus roborovskii) kept under long‐day (LD) and short‐day (SD) photoperiods. We assumed that under SD in a laboratory, the adaptive humoral immune responsiveness to the antigenic challenge would be enhanced due to the lack of winter physical stressors and food shortages and/or because of the action of an endogenous winter bolstering mechanism, while under LD the immune responsiveness would be suppressed by the activity of the reproductive system. The results support the WIEH in part. We did not find a difference in antibody production in response to sheep erythrocytes between SD and LD hamsters, but SD males had the lower number of granulocytes and the higher number of lymphocytes in white blood cell counts. Reproductive activity was lower in SD males. These males demonstrated an increase in their mass‐specific resting metabolic rate, their mass‐specific maximal metabolic rate and their level of cortisol. The result of a generalized linear model analysis indicates the negative effect on secondary immunoresponsiveness to sheep erythrocytes of mid‐ventral gland size, the organ characterizing individual reproductive quality, and designates a tradeoff between antibody production and reproductive effort. The mass‐independent maximal metabolic rate also negatively affected antibody production, indicating a tradeoff between maximal aerobic performance and the adaptive immune function. The higher stress in SD males seems to be the most likely reason for the lack of the effect of daylight duration on antibody production.