T he T heory and Practice of R abies Control

E B N E S T S. T I E I? K E L , V e t e r i n a r i a n *

R a b ie s Is probably one of the o ld e st known vaccine treatm ents in exposed p e rso n s. Laboratory
anim al d is e a s e s com m unicable to m an. Many con­ rese a rc h a t present is attac k in g th is serious prob­
cepts of the d is e a s e a s d e sc rib e d by D em ocritus lem by d irectin g its efforts along two lin e s. F ir s t
and A risto tle in a n c ie n t tim es a re the sam e a s is an attem pt a t the developm ent of a hyperimmune
we know them today. A s early a s 100 A .D ., C e lsu s rab ies serum . The second is the p o ssib le refin e­
cau terized the wounds of persons b itte n by rabid ment of brain and nerve tis s u e v ac cin es by remov­
an im a ls. It w as the work of P a s te u r, how ever, that ing the so -ca lled en c ep h alito g en ic facto rs by bio­
gave us our first in sig h t into the nature of the chem ical m ethods. T he s ta tu s of both of th ese
c a u sa tiv e ag en t, some understanding of the immun­ a c tiv itie s s till is experim ental, although they have
ity m echanism , and the developm ent of a new pro­ shown great promise in the laboratory. In the mean­
ph y lactic to o l, ra b ie s v accin e. tim e, practicing p h y sicia n s and health o ffic ia ls
S ince its introduction on th e North A m erican are being ask ed to e x e rc ise sound judgm ent in the
continent from Europe in the middle of the e ig h t­ m anagem ent of su sp e c te d exposure to m inimize
eenth century, ra b ie s in sid io u sly h a s continued to the prom iscuous adm inistration of human rab ies
ex act its to ll from the public h e a lth , ag ricu ltu ral v a c c in e .
econom y, and w ildlife co n serv atio n of the U nited We are convinced th at the ultim ate solution to
S ta te s . In sp ite of its ap p aren t entrenchm ent in the rabies problem is predicated on the control and
large segm ents of c iv ilized p o p u latio n s, it is NOT ev en tu a l elim ination of the d is e a s e from anim al
a d is e a s e “ we have learned to live w ith .” The p o p u latio n s. T h is may be accom plished by the
in evitab le term ination of th e d ise a se in ago n izin g se ttin g up of transm ission barriers such a s anim al
death h as made it one of th e m ost feared m aladies im m unization, re stric tio n of anim al movement,
affectin g m an. Furtherm ore, the u n p le a sa n t and and the reduction of e x c e ssiv e numbers of s u s ­
expensive s e rie s of v a c c in a tio n s in d icated a fte r ceptible w ild life. E x ten siv e laboratory research
exposure is e s ta b lish e d and the re a liz a tio n th at and field p ro jects have proved th a t th ese te c h ­
th e se v a c c in a tio n s are not alw ays given w ithout niques may be ap p lied s u c c e ssfu lly to erad icate
danger, have been the so u rce of a conglom erate the d is e a s e from a given a re a if integrated in to a
headache for the h ea lth officers of th e country. carefully planned and w ell execu ted program. D ra­
Exam ination of the epidem iology of rab ies r e ­ m atic dem onstrations of the e ffe c tiv e n e ss of such
v eals th a t it is ubiquitous in g eographical d is tr i­ programs have been disp lay ed in re c e n t years in
bution. C lim ate and s e a s o n have no influence on many parts of the U nited S ta te s . It is our desire
its occurrence. It is found in the a rc tic regions of to m uster the forces of the rem ainder of the country
A lask a and C anada a s w e ll a s the tro p ic a l coun­ to s e t sim ila r m achinery in motion for an all-out
trie s of the Old and New Worlds. By th e sam e fight a g a in st ra b ie s.
to k en , it may be p re se n t during any s e a s o n of the It is now an e sta b lish e d prem ise th at coordina­
y ea r. T he d is e a s e , in n a tu re , is ch aracterized by tion of control a c tiv itie s is the keynote of a su c ­
a re la tiv e ly long and v ariab le in cubation period. c e ssfu l state-w id e rab ies control program. E xper­
The probability of human infection is dependent ience has shown th at th is can be a ch iev ed if the
upon the concentration of th e virus in the s a liv a ad m inistration of su ch a program is delegated to a
of the b itin g anim al, the s ite of the b ite on the qualified public health v eterin arian a t State le v el.
body, the depth of the b ite , the m u ltip licity of the The d u t i e s and re s p o n s ib ilitie s of the health
b ite , and the p o ssib le in terp o sitio n of clo th in g. departm ent veterinarian in ad m inistering a s ta te ­
In an o th er phase of the problem , our atten tio n wide program would in clude coordinating the efforts
h as been drawn in re c e n t y e a rs to an in c re a sin g of lo c al control by encouraging ac cu ra te reporting;
number of n o stv a c c in a l com p licatio n s follow ing studying the movement and com parative regional
adm inistratio n of the prescrib ed s e r ie s of ra b ie s prevalence of the d is e a s e w ithin the S ta te and

♦ V e t e r in a r y P u b l i c H e a lt h S e r v i c e s , C o m m u n ic a b le D i s e a s e C e n t e r

Courtesy of the David J. Sencer CDC MuSeum

 alerting counties on the presence of rabies in
neighboring areas; appointing rabies inspectors;
improving methods for the shipment of specim ens
to diagnostic laboratories; surveying fa c ilitie s
for collection and impoundment of stray dogs;
making canine vaccines available where needed;
exchanging information with neighboring States
having similar problems; preparing and distributing
educational material throughout the State', and, by
frequent v is its , advising and consulting with local
authorities on current p o lic ies and methodology
of control practices.
Through professional s o c ie tie s , the State public
health veterinarian is in ex cellen t position to stim ­
ulate the interest of the private practicing veter­
inarians of the State and en list the active partici­
pation of practitioners in local control programs.
He can serve as an effective liaison officer b e ­
tween the State health department and other inter­
ested State agen cies such as agriculture and game
conservation.
T he operational phases of a rabies control pro­
gram are carried out at the local le v e l. F ield
demonstrations have shown that local programs
work best on a county-wide b a sis. S u ccessfu l
results cannot be expected if the program is limited
to a city or town without including the surrounding
suburban and rural areas of the county. The rabid
dog often can run the length or breadth of the
average American county, spreading the infection
to each animal he bites in his path.
Local rabies control programs should be operated
on the b asis of three broad m easures. The first
i s ANNUAL ANTIRABIES VACCINATION OF
ALL DOGS. The importance of canine vaccinati on
a s the primary tool in an efficien t control program
is now a firmly established fact and n ee d s only
a w ell organized educational campaign to bring
this fact to the p u b l i c . The s e c o n d is the
IMPOUNDMENT AND DESTRUCTION OF ALL
STRAY AND OWNERLESS DOGS. N eed less to
sa y , vaccination w il l not reach the stray dogs of
a community, and it is the stray animal that very
often is incriminated in the spread of the d ise a se .
T his measure requires the operation of a local
pound or humane shelter where strays may be
kept for a sp ecified period of tim e, and, if un­
claimed at the end of that period, humanely de­
stroyed. Strays should be collected by teams of
dog wardens and a ssista n ts using trucks with
H eads s h ip p e d t o la b o r a t o r ie s fo r d i a g n o s i s s h o u ld b e proper en closu res. The third is R EGISTR AT ION
p l a c e d in a s m a ll s lip - t o p c o n t a in e r , w h i c h in tu rn s h o u ld OF ALL DOGS. R egistration of a ll dogs in a com­
b e p la c e d in a n o th e r c o n t a in e r la r g e e n o u g h to p e r m it i c e
t o b e p a c k e d b e t w e e n th e in n e r an d o u te r o n e .
munity is an important adjunct of a su cc essfu l

Courtesy of the David J. Sencer CDC Museum

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3 ¡ES H C C I N ATION f ü ^ V

P h o t o by Me mphi s S h e I b y C o u n t y H e a l t h D e p a r t m e n t

I n t e n s i f i e d m a s s c a n in e im m u n iz a tio n te c h n iq u e s a re p a ra m o u n t fo r a c h i e v in g s w ift r e d u c tio n o f s u s c e p t i b l e s .

control program. If properly enfo rced , it s e rv e s to S U S C E P T I B L E S MUST B E A C H I E V E D by v a c c i­

defray the e x p e n se s of the o v er-all program, e s ta b ­ n atin g a t le a s t 70 percent of th e dogs in the sh o rt­
lish e s re sp o n sib ility of dog ow nership, a s s u re s a e s t p o ssib le period of tim e. T o th is end, e ffe c ­
reaso n ab ly accu rate dog c e n s u s , and id e n tifie s tive a d m i n i s t r a t i o n is param ount. Community
the unwanted or hom eless s tra y s . in te re st m ust be organized through every a v a il­
T he com bining of v accin atio n and re g istra tio n ab le medium. Dog inoculation c lin ic s should be
has proved in some a re a s to be a sound id e a . It held over a 1- to 2-week period throughout the
tends to make the control program le s s cumber­ county a t stra te g ic points b ased on population
som e. T he dog owner u su ally a p p re c ia te s the con cen tratio n s and geographic d istrib u tio n of
fa ct that he h a s only one trip to make when he cases.
can have h is dog v a c c in a ted and re g iste re d a t In are a s of ra b ie s outbreaks in w ild an im als,
the sam e tim e. The issu in g of a single uniform tag su ch a s foxes, adequate trapping programs should
for the d o g ’s co llar and a sin g le uniform c e rtifi­ be in stitu te d in cooperation w ith the S tate game
c a te , made out in tr ip lic a te , is tantam ount to conservation a u th o ritie s. R a b ies in foxes tends
re g istra tio n . In th is sch em e, a sin g le fee can be
to assum e epizootic proportions in regions over­
charged which w ill be low enough to cover a ll
populated with th is s p e c ie s . If it becom es e sta b ­
c la s s e s of dog owners and high enough to defray
lish ed in the su sc e p tib le w ild life of an a re a , it
the e x p e n se s of v accin atio n and control o p erations.
w ill run its ravaging course in a year or more; and
In co n trast to those com m unities w hich have
in th at tim e, the resu ltin g m ortality may decim ate
carried out effective m ass canine immunization
the fox population more com pletely than any tra p ­
cam paigns, we have had the opportunity to observe
ping operation. T he o b jectiv e in trapping pro­
a few programs which w e re , a t b e st, abortive in
cedures is to reduce the number of su sc e p tib le
th eir ex ecu tio n . C areful a n a ly s is of th e u tilizatio n
of vaccin atio n in the field h a s convinced us th a t foxes to a le v el which w ill not support an e p i­
it is u se le s s to ex p ect re s u lts u n less the program z o o tic , and thereby prevent the occurrence of this
h a s the n e c e ssa ry in te n sifie d c h a ra c ter. In the d is a s te r in the foxes th em selv es and the danger
face of an outbreak, S WI F T R E D U C T I O N O F of its spread to man and dom estic anim als.

Courtesy of the David J. Sencer CDC Museum