Stop Foaming at the Mouth: Analyzing Rabies Post-Exposure Prophylaxis (PEP) facilities, PEP Completions, and Barriers
Abstract
In general, post-exposure prophylaxis (PEP) is recommended for persons exposed to a rabid or high-risk animal to prevent infection with rabies virus. In the United States, the PEP regimen consists of local wound treatment, administration of one dose of immune globulin (except for persons who have previously received complete vaccination regimens, either pre-exposure or post-exposure), and 4 doses of rabies vaccine over a 14-day period. Rabies immune globulin (RIG) is usually only offered in Emergency Departments. Additional doses of rabies vaccine should be given on days 3, 7, and 14 after the first vaccination. A 5th dose could be indicated on the 28th day if the patient is immunocompromised.
Cobb & Douglas Public Health (District 3-1) Acute Disease Epidemiology manages animal bite cases, gives rabies recommendations, and monitors PEP completion. Cobb & Douglas Public Health’s clinic offers rabies vaccine for PEP and Pre-Exposure Prophylaxis (PrEP). Data from SendSS (State Electronic Notifiable Disease Surveillance System) and Cobb and Douglas Public Health’s VHN (Visual HealthNet) will be analyzed. District 3-1’s rabies PEP completion rate will be compared with the completion rate of other districts in the Metro Atlanta area: District 3-2 (Atlanta,) District 3-3 (Clayton,) District 3-4 (Lawrenceville,) and District 3-5 (DeKalb) to assess if Districts offering PEP in their health department have higher PEP completion rates compared to those that do not offer PEP. Offering PEP at the health department can improve ease of access and provide an affordable alternative to a hospital visit. Rabies vaccine can be expensive for health departments to keep in stock and the vaccine can expire before use, depending on demand. However, if the PEP completion rate is higher in District’s that offer rabies vaccine, it could be an important tool for health districts to utilize in effort to prevent rabies in humans.
Keywords
Rabies, animal bites, post-exposure prophylaxis, PEP, vaccine, health department, epidemiology
Stop Foaming at the Mouth: Analyzing Rabies Post-Exposure Prophylaxis (PEP) facilities, PEP Completions, and Barriers
In general, post-exposure prophylaxis (PEP) is recommended for persons exposed to a rabid or high-risk animal to prevent infection with rabies virus. In the United States, the PEP regimen consists of local wound treatment, administration of one dose of immune globulin (except for persons who have previously received complete vaccination regimens, either pre-exposure or post-exposure), and 4 doses of rabies vaccine over a 14-day period. Rabies immune globulin (RIG) is usually only offered in Emergency Departments. Additional doses of rabies vaccine should be given on days 3, 7, and 14 after the first vaccination. A 5th dose could be indicated on the 28th day if the patient is immunocompromised.
Cobb & Douglas Public Health (District 3-1) Acute Disease Epidemiology manages animal bite cases, gives rabies recommendations, and monitors PEP completion. Cobb & Douglas Public Health’s clinic offers rabies vaccine for PEP and Pre-Exposure Prophylaxis (PrEP). Data from SendSS (State Electronic Notifiable Disease Surveillance System) and Cobb and Douglas Public Health’s VHN (Visual HealthNet) will be analyzed. District 3-1’s rabies PEP completion rate will be compared with the completion rate of other districts in the Metro Atlanta area: District 3-2 (Atlanta,) District 3-3 (Clayton,) District 3-4 (Lawrenceville,) and District 3-5 (DeKalb) to assess if Districts offering PEP in their health department have higher PEP completion rates compared to those that do not offer PEP. Offering PEP at the health department can improve ease of access and provide an affordable alternative to a hospital visit. Rabies vaccine can be expensive for health departments to keep in stock and the vaccine can expire before use, depending on demand. However, if the PEP completion rate is higher in District’s that offer rabies vaccine, it could be an important tool for health districts to utilize in effort to prevent rabies in humans.
