1. RABIES Board of Health April 2015

2. Rabies Disease Rabies is a highly contagious viral disease. The disease causes inflammation of the brain and spinal cord. It is nearly always fatal The rabies virus infects warm-blooded mammals such as domestic and wild animals as well as humans

3. Rabies Disease Commonly infected animals are dogs, cats, bats, raccoons, skunks, foxes, wolves etc. Infected insectivorous bats are present throughout Canada and USA Rarely infected animals are – rabbits, squirrels, chipmunks, rats, mice etc.

4. Symptoms Rabies symptoms usually appear within 3 to 8 weeks after infection or exposure to the virus

5. Symptoms Two forms of rabies disease: Furious rabies – excitability, hydrophobia, confusion, convulsions, coma and finally death within 1-2 weeks Paralytic (Dumb) rabies – paralysis of limbs and respiratory muscles, decreased consciousness, phobia/ hydrophobia, coma and finally death within 1-2 weeks

6. Transmission The virus is transmitted to a person through contact with saliva of an infected animal via bites or scratches or contact with mucus membrane or open skin wounds

7. Prevention and Control Avoid animal exposure (bite/scratch or contact with saliva of a rabid animal) Do not touch an unknown pet or wild animal Maintain control of your pet Vaccinate pets against rabies Report animal exposure incident to the Health Unit or consult with a medical practitioner immediately after the exposure

8. Investigation of Suspected Rabies Exposure (animal exposure) Incidents: a)Animal is alive and available for Quarantine:

9. Investigation of Suspected Rabies Exposure (animal exposure) Incidents: b) Unable to Quarantine the animal : 1.Animal died or euthanized after incident and is available for rabies test: Scenario 1 – Based on risk assessment, physician orders vaccine for the victim – The animal specimen is sent for rabies test – The rabies test result is received within 48 hours  Based on the rabies test result, rabies vaccine is continued or discontinued

10. Investigation of Suspected Rabies Exposure (animal exposure) Incidents: b) Unable to Quarantine the animal : 1.Animal died or euthanized after incident and is available for rabies test: Scenario 1 – Based on risk assessment, physician orders vaccine for the victim – The animal specimen is sent for rabies test – The rabies test result is received within 48 hours  Based on the rabies test result, rabies vaccine is continued or discontinued

11. Investigation of Suspected Rabies Exposure (animal exposure) Incidents: Scenario 2 – Vaccine is not ordered. – The animal specimen is sent for rabies test – The Physician and the Health Unit wait for the rabies test result  Based on the result, the physician decides whether or not rabies vaccine is required for the victim

12. Investigation of Suspected Rabies Exposure (animal exposure) Incidents: 2. Animal is not available for rabies test:  Based on risk assessment rabies vaccine is recommended

13. Brighton 107 City of Kawartha Lakes 156 Haliburton 66 Port Hope 121

14. Rabies Investigation by County: 2014 Northumberland228 City of Kawartha Lakes156 Haliburton66 Total 450

16. Transition from Canadian Food Inspection Agency (CFIA) to the Ministry of Health (Ontario): Animal specimen collection from HKPR jurisdiction: CFIA was involved in collecting and sending animal specimen to the Ottawa laboratory for rabies test CFIA stopped collecting and sending animal specimen from April 2014 Rabies Specimen Collection System Transition from Federal to Provincial

17. How did we investigate animal exposure incidents when there was no rabies specimen collection system in place?

18. Management of Rabies Investigation in the Interim Period: The province was not ready to take over the rabies specimen collection system The MOHLTC advised the Health Units to offer rabies vaccine to victims until a Provincial specimen collection system is in place MOHLTC – Ministry of Health and Long Term Care (Ontario) CFIA – Canadian Food Inspection Agency (Federal)

19. The MOHLTC worked with the Ontario Health Units and OAVT (Ontario Association of Veterinary Technicians) to establish a Rabies Specimen Collection System in Ontario Registered Veterinary Technicians (RVTs) were recruited by the OAVT The RVTs received training in packaging and shipment of Dangerous Goods Launching the Rabies Specimen Collection System in Ontario

20. The Rabies Specimen Collection System was launched on January 05, 2015 with the participation of initial 10 Health Units including the HKPR

21. Launching the Rabies Specimen Collection System in Ontario The HKPR District Health Unit orders and distributes packaging materials to RVTs – As of March 2015, the HKPR Health Unit submitted 1 dog specimen through the OAVT

22. Rabies specimen data from 2012 and 2013