PDPH Advisory – Rabid Cats in Philadelphia

Within the past month, 3 cats (all feral or stray) from Philadelphia have tested positive for rabies, which represents a marked increase. Typically, no more than 2 cats from Philadelphia test positive for rabies annually. Although rabies infection in humans is fatal, timely receipt of post-exposure prophylaxis (PEP) with rabies immunoglobulin (RIG) and rabies vaccine following exposure to an infected mammal’s saliva is extremely effective in preventing illness and fatalities in humans. The Philadelphia Department of Public Health (PDPH) encourages area providers to report animal exposures (bites and non-bites) and can provide services that aid the clinical decision whether to administer rabies PEP to the human victim. Advise patients not to approach, pet, or capture stray or wild animals and to vaccinate their pets against rabies.

Animal Exposure Reporting and Surveillance
-The following animal exposures can transmit the rabies virus to humans: bites, scratches, possible bat exposures (asleep in a room with a bat, or a child or disabled adult in a room with a bat), and mucous membrane or open wound contact with animal saliva or brain material.
-To report animal exposures to PDPH, call 215-685-6748 or fax completed PDPH Animal Exposure Report Forms (https://hip.phila.gov/Portals/_default/HIP/ReportDisease/AnimalExposureReportingForm.pdf) to 215-238-6947. Obtain and report information on the victim and the animal, including its location.
-If the animal’s location is known, PDPH will coordinate services to determine if rabies PEP is needed:
=10-day observation and confinement in the owner’s home or at the Philadelphia Animal Care and Control Team (ACCT) shelter for exposures involving healthy dogs, cats, or ferrets
=Rabies testing for wild mammals and unhealthy dogs, cats, and ferrets that will not survive 10-day quarantine. Contact ACCT at 267-385-3800 to capture wild and stray animals associated with human exposures, and for preparation and delivery of animal specimens for rabies testing.

Rabies Post-Exposure Prophylaxis (PEP)
For patients with animal exposures (bites and non-bites), rabies post-exposure prophylaxis should be administered as soon as possible after the exposure when:
-The animal’s location is unknown/uncertain;
-The animal tests positive for rabies; OR
-For dogs, cats, and ferrets, the animal does not survive the 10-day quarantine and is not tested.
Rabies PEP may also be initiated for wild animal exposures when testing cannot be performed within 48 hours of exposure and discontinued if the animal tests negative for rabies. Please see the attached PDPH Rabies PEP Guidelines by Animal Type for further information.

Previously unvaccinated, healthy patients will need RIG (dosage based on body weight) and 4 doses of rabies vaccine. RIG and dose 1 of the rabies vaccine should be given at the first visit with doses 2, 3, and 4 of the rabies vaccine given 3, 7, and 14 days after dose 1, respectively. Immunocompromised patients should receive a 5th dose on day 28. Patients with a history of pre-exposure vaccination only need two doses of rabies vaccine on day 0 and day 3. For additional information, visit: https://hip.phila.gov/DiseaseControlGuidance/AnimalBites. Contact PDPH at 215-685-6742 for questions related to Rabies PEP administration.

Originally released by the Philadelphia Department of Public Health on July 28, 2017

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