Rabies surveillance in the United States during 2020

Abstract

OBJECTIVE To provide epidemiological information on animal and human cases of rabies in the US during 2020 and summaries of 2020 rabies surveillance for Canada and Mexico. ANIMALS All animals submitted for laboratory diagnosis of rabies in the US during 2020. PROCEDURES State and territorial public health departments and USDA Wildlife Services provided 2020 rabies surveillance data. Data were analyzed temporally and geographically to assess trends in domestic and wildlife rabies cases. RESULTS During 2020, 54 jurisdictions submitted 87,895 animal samples for rabies testing, of which 85,483 (97.3%) had a conclusive (positive or negative) test result. Of these, 4,479 (5.2%) tested positive for rabies, representing a 4.5% decrease from the 4,690 cases reported in 2019. Texas (n = 580 [12.9%]), Pennsylvania (371 [8.3%]), Virginia (351 [7.8%]), New York (346 [7.7%]), North Carolina (301 [6.7%]), New Jersey (257 [5.7%]), Maryland (256 [5.7%]), and California (248 [5.5%]) together accounted for > 60% of all animal rabies cases reported in 2020. Of the total reported rabid animals, 4,090 (91.3%) involved wildlife, with raccoons (n = 1,403 [31.3%]), bats (1,400 [31.3%]), skunks (846 [18.9%]), and foxes (338 [7.5%]) representing the primary hosts confirmed with rabies. Rabid cats (288 [6.4%]), cattle (43 [1.0%]), and dogs (37 [0.8%]) accounted for 95% of rabies cases involving domestic animals in 2020. No human rabies cases were reported in 2020. CONCLUSIONS AND CLINICAL RELEVANCE For the first time since 2006, the number of samples submitted for rabies testing in the US was < 90,000; this is thought to be due to factors related to the COVID-19 pandemic, as similar decreases in sample submission were also reported by Canada and Mexico.

Clinical and epidemiologic features of persons accessing emergency departments for dog and cat bite injuries in California (2005–2019)

“…During the study period, 3 Californians died of rabies, 2 of whom were bitten by canids outside the US and the third was bitten by a bat in California. 35 The absence of rabies deaths in California attributable to autochthonous dog bites contrasts sharply with the 27 patients in the present study who died prior to discharge from the ED, presumably from the DBR injuries they sustained. The 2 deceased cat bite patients were older adult females, whereas dog bite patients who died were predominantly young (< 5 years) males.…”

“…The highest proportion of dog bites that occurred in residences was for patients aged < 5 years (93.0%), and the highest proportions of cat bites that occurred in residences were for patients aged < 5 years (92.3%) and adults aged ≥ 55 years (92.3% to 98.9%). More DBR and CBR visits occurred in the summer (53,306 DBR and 10,388 CBR in July) than in winter (35,656 DBR and 6,528 CBR in February).…”

Ecological and Socioeconomic Factors in the Occurrence of Rabies: A Forgotten Scenario

“…As a means of dealing with this issue, scientists have developed prediction approaches, such as a probabilistic decision tree approach, which may calculate the likelihood that a human will contract clinical rabies after being bitten by a dog suspected of having the virus [ 53 ]. Knobel et al (2005) utilized this technique on the data from different countries to conclude that canine rabies was responsible for about 55,000 deaths per year across Africa and Asia [ 54 ]. However, since this publication in 2005, more data has become available, and the dynamics of the disease have shifted, with rising occurrence in some regions and the appearance of rabies in those that had previously been free of it; thus, a new model needs to be developed taking into account the shifting dynamics of rabies in recent years.…”

“…The United States of America (USA) is one country that has maintained a significant investment in dog vaccination ($0.11/person/year) [ 67 , 68 ]. As a result, the cost of preventing rabies in the USA is relatively low ($0.02/person/year), and the rabies burden is also low (200 deaths per year across the continent, largely in Haiti) compared to regions where dog vaccination is not widely practiced [ 54 ]. As opposed to the internationally coordinated effort in Latin America, many developing countries have left rabies control and prevention to the private sector with no legal obligations or incentives (for example, as part of structural adjustment programs in sub-Saharan Africa).…”

Rabies surveillance in the United States during 2021

“…Rabies virus variants (RVVs) maintained in mesocarnivores have evolved in their respective reservoir host spe-cies and circulate in discrete geographic regions of the country (Figure 1). 1 While dog-mediated RVVs, the leading cause of human rabies deaths globally, were first eliminated from the US in the 1970s, human exposure to rabies continues to occur from interactions with wildlife and unvaccinated domestic animals. 2 Therefore, national surveillance is critical to maintain an understanding of changes in RVV distributions, identify notable events such as translocation of endemic RVVs and host-shift events, and monitor the introduction of nonendemic variants.…”