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Guidelines for Emergency Service Rabies Suspect Animal Handling and Housing

General Considerations

Rabies is epidemic in Wake County and throughout North Carolina. Our first consideration in the VHC work-place is the health and well-being of hospital personnel and students. Protecting all hospital workers requires diligent communication between all hospital personnel. The key first step is considering rabies as a suspect diagnosis in the differential diagnosis.

Rabies vaccination in North Carolina. The vaccination of all dogs and cats in NC is mandatory (NC Statuette 130A-196). Our guidelines for handling suspect animals and animals potentially exposed to rabies virus are dictated by the interpretation of the state statuette by the Office of the State Epidemiologist.  Only animals that have been vaccinated by a licensed veterinarian are considered vaccinated. Initial vaccination should occur when the animal is at least four months of age. The first vaccination is considered current for one year after vaccination. The second vaccination is considered current for 3 years (as long as the appropriate vaccine is used). At the time of vaccination the information is sent to the county health department, and the veterinarian administering the vaccine retains documentation of the vaccination. A copy is provided to the owner. The State of North Carolina does not recognize waivers to this law for medical purposes.

Guidelines for Emergency Service Rabies Suspect Animal Handling and Housing

Vaccination Status of Animal Entering the VHC complex

  • Animals entering the CVM VHC must be vaccinated for rabies.
  • The vaccination status of each animal should be recorded during first contact with the client.
  • Animals that have not been vaccinated for rabies should be vaccinated by their referring veterinarian prior to entering the VHC complex
  • Exceptions due to the medical status of the patient must be discussed with the hospital epidemiologist (jay_levine@ncsu.edu 919 513-6397, 919 600-8684).
  • At times animals entering through the emergency service may arrive without prior knowledge of their vaccination status. Animals that are not vaccinated are managed as rabies suspects while in the VHC.

Animals That Are Not Vaccinated for Rabies Are Rabies Suspects

  • Place a medical alert in the animal’s UVIS record.
  • Inform hospital staff that the animal has not been vaccinated at the time of admission.
  • Place a rabies contact log on the animal’s cage and record the names and phone numbers of all individuals having contact with the animal.
  • Limit handling of the animal to hospital staff and students that have been vaccinated for rabies.

Animals with a Bite Wound

Obtain a Complete History

  • Obtain the vaccination history of the animal bitten.
  • If the attacking animal was a domestic dog, cat or ferret, attempt to identify the vaccination history of the attacking animal.
  • If the attack is wildlife-related, request information about the attacking animal.
  • Any information about the species of attacking animal, and the situation of the attack (e.g. behavior), may prove important).
  • In what municipality or county does the animal reside.
  • Does the animal reside outdoors, in a fenced yard, tethered, walked only on a leash, or have a variable environmental history (indoors, and outdoors)

If the client’s animal has been vaccinated, and the vaccinationhistory is up to date (current)

  • Clean the wound, treat the animal and revaccinate the animal
  • Recommend that the clients follow-up with their usual veterinarian.

If the client’s animal is not vaccinated and the attacking animal is a dog, cat or ferret with a current vaccination history and is not displaying clinical signs of neurologic disease

  • Clean the wound, treat the animal
  • Vaccinate the animal
  • Recommend that they follow-up with their usual veterinarian

If the attacking animal is a nonvaccinated dog, cat or ferret (never been vaccinated or not current), or wild vertebrate with a suspicion of rabies: fox, raccoon, bat, skunk, beaver, muskrat, bobcat, coyote.

  • Clean the wound, treat the animal
  • Contact the technician supervisor for the service in which you are working. The technician supervisor will contact Raleigh Animal Control. If the incident did not occur in Raleigh, the animal control officer will contact the appropriate animal control officer from the county or municipality in which the bite occurred.
  • Recommend to your client that they cooperate fully with the animal control officer (whether the animal is confined or euthanized is a decision made by the animal control officer, it is not a clinician decision).

The attacking animal was killed by the client or another party and is available and was brought to the clinic

  • Clean the wound, treat the animal
  • Contact the technician supervisor for the service in which you are working. The technician supervisor will contact Raleigh Animal Control. If the incident did not occur in Raleigh, the animal control officer will contact the appropriate animal control officer in the county or municipality in which the bite occurred.
  • Place the attacking animal in a biohazard bag (double bags), place an appropriate necropsy tag on the animal and place it in the necropsy room cooler. Thoroughly complete the rabies submission form available in necropsy.
  • Recommend to your client that they cooperate fully with the animal control officer (whether the animal is confined or euthanized is a decision made by the animal control officer, it is not a clinician decision).

The attacking animal escaped and is not available for testing

  • Clean the wound, treat the animal
  • Contact the technician supervisor for the service in which you are working. The technician supervisor will contact Raleigh Animal Control. If the incident did not occur in Raleigh, the animal control officer will contact the appropriate animal control officer in the county or municipality in which the bite occurred.
  • Recommend to your client that they cooperate fully with the animal control officer (whether the animal is confined or euthanized is a decision made by the animal control officer, it is not a clinician decision).

The animal you are treating has bitten a CVM VTH hospital employee or student.

  • Call 911 if it is a life threatening or necessitates treatment by a trauma center. Campus police will also transport someone to Rex Emergency room if the injury is severe, but not immediately life threatening. In addition, if the injury is not life threatening do not hesitate to immediately head to the emergency room.
  • If the wound is not life threatening or severe the injured individual should take an incident report form (in Emergency room or ICU file cabinet) and head to Rx Urgent Care on Lake Boone Rd.
    3100 Blue Ridge Rd # 103
    Raleigh, NC 27612
    (919) 719-2250
  • Contact the technician supervisor for your service. The technician supervisor will contact Raleigh Animal control.
  • Inform the owner that in accordance with state law you have informed the animal control officer and that they can expect a call from animal control.
  • Recommend to your client that they cooperate fully with the animal control officer (whether the animal is confined or euthanized is a decision made by the animal control officer, it is not a clinician decision).
  • If the animal is currently vaccinated for rabies (up to date), at the discretion of the animal control officer the vaccinated animal may be released back to the owner for monitoring.
  • The client should be told to contact the Director of Clinical Services (513-8558) or Jay Levine (513-6397/600-8684) if the animal displays any unusual behavior within the next ten days (aggressive, ataxic, or lethargic). If they contact you, and there is a problem that can be considered compatible with clinical signs of rabies infection please contact us immediately. Please call until you reach someone, don’t just leave a message.
  • If the animal is not currently vaccinated (or the vaccination date has passed without vaccination). At the discretion of the animal control officer the  animal will either be confined at the owners expense at a local veterinary clinical or designated animal shelter. We do not board animals during this confinement period, and an animal that is under confinement must not be released (discharged) back to the owner until the end of he confinement period. Related discussions should be between the animal control officer and the client. We are there to support the client, but have no role in the decision making process.
  • If the animal is considered dangerous and a public health threat, or the client is uncooperative the animal control officer can recommend euthanasia and testing. Recommend to your clients that they fully cooperative with animal control personnel. They will make no exceptions, and will follow the law.
  • If the attacking animal is euthanized, the animal will have to be placed in a biohazard bag, placed in a cooler, with blue ice (not frozen), and transported to the state rabies laboratory. The animal control may transport the animal.  If the animal control officer is not immediately available for transport. The animal will need to be taken to the necropsy cooler, an appropriate tag placed on the animal, and the rabies lab. submission form completed. Communication between the attending clinician and the necropsy lab. is paramount. We need to ensure that the animal is processed and taken to the State Rabies laboratory. So be sure to follow up with a call to the necropsy room at 513-6626.
  • If an animal has bitten someone, and dies while in our hospital.
    • Contact the technician supervisor for the service in which you are working.
    • Place the animal in the necropsy room cooler, as note above.
    • Do not release the animal back to the owner. That is a decision that will be made by Raleigh Animal Control.

Animal confinement for assessment for Rabies

The decision to confine or euthanize an animal is made by animal control personnel. At no time should a clinician advise a client about the disposition of their animal. Animals may be confined at the discretion of the animal control officer in accordance with State Epidemiology office directives based on the interpretation of state law. If the animal dies within the confinement period, regardless of whether it is euthanized, it must be tested by the state Rabies laboratory.

If the animal bite occurred in one county, but the animal resides in another, the animal control officer in the county where the bite occurred is responsible for contacting animal control in the other county. So leave the correspondence, and decision making to Raleigh Animal Control.

In all circumstances the client must be asked to sign the VHC Rabies information waiver form that documents that you provided them with information about the health risks associated with potential exposure to rabies virus and the various options for the animal.

Animal Control in Wake County

Responsibility for Animal Control in Wake County is dispersed between municipalities.  The VHC is within the functional working area of Raleigh Animal Control. They are our primary contacts. Our technician supervisors are our primary points of contact with Raleigh Animal Control. However, if you need information from an animal control officer, first identify the municipality in which the animal was found or the incident occurred and then call animal control in the appropriate municipality. In Raleigh, Cary, Garner and Holly Springs you will initially be talking to a police dispatcher only interested in the address at which the animal was found.

  • Wake County Animal Control: 919 212 7387
  • Raleigh Animal Control-  919 740-6918
  • Cary Animal Control: 919 319-4517
  • Holly Springs: 919 557-9111
  • Garner Animal Control: 919 773-8524

Additional Animal Control Contact information for surrounding counties: http://www.ncarca.org/agencylistings.asp

Animal Control for Other Surrounding Counties

  • Durham County 919-560-0630
  • Franklin County 919-496-8100
  • Granville County 919-603-1339
  • Johnston County 919-934-8474
  • Halifax County 252-583-5021
  • Harnett County 910-893-2191
  • Lee County 919-718-4641
  • Nash County 252-459-9855
  • New Hanover County 910-798-7500
  • Orange County 919-245-2075