Bite Injuries among Vaccination Staff Participating in a Mass Canine Rabies Vaccination Campaign, Haiti 2016–2017

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  • 1 International Animal Health MSc, Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom;
  • | 2 Mission Rabies, Cranborne, Dorset, United Kingdom;
  • | 3 The Royal Dick School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom;
  • | 4 Department of Animal Health, Ministry of Agriculture, Natural Resources, and Rural Development, Port-au-Prince, Haiti;
  • | 5 Christian Veterinary Mission, Port-au-Prince, Haiti;
  • | 6 Pan American Health Organization, Port-au-Prince, Haiti;
  • | 7 Infection Medicine, Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom;
  • | 8 Pan American Health Organization, Washington, District of Columbia;
  • | 9 National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Elimination of dog-transmitted human rabies worldwide will require large-scale dog vaccination campaigns. However, this places participating vaccinators at increased risk. Data from the 2016–2017 Haitian mass rabies vaccination campaign was analyzed to determine dog bite incidence among vaccinators. A survey was then developed for completion by all identifiable bitten vaccinators covering demographics; experience and training; bite episode details; attitudes toward dogs and rabies; and medical care. A parallel group of unbitten vaccinators was also surveyed. Dog bite incidence was 0.03% (43/127,000) of all dogs vaccinated. The capture, vaccinate, and release method of vaccination carried a significantly higher risk of dog bite (0.35%, 6/1,739 vaccinations) than other methods (P < 0.001). Twenty-seven bitten vaccinators, and 54 control vaccinators were included in the survey analysis. No differences were found between groups in demographics, experience, or training. However, bitten vaccinators were significantly more likely than the control group to have experienced a dog bite before the study period (P < 0.001). This may be associated with a lesser appreciation of dogs, and/or a poorer ability to interpret dog behavioral signals within this group. Although 98% of the control group indicated they would seek medical care for a dog bite, only 35% of bitten vaccinators sought such care. On a yearly basis, for the Haitian campaign, a full series of postexposure rabies vaccinations for all bite victims would prove more cost-effective than preexposure vaccination of all vaccinators. These findings may prove useful for the planning and safety of future mass dog vaccination campaigns.

Author Notes

Address correspondence to Rudy T. Kirkhope, International Animal Health MSc, Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh, United Kingdom EH15 4TJ. E-mail: rudy.kirkhope@gmail.com

Financial support: The primary author received a travel scholarship from the University of Edinburgh department of Biomedical Sciences to assist with expenses while visiting Haiti.

Disclosure: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Authors’ addresses: Rudy T. Kirkhope, International Animal Health, Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom, E-mail: rudy.kirkhope@gmail.com. Andrew D. Gibson, Mission Rabies, Cranborne, Dorset, United Kingdom, The Royal Dick School of Veterinary Studies, and the Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom, E-mail: andy@missionrabies.com. Pierre Dilius Augustin, Department of Animal Health, Ministry of Agriculture, Natural Resources, and Rural Development, Port-au-Prince, Haiti, E-mail: pdilius@yahoo.fr. Kelly Crowdis, Christian Veterinary Mission, Port-au-Prince, Haiti, E-mail: crowdisk@yahoo.com. Natael Fénelon, Pan American Health Organization, Port-au-Prince, Haiti, E-mail: fenelonnat@paho.org. Ewan T. MacLeod, Infection Medicine, Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom, E-mail: ewan.macleod@ed.ac.uk. Marco A. N. Vigilato, Pan American Health Organization, Washington, DC, E-mail: vigilato@paho.org. Emily G. Pieracci and Ryan M. Wallace, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: ydi7@cdc.gov and euk5@cdc.gov.

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