Practice Title: Targeted Rabies Outreach at Veterinary Clinics & Online to Increase Awareness & Reduce Risk
Department: Los Angeles County Department of Public Health
Size: Large (Population of 500,000+ people)
State: California
Summary of Practice:
The Los Angeles County (LAC) Department of Public Health (DPH) has over 5,000 employees, making it one of the largest accredited health departments in the nation. DPH’s mission is to protect health, prevent disease, and promote health and well-being for everyone in LAC. Department activities and services range from data collection and analysis, health education, communicable disease control and health inspections to provision of preventive health services, emergency preparedness, policy development and veterinary public health. LAC is unique in that DPH has authority over rabies control and animal disease surveillance activities, whereas the 28 local animal control agencies provide shelter, licensing, and stray animal control services. However, rabies control can only be achieved by collaboration with local animal control agencies, veterinary clinics, health care providers, and the public.
LAC is home to a large diverse population of about 10 million residents, which represent many of the cultures around the world. Over a third of residents are foreign born, 55% of residents speak languages other than English, and about 3.5 million speak Spanish. There are 1.4 million residents who speak English less than very well. In LAC, 49% of residents are Latinos, 25% non-Hispanic Whites, 15.6% Asian, 9% Black or African American, 1.5% American Indian or Alaskan Natives, 0.4% native Hawaiian or Pacific Islanders, and 3% multiracial. The environment of LAC spans urban, suburban, and rural settings, covering land from the ocean to mountains and high desert. Both domestic and wild animals are found in all areas of LAC.
The Veterinary Public Health program (VPH) is responsible for rabies surveillance and control in LAC. Since the 1970’s, rabies has only been found to be circulating in bats, with one spillover to a skunk in 2014. Local veterinarians haven’t treated rabid animals for decades, except two ill imported pets that were diagnosed with rabies shortly after arriving in the US (1987 – cat from Mexico, 2004 – dog from Thailand). Through the years, the program noted many LAC residents and veterinarians were not aware that bats could carry rabies locally and handled bats inappropriately. Examples include multiple children handled a bat at camp, a bat was taken into a classroom for examination, and multiple people tried to help bats by moving or feeding them. Residents have released bats from homes after they may have had access to the bedrooms. When public health became aware of the potential exposures, the individuals received rabies post-exposure prophylaxis (PEP), preventing the spread of the virus. However, many of these exposures could have been prevented if the person had knowledge of bat and rabies risk. In 2017, VPH conducted a survey of local veterinarians on their knowledge about local rabid bat cases and their rabies immunization practices. The survey showed that although a rabid bat had been detected within 5 miles of 85% of the veterinary hospitals in the preceding decade, only 36% of the clinics reported being aware of this.
The general lack of awareness about bat rabies is a local public health issue which resulted in preventable potential rabies exposures, increased medical costs, and the lack of preventive measures such as pet immunization and bat exclusion from homes. To address this problem, in 2018 VPH developed a targeted outreach and education campaign to increase awareness of bat rabies and steps people could take to reduce risk. The goals were to:
1) educate residents in neighborhoods where a rabid bat was found and
2) contact veterinary practices within five miles to request assistance with public education about the rabid bats and encourage clients to keep their pet’s rabies immunizations up to date.
An educational flyer, standard rabid bat notice, and standardized messaging were developed. A listing of veterinary clinics, with contact phone/fax numbers and email addresses was created, and nearby clinics were identified using Google maps each time a rabid bat was identified. Since learning that some people had found information on-line encouraging them to release bats that are found in homes, VPH updated its website to include information about what to do if a bat is found in the home, including a flow chart about what to do and a video about never touching bats. Starting in 2019, each time a rabid bat was identified, residents in the neighborhoods were provided the handout and flyer by door-to-door outreach, emails by their homeowner’s association, and/or through social media platforms such as Nextdoor. The flyer was shared with veterinary clinics, and they were encouraged to post them in their lobbies and share them on their social media platforms, websites, and other venues.
The project objectives were met. Between 2018 and 2021, awareness of bat rabies improved in areas where infected animals were found. The number of animals tested for rabies in LAC increased annually from 592 in 2018 to 709 in 2021, as did the number of bats tested (241 in 2018 to 322 in 2021). The number of rabid bats detected also increased from 27 in 2018 to 68 in 2021. Collaborating with homeowner’s associations and posting of information on neighborhood social media platforms reduced staff time required for door-to-door outreach with many of the cases. The number of homes visited also increased from 189 in 2018 to over 740 in 2021. More rabid bats were found in neighborhoods where outreach had occurred previously, but fewer people had direct contact with the animals and most immediately contacted animal control for assistance. A preliminary analysis revealed less people touched bats with their bare hands over time as well (3.3% in 2018 to 1.6% in 2021). The level of veterinarian contact and collaboration increased. Veterinary clinics were contacted about bat rabies 52 times in 2018 and 654 times in 2021. When staff distributed reporting manuals to clinics in 2020, VPH rabid bat posters were seen next to the entrance of most clinics in the Santa Clarita Valley, an area where about 40% of rabid bats are found each year.
Program website: http://publichealth.lacounty.gov/vet/
Rabid bats in LAC website: http://publichealth.lacounty.gov/vet/bats.htm
Rabid bat in home website: http://publichealth.lacounty.gov/vet/batinhouse.htm
Targeted Rabies Outreach at Veterinary Clinics & Online to Increase Awareness & Reduce Risk
Category
Infectious Disease Prevention and Control
Description