Studies
“Appropriateness of Rabies Postexposure Prophylaxis Treatment for Animal Exposures,” published in the Journal of the American Medical Association, 2000. Complete article available (open access) online here.
“Epidemiology of Animal Exposures Presenting to Emergency Departments,” published in Academic Emergency Medicine, 2007. Abstract available online here.
Overview
In these two related studies, researchers examined the circumstances under which emergency department patients sought rabies post-exposure prophylaxis (RPEP).
Contact with dogs prompted the majority of rabies-related emergency department visits (81%)
Results from the first study showed that contact with dogs prompted the majority of emergency department visits (81%) while contact with cats prompted only 13% of such visits [1]. Analysis conducted in the follow-up study revealed that dog exposures were much more likely to occur outside the home (e.g., in public parks) compared with cat exposures [2].
Key points
Over the span of 27 months, researchers recruited 2,030 patients from 11 big-city hospitals across the country, each of whom arrived with a “complaint related to mammalian animal exposure by bite, scratch, body fluid exposure, handling, or proximity.” Of these patients, 1,635 (81%) were seeking treatment due to contact with a dog while 268 (13%) were seeking treatment due to contact with a cat. The other 127 (6.3%) cases were related to contact with wildlife.
These rates of treatment are quite different from documented rates of infection; data compiled by the Centers for Disease Control and Prevention show that more than 90% of rabies cases in the U.S. “now occur in wildlife” [3].
Using this same 2,030-patient data set, researchers later published the results of their investigation into the circumstances of each exposure. They found that 499 of 1,499 dog exposures (33%) occurred in the public street or park, compared to 29 of 248 (12%) of cat exposures; by contrast, 358 dog exposures (24%) occurred in the home, compared to 132 cat exposures (53%) [2].
Most exposures, for both dogs and cats, were provoked.
These researchers also reported that most exposures, for both dogs and cats, were provoked: 1,277 of 1,499 dog exposures (85%) and 227 of 248 (92%) of cat exposures [2].
And finally, patients under the age of 18 were more likely than adults to be bitten by dogs, hamsters, gerbils, or rabbits, but less likely to be bitten by cats. These findings challenge some common misperceptions about the rabies risk posed by free-roaming cats.
References
Moran, G.J.; Talan, D.A.; Mower, W.; Newdow, M.; Ong, S.; Nakase, J.Y.; Pinner, R.W.; Childs, J.E. Appropriateness of rabies postexposure prophylaxis treatment for animal exposures. Journal of the American Medical Association 2000, 284, 1001–1007.
Steele, M.T.; Ma, O.J.; Nakase, J.; Moran, G.J.; Mower, W.R.; Ong, S.; Krishnadasan, A.; Talan, D.A. Epidemiology of animal exposures presenting to emergency departments. Acad Emerg Med 2007, 14, 398–403.