Public health aspects of rabies

Environmental Health Services personnel are responsible for communicable disease surveillance and control, which includes rabies. They conduct contact investigation on all rabid animals reported by Veterinary Services. A patient admitted to USAF Hospital Clark with a clinical diagnosis of rabies (confirmed on autopsy) presented a more complex investigation problem. Identification of hospital personnel who had significant contact with the patient was relatively easy. There were 21 hospital personnel identified as requiring antirabies prophylaxis. Social contacts of the patient were more difficult to identify. Numerous friends and co-workers were interviewed. Only one person was determined to need prophylaxis as a result of the investigation. One of the most important aspects of any rabies investigation is coordination between all involved personnel. These personnel represent various disciplines including veterinary, medical, and public health (both military and civilian). If all individuals are to be identified, evaluated, and given complete, correct information, there must be open lines of communication between the various disciplines.