Related Experiment Video
Updated: May 15, 2025
Field Postmortem Rabies Rapid Immunochromatographic Diagnostic Test for Resource-Limited Settings with Further Molecular Applications
Published on: June 29, 2020
Factors Associated With Unsuccessful Rabies Tests in Utah, 2014-2023
Clarissa N Keisling1, Will Boyd, Hannah Rettler
1Author affiliations: Utah Department of Health and Human Services, Utah (Ms Keisling, Ms Rettler, Dr Oltjen, Ms Nowak, Ms Ayres, Ms Kinnick-Hansen, Mr Harbour, and Dr Lanier); Utah Department of Health and Human Services, Council of State and Territorial Epidemiologists, Utah (Ms Keisling; Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, United States Public Health Service (Mr Boyd); and United States Public Health Service, Centers for Disease Control and Prevention, Office of Readiness and Response, Division of State and Local Readiness, Career Epidemiology Field Officer Program, Utah (Dr Lanier).
Context:
Testing potentially rabid animals is crucial for providing accurate recommendations to prevent rabies infection. When a test of the animal is unsuccessful, (ie, does not produce a positive or negative result) after a potential exposure, health officials cannot rule out rabies and must recommend rabies postexposure prophylaxis, presenting an economic burden to patients and health care systems.
Objectives:
To better understand factors associated with unsuccessful rabies tests to inform interventions that would reduce preventable unsuccessful testing.
Design:
We performed tests of independence between unsuccessful test rates and frequently submitted animal and submitter types. We used Cochran-Mantel-Haenszel (CMH) tests to assess the significance of the association between unsuccessful tests and animal type and submitter type, while controlling for the effects of each. Stratified bivariate analyses identified specific factors driving significant CMH results.
Results:
Of 2 806 specimens submitted for rabies testing during January 2014-March 2023, 113 (4%) were unsuccessful. Bats, raccoons, and skunks each had higher unsuccessful test rates compared to dogs or cats ( Ps < .001-.003) and together comprised 87 (77%) of the 113 unsuccessful tests. Submissions by citizens had a higher proportion of unsuccessful tests than submissions by animal control ( P < .001); animal control had the lowest unsuccessful test rate of all submitter types. Unsuccessful test rates differed when controlling for submitter type ( P < .001) and animal type ( P = .01). Submissions of bats by citizens had a significantly greater proportion of unsuccessful tests than submissions of bats by animal control ( P < .001).
Conclusions:
More than three-quarters of unsuccessful tests were attributed to bats, skunks, and raccoons, emphasizing the need to improve submission quality for these animals. We recommend training Utah rabies response partners on proper specimen handling and submission. Efforts should also focus on educating citizens to route submissions through trained rabies responders. Conducting focus groups with specific entities that have the lowest unsuccessful test rates could yield model submission practices.
