Rhode Island's Centralized Rabies Control Program: Reducing Unnecessary Postexposure Prophylaxis and Associated...

Rabies is a fatal viral disease transmitted through bites or scratches from infected mammals. After exposure, rabies can be prevented with timely administration of postexposure prophylaxis (PEP). Rabies PEP is expensive for patients and time consuming for both patients and providers. The Rhode Island Department of Health's (RIDOH) centralized rabies control program has sole authority for approving rabies PEP for humans bitten by animals in Rhode Island (RI).

To investigate the impact of RIDOH's unique animal bites control program requiring animal bite reporting and health department approval for PEP release on PEP administration rates in Rhode Island and associated health care dollar savings.

Longitudinal analysis from 2013 to 2022.

Rhode Island.

Rhode Island Residents.

Animal bite and PEP administration rates over time; number of people with animal bite exposures who did not receive PEP based on guidance from the RIDOH rabies control program; estimated health care dollar savings resulting from reduced PEP administration.

Animal bite rates increased by 43 bites per 100,000 people, whereas PEP rates decreased by 29/100,000. PEP was prevented in an estimated 1800-2300 individuals with animal bite exposures yearly, resulting in annual estimated health care savings of 5-16 million dollars.

Rabies exposure assessment, risk communication, patient counseling, and animal testing provided by the rabies control program may have reduced PEP administration rates, despite increases in reported animal bite exposures, during 2013-2022. Reduced PEP usage affects health care systems across the state, saving health care dollars and reducing emergency department and clinic visits.