In the first case, the child was in a different city at the time the alleged incident occurred, and in the second case, the caller refused to supply any information that could be used to validate the episode. We received 2 noncredible reports: a child with a dog ate a bait and a child licked a bait. In addition to the previously described children, 6 children picked up intact baits. Results of an examination were normal, and the person refused to have blood drawn for rabies or vaccinia titers.Įleven children were involved in 9 credible incidents. This person was seen by a family nurse practitioner 2 weeks later. One uninsured person, who was sent to a hospital emergency room because of potential vaccine exposure to the eye, signed out against medical advice to avoid receiving a bill. The other 3 persons (including 1 child) hit by baits did not report vaccine contact or injury. The bait was examined by program personnel and appeared to be intact. This person reported that after being struck, pink liquid spilled out of the bait. The final possible exposure to vaccine involved 1 of 4 persons hit by a bait. Of the 7 reports of possible human vaccine exposures, 3 incidents (4 persons) involved owners who put hands or fingers in a dog's mouth to retrieve a bait, 1 incident involved a dog that licked 2 children right after rupturing the bait, and 2 incidents (3 persons of whom 2 were children) involved picking up a potentially ruptured bait. No documented adverse reactions were associated with any definite or potential human exposures. Seven reports of possible human contact with vaccine involved 10 persons. The only definite human exposure to vaccine occurred when a dog ruptured a bait and contaminated its owner's hands. Eight of these dogs ate the bait, and another 6 ruptured the plastic sachet.
In 56 reports, a dog picked up the bait in its mouth. Four involved persons who were hit by baits from the air.
Of the 105 reports, 69 involved persons who picked up or had other skin contact with baits, and 8 reported likely contact with vaccine. This rate of reporting, 6.1 per 100,000 baits, is in the midrange of other published reports (0.12–50 per 100,000 baits) ( 5, 6). Phone calls were routed to a local or district health department where an ORV-specific form adapted from the Ohio State Health Department was used to collect uniform information about bait contact.ĭuring the 2003 campaign, Pennsylvania health departments and districts received 105 reports from persons who found 190 baits. Given the limitations of dispersing 1,421,517 baits at a frequency of 75 to 150 baits/km 2 from 200 m in the air, human habitat could not be totally avoided.Įach bait was printed with a toll-free phone number. Aircraft did not release baits when over homes or other areas where humans or pets were likely to be present. Workers distributed these baits on the ground from vehicles or by air from fixed-wing aircraft using conveyor belts. The baits consisted of a vaccine-filled plastic sachet surrounded by a fishmeal polymer.
We report our experience monitoring pet and human exposure to V-RG as part of a multiagency federal-state cooperative program that distributed 1,710,399 V-RG-laden baits from August 11, 2003, to September 17, 2003, over 25,189 km 2 of western Pennsylvania (human population ≈3 million). Usage monitoring ( 4, 5) found only 1 human adverse complication to date ( 6). Safety experience includes extensive animal studies ( 2, 3) in which significant adverse effects were seen only with parenteral (but not mucosal) exposure of nude mice to V-RG ( 4). The current US-licensed ORV consists of a rabies virus glycoprotein gene inserted into the thymidine kinase gene of an attenuated strain of the Copenhagen vaccinia virus (V-RG) ( 2). To the Editor: Oral rabies vaccine (ORV) programs control rabies in terrestrial reservoir species by distributing vaccine in baits ( 1).