In an animal bite/injury incident, the animal is normally either put under a rabies quarantine for ten days or euthanized and the brain submitted for rabies testing. In either situation, the LPHA should monitor the process until it has a successful public health outcome.

Quarantine:

• Veterinary or animal control facility: This is the normal procedure when an animal has not received a rabies vaccination or the vaccination is out of date. The LPHA should ensure that the quarantining official has a point of contact and telephone number at the LPHA so that this individual can be contacted immediately if the animal begins to s how signs of rabies. The LPHA should then arrange for the animal to be immediately euthanized and the brain submitted to the laboratory for testing.
• Home of the animal’s owner: A less preferable method of quarantine is at the animal owner’s home. This may be an authorized alternative under some local animal control ordinances. In these instances, it is usually reserved for low -risk situations, i.e., animal’s rabies vaccination is up -to-date, animal is in apparent good health, owner is able to secure the animal on the premises, and the incident was provoked. Whenever a home quarantine is instituted, the LPHA should present the owner with a notice (see “Letter of Notification”) that they must quarantine the animal in a secure location and that they are assuming all liability for the quarantine (including patient medical care if the animal escapes from quarantine and postexposure prophylaxis is required). A “secure” location is defined as being inside the owner’s home or in a well fenced -in area outdoors. Tethering the animal outdoors, even for short period, is never a suitable method of securing the animal. The LPHA or other official (law enforcement, animal control) should physically check on the animal beginning, mid, and end of quarantine to ensure that the animal is still securely confined and is in apparent good health. If LPHA staff do not directly conduct this function, they should regularly contact the official who is making these inspections.

Rabies testing:

If rabies testing is indicated in lieu of quarantine or during a quarantine, the LPHA should use the services of a local veterinarian to ensure that the appropriate specimen is submitted to the laboratory for testing. The LPHA should provide the veterinarian with necessary information and should disseminate final laboratory results to interested parties such as the patient, animal owner, law enforcement, and animal control officials.

• The LPHA should, in almost all instances, recommend that an animal bite/injury patient seek medical evaluation. The LPHA should consult with the patient and the patient’s physician to ensure that the physician has all information needed for decision making and that basic wound precautions have been taken (e.g., wound cleansed, need for antibiotics assessed, tetanus vaccination current). In the event that rabies postexposure prophylaxis is needed, the LPHA should provide the physician with product -ordering information if needed and follow up with the patient to ensure that the month-long series of shots is obtained.
• If an animal bite/injury results in the potential transmission of diseases other than rabies (e.g., herpes B virus, tuberculosis), the LPHA should also arrange for the animal and exposed person to receive indicated laboratory tests and appropriate prophylaxis for the person.
• DHSS will work with the LPHA in determining disease risk factors, developing recommendations, facilitating proper animal disposition, and ensuring patient follow up. If routine quarantine procedures do not work, an “Order of Quarantine” may be issued by DHSS. A similar order can be issued to have the animal seized, euthanized, and tested if that should become necessary.