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State of Alaska Epidemiology Bulletin

Bulletin No. 10
July 29, 1977
School Starts Soon.... But.... No Shots, No School

In six weeks, school will start again. It's time for a reminder to all health care providers that Alaska law requires that all children attending school in Alaska be immunized against diphtheria, tetanus, pertussis, polio, measles and rubella. This fall no incoming students will be allowed to warm a seat unless they are immunized in compliance with regulations. Last year's school immunization campaign was an overwhelming success. No cases of measles have occurred in Alaska since February 11, 1977. Immunization levels are very high throughout the state. Major efforts must be directed at children entering Kindergarten, 1st Grade, transfer students, and children new to the school district. We must get the word out to one and all so that parents can get their children immunized or get proper records by August 30. Rabies in Alaska An Update

Each year a large number of people must undergo a long and often painful series of shots because they have been exposed to rabies. An analysis of our experience in the past few years will show that much of this treatment can be avoided by simple measures. Rabies exists in Alaska independently of man in wild animals. Arctic and red foxes are the most important hosts in perpetuating the virus. It is impossible to effectively eradicate rabies from wild life. How, then, can we prevent people from being exposed to rabid animals?

TABLE 1: Number of Animals Tested and Positive
for Rabies by Year
  Red Fox Arctic Fox Dog Cat Total
1975 6/18 0/8 1/77 0/21 7/116
1976 36/64 2/12 6/81 1/31 45/188
1977* 10/37 20/52 2/35 0/8 32/132
*Through June 1977

The first Table shows the number of animals found to be positive for rabies over the number of animals submitted for testing at the Virology-Rabies Unit in Fairbanks. The large increase in number of positive foxes which occurred in 1976-77 was due to an epizootic in the fox population on the Alaska Peninsula. It is readily apparent that most of the positive animals which are submitted to the State of Alaska for examination are foxes.

TABLE 2: Human Exposures to Rabid Animals by Year
  Fox Dog Cat Total
1976 6 65 (87%) 4 75
1977* 3 21 (88%) 0 24
*Through June 1977

Table 2 lists the human exposures to rabid animals by year. In 1976, 75 persons were treated for post-exposure prophylaxis. In the first six months of 1977, 24 people required such treatment. Table 1 shows that during that period of time, only eight dogs were discovered to be positive for rabies. However, those eight dogs resulted in the exposure of 86 people, or 87% of the total number of people who had to undergo treatment because of exposure to rabies.

TABLE 3: Drug Cost of Post-Exposure Treatment (99 People)
January 1976-June 1977
Human Rabies Immune Globulin @ $170.00/person $16,830.00
Duck Embryo Vaccine (23 Dose Course) @ 3.15/dose 7,172.55

Table 3 lists the cost to the State of Alaska in providing the special drugs necessary for post-exposure treatment. It cost the State of Alaska $24,112.55 to pay for the drugs for the 99 persons treated during the 18-month period of time. None of the eight dogs involved in exposing the 86 people who required treatment had been properly vaccinated against rabies.

It is absolutely clear that dog/human contact is responsible for the majority of cases requiring post-exposure prophylaxis against rabies. The simple measure of vaccinating all dogs against rabies can prevent the need for post-exposure prophylaxis treatment in 87% of the total number of people treated each year in Alaska. We urge all health care providers, all public health workers, and all veterinarians to work together to see that all dogs are vaccinated against rabies.

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