Investigating Individual and Population Determinants of Rabies Exposure in Georgia Using a Comprehensive Bite Surveillance System Open Access

Hsu, Trevor (2016)

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Georgia's Animal Bites Module (ABM) is part of the Georgia Department of Public Health's State Electronic Notifiable Disease Surveillance System (SendSS) and is one of the most extensive animal bite reporting systems in the U.S [7]. Georgia's surveillance system is novel and arguably only 2 other states capture data on animal bites and rabies at a level similar to Georgia. This system was used in our study to help identify local-scale human population dynamics that affect the incidence animal bites. The local scale of our model is represented at the county level. This study was conducted to examine the extent that human population density and metropolitan versus non-metropolitan environment, and human characteristics such as race, gender, and age, affect the likelihood of being bitten as well as an individual's likelihood of specifically being bitten by animals that pose a ‘high risk' of transmission. This study uses multilevel multivariable modeling to examine the how human population density and metropolitan environment affects the likelihood of individuals being bitten by animals and infected with rabies. Two statistical models were constructed using bite records. One examines potential factors that affect the risk of all animal bites in Georgia white the other examines potential factors that affect the risk of bites from animal species with a high known risk of rabies transmission based on cited literature. These models may provide useful insight for public health agencies to direct education and training efforts for rabies prevention and surveillance in the Southeastern United States.

Table of Contents

Epidemiology. 7

Virology. 8

Transmission. 8

Symptoms. 9

Diagnosis. 11

Vaccine and Treatment. 11

Prevention and Control 14

Domestic Rabies. 15

Bats. 16

Southeastern Raccoon Strain and Georgia. 18

Spatial Analysis of Rabies in the Environment. 21

Analysis of Rabies by Animal and Human Characteristics. 25

Surveillance. 27

Justification of Study. 30

Methods. 32

Results. 34

Limitations. 40

Conclusion. 43

Figures and Table. 46

Work Cited. 52

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