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Successful Texas public health effort takes to the skies to combat rabies.

IN JANUARY, about 1 million tiny packets the size of takeout ketchup packages fell from the Texas sky. The packets had been dipped in fish oil, rolled in fish crumbles and imprinted with a "do not disturb" warning. Harmless to people, the tiny packets are the perfect bait for wild canines.

Since 1995, public health authorities in the Lone Star state have been flying over wild areas of southern and western Texas, dropping millions of such cleverly camouflaged baits filled with rabies vaccine. And their efforts have been a success: Canine rabies cases in southern Texas fell from 122 in 1994 to zero in 2000, with single cases in 2001 and 2004 each within a mile of the Rio Grande. Cases of fox rabies, once prevalent in west Texas, dropped from 244 cases in 1995 to zero in 2010. Rabies in humans is fatal if not treated before symptoms arise.

A few years before the aerial drops began, wild rabies seemed to be making a comeback in Texas, with rabies outbreaks moving northward from the border by about 50 miles a year, said veterinarian Ernest Oertli, PhD, DVM, director of the Oral Rabies Vaccination Program at the Texas Department of State Health Services. By 1994, wild rabies had made its way up to the outskirts of San Antonio, Austin, Waco, Dallas and Fort Worth. Regular management strategies focused on vaccinating domestic pets to act as a buffer between wild rabies and humans, Oertli said. Still, that was not enough--Texas health officials needed a way to eliminate rabies in the wild. They found the solution in Canada, where officials were using aerial rabies bait drops to curb the disease among red foxes, Oertli said. Soon after, Texas became the first U.S. state to adopt the aerial strategy.

"We thought we'd be able to at least control rabies (in coyotes and foxes), if not eliminate it completely," Oertli told The Nation's Health.

State health officials, working with Texas Wildlife Services and Texas Military Forces, first targeted coyotes and then went after gray foxes. During the first aerial drop, officials put down about 350,000 rabies vaccine baits, Oertli said. Nearly two decades later, the Oral Rabies Vaccination Program has dropped a total of more than 36 million rabies vaccine baits over a total 501,200 square miles.

In vulnerable areas where bait cannot be dropped from planes, local public health officials lay the bait by hand. Gustavo Olivares, interim director of environmental health at Cameron County Department of Health and Human Services, which is located in the southernmost tip of Texas on the border with Mexico, has been working with state officials for years to manually lay rabies vaccine baits in hard-to-reach areas. This year, Olivares and his colleagues hand-distributed 1,800 baits in coordination with the aerial drop. In addition, health officials in Cameron County provide rabies education in schools and encourage residents to get their pets vaccinated, often organizing rabies vaccination clinics in communities with little access to veterinarians.

"Without these programs, rabies would come back," Olivares said.

To the north in Laredo, which also sits on the Mexico border, four pet dogs tested positive for rabies in the past 12 years--"and once you have it in domestic canines, the threat to humans is imminent," said Hector Gonzalez, MD, MPH, director of the City of Laredo Health Department. Fortunately, it has been six years since an animal tested positive for rabies in Laredo, Gonzalez said. Health workers in Laredo also lay rabies bait by hand, mainly along the banks of the Rio Grande. Gonzalez noted that prior to the aerial drop, rabies was traveling steadily toward central Texas; now, the threat is almost entirely contained to the border. While Mexico has had great success in vaccinating pets against rabies, it does not have a wildlife rabies program, Gonzalez noted.

"Surveillance, vigilance and vaccines have made the difference," he told The

Nation's Health. Nationwide, more than 90 percent of all rabies cases reported to the Centers for Disease Control and Prevention occur among wildlife. While in the U.S., two to three people die each year from rabies, more than 55,000 people world-wide succumb to the disease annually.

For more information on the Texas Oral Rabies Vaccination Program, visit www.dshs.state.tx.us/idcu/disease/rabies/orvp.

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Title Annotation:STATE & LOCAL
Author:Krisberg, Kim
Publication:The Nation's Health
Geographic Code:1U7TX
Date:Apr 1, 2013
Words:729
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